Fatal and Non-Fatal Illness and Injury in Sporting Officials

Abstract

Despite 14 deaths of sport officials reported between 2003 and 2018, little is known about the physiological and environmental risk factors for injury or death during sport officiating. PURPOSE: To establish a comprehensive database for cases of illness, injury, and death of sport officials and to identify differences by sport or environment. METHODS: Relevant key words were utilized in a popular search engine to systematically retrieve online media sources from 2000-2019 for a referee, sporting official, umpire, or similar who experienced a work-related illness, injury, or death. Chi-square tests were used to determine if fatality is independent from type of injury, sport, and location (indoor, outdoor), and if type of injury is independent from sport or environmental conditions. RESULTS: Among 134 persons, 146 events of injury, illness, and death were identified. Sport officials were predominantly male (n = 129; female, n = 2; unknown, n = 3), ranging in age from 20-80 y (mean ± SD; 52 ± 13 y) with 2-48 y (23 ± 12 y) of officiating experience. Events were primarily musculoskeletal (n = 55), cardiovascular (CV) (n = 43), or head (n = 30) injury. Sixteen events (7 fatalities, all during soccer games) were intentional injury by another person; all others were presumed accidental. Events occurred most frequently during baseball (n = 30), soccer (n = 26), American football (n = 22), and ice hockey (n = 22) games, primarily at the professional (n = 70) and high school (n = 27) level. CV events occurred primarily while officiating basketball (n = 14) and American football (n = 12); head injuries occurred most often while officiating baseball (n = 11; P < 0.001). Fatalities (n = 36) occurred more frequently during soccer games (n = 13; P < 0.001) and almost half of all fatalities were CV events (n = 17; P < 0.001). Fatal events occurred at similar rates in indoor (16.0%) and outdoor (23.3%) settings (P = 0.32). Outdoor CV events occurred independent of dry-bulb temperature and relative humidity (P = 0.92). CONCLUSION: Soccer officials experience the highest frequency of violent injury and death. CV events occur most frequently while officiating basketball and American football; further investigation is warranted to determine if the high incidence of CV events correlate with health status and the high physiological demand of officiating these sports.