Medical research indicates reduced life span for saxophonists - Joke, or just really bad science?

I just ran across a 1999 article from the British medical journal The BMJ, presenting a purported study of "the impact of too much sax on the mortality of famous jazz musicians."

The article states that saxophonists can be expected to have a reduced lifespan, probably due to frequent use of circular breathing: "Raised pressure in the neck region can increase mortality either by reducing blood supply to the brain (cerebrovascular ischaemia) or venous stasis (thromboembolism)."

You can read the article here.

The authors of this article appear to be idiots. As scientific method, this study fails in basic ways: 

• Their initial assumption, that circular breathing is a common technique, is just wrong, as they could have ascertained by asking any professional sax player. 
• They ignore or dismiss other probable factors affecting longevity: environment, socioeconomic status, the state of medicine in the early 1900s, stress of a touring musician's lifestyle.
• Their sample (813 musicians born between 1882 and 1974) is not particularly large, and is not representative of the actual sax-playing population.

At first reading, I was astounded by what appeared to be incredibly bad science, from authors who had no idea what they were talking about. Upon further reflection, though, I'm pretty sure the authors were just having some fun.

There are a number of giveaways. For example, the caption to the article's Figure 1 states that in circular breathing,

Intake of breath fills the chest and stomach; cheeks and neck are inflated when air is halfway up the chest. While forcing air from cheeks and neck into the instrument, the player simultaneously breathes in through the nose to the bottom of the stomach.

Note: we breathe with lungs, not stomach. 

Figure 2 indicates that not even one saxophonist in the sample reached the age of 70 (a strong indication that the authors just made up the figures, and did no actual statistical analysis at all). 

There were a number of tongue-in-cheek tipoffs, including the statement,

Further research is, however, needed in this area: it is anticipated that attendance at a number of national and international concert venues would resolve this issue, and the researchers are currently seeking funding for this.

Fittingly, the authors of the sax-mortality article closed with a quote from Sonny Rollins, 69 years old at the time of the article, and 90 years old now.

According to Wikipedia, The BMJ is a respected journal of medical research. However, they have a history of printing less-than-serious articles, for example, a 1974 article describing a condition known as cello scrotum, said to afflict male cellists. Although meant as a joke, this article was apparently taken seriously by some in the medical community. 35 years later, in 2009, the author finally wrote a letter to The BMJ revealing that the article had been a hoax.

Unfortunately, the article on sax-mortality was likewise believed by quite a few people, as you can see in the responses section in the online article. It's pretty amusing, and worth a read. At least a couple of "real" medical research articles have taken this one seriously enough to cite it as a reference (click here).

I first ran across the sax-mortality article in a reprint that was posted by the NIH, without any notice that it might be a joke. That wasn't helpful. We don't need any more spurious medical information, particularly concerning saxophones.

Some people will believe anything.