Background Deaths relating to sport/recreation are thought to be rare. However, in Australia, a lack of published data has limited our understanding of the number of deaths in different sports and settings.

Objective To gain a first understanding of the number/cause of deaths across different sports/recreation activities in Australia.

Design A case-series analysis was undertaken using the National Coronial Information System (NCIS) in Australia.

Setting All sport and physical recreation activities in Australia as coded in the NCIS, including recreational and professional participants.

Patients Cases are ‘closed’ NCIS cases of all ages who died in the period 2000 to 2016 as a result of participating in sport and physical recreation. Cases were selected from NCIS activity level one categories – Sport and Exercise During Leisure Time, Education, Leisure or Play and Paid Work.

Interventions None.

Main Outcome Measurements The number of deaths by sport/recreation activity and associated demographic data (e.g. sex, age). The cause, mechanism of injury and contributing factors are explored.

Results 5060 cases were included. The three most frequent activities were “Individual water sports” (42%), “Individual athletic activities” (9%) and “wheeled non-motor sports” (7%). Combined, team bat/stick and team ball sports contributed 7% of cases. Males accounted for 88% of cases. The proportion of deaths by age increased from 4% in 5–14 year olds, peaked at 19% in 45–54 year olds, before declining. The most common causes were identified as cardiac-related (39%), drowning (34%) and blunt force trauma (19%.)

Conclusions There is demonstrable evidence from other injury settings for data to inform safety measures that can prevent fatalities. These results provide a first understanding of the people/activities most often impacted by death in different sports settings across Australia. With this information, leading activity contexts and causes will be explored to identify common mechanisms and potential prevention priorities and strategies.