Natural Causes of Sports- and Recreation-Related Deaths in the General Population: A 14-Year Review in Québec, Canada

Background: This study analyzed trends in the frequencies and rates of natural deaths associated with sport and recreation activities in Québec, Canada, from January 2006 to December 2019, and investigated their etiology and characteristics. Methods: (ÉBARS) and Canadian census population data. Results: A total of 297 natural deaths occurred, resulting in a population-based death rate of 0.26 per 100,000 person-years. The participation-based rate was 0.23 per 100,000 participant-years, focusing only on the 24 matching activities in both editions of the ÉBARS. Cycling (20.5%; n = 61), ice hockey (8.8%; n = 26), and hunting (8.1%; n = 24) were associated with the highest frequencies and rates of death. Most of the deaths (95.3%; n = 283) were of cardiac origin, with acute coronary syndrome and malignant cardiac arrhythmia identified as the most common causes. Automated external defibrillators were unavailable at 65% of death sites, and bystander cardiopulmonary resuscitation was performed in 60.9% of cases. Men accounted for the vast majority (92.6%; n = 275) of deaths. Death rates increased starting from age 35, peaking in males 45 and over. Conclusions: Efforts aimed at screening for cardiovascular risk factors and ensuring the widespread availability of automated external defibrillators at recreational sites, including remote areas such as hunting territories, could reduce the incidence of natural deaths associated with sport and recreation activities in Québec.