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rtodd
April 17th, 2010, 07:34 PM
Interesting article. They recommend better screening of participants.


In Triathlons, Swimming Poses Greatest Risk of Death
By John Gever, Senior Editor, MedPage Today
Published: April 06, 2010
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and
Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner Earn CME/CE credit
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Most triathlon participants who drop dead during the competition do so in the water, researchers said.

Investigation of 14 sudden deaths among triathletes from 2006 to 2008 showed that all but one occurred during the swimming portion, reported Kevin M. Harris, MD, of the Minneapolis Heart Institute of Abbott Northwestern Hospital in Minneapolis, and colleagues.

No deaths occurred during running events. One participant died after a bicycle crash.

All the swimming deaths were officially attributed to drowning, "but seven of nine athletes with autopsy had cardiovascular abnormalities identified," the investigators wrote in a research letter appearing in the April 7 Journal of the American Medical Association.Action Points
--------------------------------------------------------------------------------

Explain to interested patients that triathlons typically involve strenuous exertion that may contribute to sudden cardiac death in patients not in top physical shape.



Explain that a cardiovascular stress test and other evaluations may be warranted for individuals seeking to train for or participate in triathlons for the first time.


Harris and colleagues recommended that triathlon organizers set minimum achievement standards for participants, "including swimming proficiency."

The apparent cardiovascular risk should motivate individual competitors to be evaluated before racing, but mass screening of participants is probably impractical, the researchers also noted.

The JAMA letter updates data reported by Harris at the 2009 American College of Cardiology annual meeting.

He and colleagues reviewed data on some 959,000 participants in events sanctioned by USA Triathlon, the major standard-setting organization for such events, from January 2006 through September 2008. The data were collected by this group and the U.S. Registry of Sudden Deaths in Athletes.

The 14 deaths translated to a rate of 1.5 per 100,000 participants, the researchers reported.

A total of 2,971 events were included in the analysis. Distances were relatively short in 45% of events, medium in 40%, and long in 15%.

For the swimming portions, these categories were defined as less than 750 meters for short events, from 750 to 1,500 meters for medium distances, and more than 1,500 meters for long triathlons.

Six of the swimming deaths happened in short events, four in medium-distance swims, and three in long races. Two of the latter were so-called Ironman triathlons in which the swims are 3,860 meters (2.4 miles).

Death rates per 100,000 participations in these swim distance categories were:

Short: 1.4 (95% CI 1.1 to 3.1)
Medium: 1.0 (95% CI 0.4 to 2.8)
Long: 2.8 (95% CI 1.0 to 7.5)

In eight of the fatal swimming incidents, the participants were noted to have called for help; five were found motionless in the water after other swimmers had moved on.

Although 41% of participants were female, only two of the 13 swimming deaths involved women.

Besides gender, another contributing factor was the number of competitors in a given race, according to Harris and colleagues.

The mean number of participants in triathlons in which an athlete died was 1,319 (95% CI 1,084 to 1,584), compared with 318 in races without deaths (95% CI 302 to 334), they reported.

"Because triathlons begin with chaotic, highly dense mass [swim event] starts, involving up to 2,000 largely novice competitors entering the water simultaneously, there is opportunity for bodily contact and exposure to cold turbulent water," Harris and colleagues wrote.

They also noted that triathlon swimmers in distress may not attract attention as quickly as a troubled bicyclist or runner.

One large study found a death rate of 0.8 per 100,000 among marathon runners, half that in the current triathlon study.

In the seven dead swimmers with autopsy findings showing cardiovascular abnormalities, six had mild left ventricular hypertrophy. Their maximum cardiac wall thickness was 15 to 17 mm and the mean heart weight was 403 grams (SD 77). One of these individuals had a clinical history of Wolff-Parkinson-White syndrome.

The seventh athlete was found to have a congenital coronary arterial anomaly.

Harris and colleagues noted that their data may not have included every athlete who died during a triathlon, as such deaths are not subject to mandatory reporting. The study was also limited to events sanctioned by USA Triathlon, leaving out an unknown number of other competitions. Finally, some athletes likely participated in multiple events included in the study.

The Hearst Foundation supported the study.

No potential conflicts of interest were reported.


Primary source: Journal of the American Medical Association
Source reference:
Harris K, et al "Sudden death during the triathlon," JAMA 2010; 303: 1255-57.


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Related Article(s):
ACC: Triathletes More Likely to Die Suddenly Than Marathoners

debaru
April 17th, 2010, 11:33 PM
A very sobering story to say the least.

I'm curious though, as to the ages of the unfortunate athletes and what their previous athletic history was prior to entering a triathlon. Were they new to the sport, seasoned participants, or somewhere in between?

Also, are participants in USAT triathlons required to make some type of statement regarding their state of health? Even if triathletes are required to provide proof of a "clean bill of health" when registering for an event, I don't see how the possibility of people dying during strenuous physical activity can be avoided.

__steve__
April 18th, 2010, 10:53 AM
Curious to their swimming ability. I see trigeeks who are horrible swimmers time to time.

nkfrench
April 18th, 2010, 01:49 PM
I also wonder how comfortable these folks were in the water. When I took a SCUBA class, some mediocre swimmers were quick to panic if anything unexpected happened such as losing masks/goggles, getting kicked or other physical contact, getting water instead of air, having a muscle cramp, brushing up against plants/fishes, not being able to see the bottom. The more confident swimmers dealt with it better.

A triathlete in great cardiovascular condition can make the mistake that they don't need to train for swimming if they don't enjoy it. If they are lean and don't float and don't understand how to pace themselves on undertrained swim muscles, it would be easy to get in trouble.

my 2c

That Guy
April 18th, 2010, 02:33 PM
I also wonder how comfortable these folks were in the water. When I took a SCUBA class, some mediocre swimmers were quick to panic if anything unexpected happened such as losing masks/goggles, getting kicked or other physical contact, getting water instead of air, having a muscle cramp, brushing up against plants/fishes, not being able to see the bottom. The more confident swimmers dealt with it better.

A triathlete in great cardiovascular condition can make the mistake that they don't need to train for swimming if they don't enjoy it. If they are lean and don't float and don't understand how to pace themselves on undertrained swim muscles, it would be easy to get in trouble.

my 2c

Along with those reasons to panic, add in the fear of swimming in a cold dark lake with little to no visibility underwater, and not being able to get a full breath due to the chest compression caused by a wetsuit. And all of those panic factors are happening at the same time! Typical chatter on the beach before a sprint triathlon:

"So have you been doing any swimming?"
"No, I haven't been in the water since that event we did 3 months ago."
:confused::confused::confused::confused::confused:

james lucas
April 18th, 2010, 02:47 PM
In the seven dead swimmers with autopsy findings showing cardiovascular abnormalities, six had mild left ventricular hypertrophy. Their maximum cardiac wall thickness was 15 to 17 mm and the mean heart weight was 403 grams (SD 77). One of these individuals had a clinical history of Wolff-Parkinson-White syndrome.

The seventh athlete was found to have a congenital coronary arterial anomaly.
The victim of a fatal heart attack at a Southern Pacific meet, several years ago, was a great athlete and experienced swimmer. This makes the case for athletes to be thoughtful about their real risks, to have a bias toward more diagnostic tests, and to be realistic and cautious as they plan preventive strategies.

Chris Stevenson
April 18th, 2010, 03:40 PM
Although inexperienced swimmers may be more prone to panic attacks -- particularly if they train entirely in pools -- nobody is immune. Marcia Cleveland wrote about this phenomenon and gives some good advice:

http://www.usms.org/articles/articledisplay.php?a=250

People here like to bash triathletes as weak swimmers. Some are, but that is probably not the reason for the fatalities. Difficulties such as heart attacks are more likely to lead to fatal consequences in the open water. Plus it is the first leg of the race, often starting with a hard sprint to attempt to get clear water, sometimes on very little or no warm up.

joshua
April 18th, 2010, 09:37 PM
rtodd - thank you for posting that. Very thought provoking indeed, as well as sobering.
I was wondering if any such studies were conducted on open water swim events not part of a triathlon. It would be interesting to compare results.
Also, why do women have a lower death rate? The point was brought up but there was no attempt to explain why.

debaru
April 18th, 2010, 09:49 PM
Also, why do women have a lower death rate? The point was brought up but there was no attempt to explain why.

I may be totally off-base, but my first thought is that there are far more men competing in triathlons than women, so based on percentage, there would be fewer women fatalities.

ViveBene
April 18th, 2010, 11:31 PM
I may be totally off-base, but my first thought is that there are far more men competing in triathlons than women, so based on percentage, there would be fewer women fatalities.

Mortality by sex is figured for each sex separately, then the two mortality figures are compared to arrive at a statement such as "women had a lower mortality."

In first study, 41% of participants were female (I'm taking the figures from above postings), 59% were therefore male. Let's smooth it a bit and say 40% F, 60% M, or a ratio of 2:3.

Of 13 swimming deaths, 11 were in men. To achieve an equal mortality in women, ca. 7.3 would have to have died (2:3 = ca. 7.3:11). But only 2 women died, not 7.

It would not be an easy task to figure out why the death rate in women was so much lower. Certainly behavioral factors weigh in (men are faster, bigger, hurt more if they run into one, have more testosterone). Maybe the currents eased women slightly out of the fray. Or the population of women as a whole prepared better. Or Darwin smiled.

Nor am I sure any conclusions about contributions to mortality from preexisting cardiac or arterial conditions can be drawn without autopsying or imaging the *entire* population of swimmers. What if 90% of all participants had some degree of arterial plaque, or an abnormality? We probably won't ever know such things. A number of elite athletes have died suddenly, during performance, of unexpected or undiagnosed conditions.

In short, :blah:

joshua
April 19th, 2010, 04:59 AM
It would not be an easy task to figure out why the death rate in women was so much lower. Certainly behavioral factors weigh in (men are faster, bigger, hurt more if they run into one, have more testosterone). Maybe the currents eased women slightly out of the fray. Or the population of women as a whole prepared better. Or Darwin smiled.



My (totally unsupported) conjecturing is that perhaps due to a different hormonal makeup women (generally speaking) aren't as prone to suicidal behavior and know when to back off. Again, just guessing.

ViveBene
April 19th, 2010, 10:16 AM
My (totally unsupported) conjecturing is that perhaps due to a different hormonal makeup women (generally speaking) aren't as prone to suicidal behavior and know when to back off. Again, just guessing.

I would certainly include it as a possible factor, and perhaps in the larger picture of protecting home and family, which means you have to stay alive.
On a hiking trip, our group had an optional bushwhacking segment that posed some difficulty. Those who went ahead with the bushwhack had no children or dependents (dogs, cats, elderly parents); those with children or dependents turned back or did not start. One tiny observation in the stream of life. It was individual choice; but what lies behind?

It bugs me, slightly, that physicians start drum beating over matters concerning which they are missing too much data to say anything useful. The Least Publishable Unit continues its endless life.

Real comparison studies would also switch around the order of events in the tri. If running were first and more ppl dropped dead running than swimming, what would be said then?

quicksilver
April 19th, 2010, 02:25 PM
In eight of the fatal swimming incidents, the participants were noted to have called for help; five were found motionless in the water after other swimmers had moved on.:confused: Where were the kayakers?

If an Olympic size pool fill with swimmers requires several life guards on duty, one would think that the same should go for open water.

aquageek
April 19th, 2010, 03:02 PM
I have a theory completely unsupported by any research or medical fact but solely by personal observation, so it's probably flat wrong but here goes.

It seems that there is some weird allure of the triathlon to the crowd that "just got fit." I hear and see over and over people who have lost a little weight and have started working-out that they "are a triathlete" and are doing triathlons. Many have never done a brick workout and certainly haven't experienced anything like the sensory overload of a tri. I don't see this much with swimming, seems most people will wait extra long to do their first meet. But, for whatever reason some folks think they lose 10 pounds, buy a bike and a suit, go to a few spin classes and they are tri ready.

Chris makes a good point about lack of warm-up. No matter how much you warm up you still have 20-30 minutes of idle time before your wave goes off. It is during this 20 minute wait that I fantasize and pray that they will cancel the run leg of the race.

E=H2O
April 21st, 2010, 01:37 PM
I returned to OWS when I started doing triathlons 3 years ago at the age of 54. Over that time I have successfully resolved a long standing shoulder problem. I have been cheek to cheek with tri athletes in many races over that time and I can assure you that there are very few generalizations you can make about them other than they are passionate about their sport and have to be a bit of a gear freak to be into the sport (although I saw one athlete that didn't know how to change a flat on their bike - clearly an exception).

I think trying to identify the cause of a limited number of deaths out of 100,000+ event entries is difficult. The sport has grown so fast. Large popular events fill their 1500 person field in a couple of months. I have even seen local events fill their field of 300 in a day after registration opens.

The cause of deaths may be as simple as the fact that there are large numbers, people are excited about the race, they get too amped, and the swim just happens to be at the start of the race. It has also been persuasively suggested that medical help can not be provided quick enough simply because people around you don't realize you are in distress. On the bike & run it is obvious to spectators when someone is in distress even if the athletes are not aware. Frankly I find triathletes at a race as friendly, and as much fun as swimmers at an OW race. It may help that in Oregon there are a number of triathlons that have beer in the finish area.

Ken Classen
April 21st, 2010, 05:13 PM
My very first open water race, around 18 years ago, I suffered a brief panic attack. I was an ex-college swimmer, played on the club water polo team, was in decent shape swimming with a masters team. I was confident heading into the race. The event itself started all 200 swimmers between the shoreline and a dock about (25 meters between dock & shore) the dock was about 50 meters long, that then required a hard right turn after clearing it (that was corrected the next year of the event). At the start I had no idea what was about to hit me, swimmers on top of me, around me, legs and arms flailing, almost immediately I suffered from a claustrophobic type attack. Before the race, my initial plan for this two mile event, was to take it out easy, I had no preemptive knowledge all these guys would be sprinting out to clear the field and give themselves room to turn at the end of the dock. I survived and I believe I went on to win my age group but the lesson was learned the hard way.

Per the article it appears most of the deaths had a pre-existing condition, that was likely aggravated in the race. However I wonder if it may have been prevented had they known what to expect and had attempted to train in conditions that simulated the event (something most open water clinics address today) Even though I had come from a swimming background I no idea what was about to hit me, I'm guessing many new triathletes don't know either.

orca1946
April 21st, 2010, 06:08 PM
Sad to say , but one of my friends that I got started in Tris , died in the swim portion ! I miss him !

TriBob
April 21st, 2010, 08:58 PM
Curious to their swimming ability. I see trigeeks who are horrible swimmers time to time.

This is true. I was life guarding a race and had to rescue someone only 100 yards into a 500 yard swim. He said he forgot how hard swimming was. The last time he swam was as a kid 20 years ago and thought he would just get through the swim.

joshua
April 22nd, 2010, 12:47 AM
I have a theory completely unsupported by any research or medical fact but solely by personal observation, so it's probably flat wrong but here goes.

It seems that there is some weird allure of the triathlon to the crowd that "just got fit." I hear and see over and over people who have lost a little weight and have started working-out that they "are a triathlete" and are doing triathlons. Many have never done a brick workout and certainly haven't experienced anything like the sensory overload of a tri. I don't see this much with swimming, seems most people will wait extra long to do their first meet. But, for whatever reason some folks think they lose 10 pounds, buy a bike and a suit, go to a few spin classes and they are tri ready.



I see another phenomena: long distance runners who have banged their legs into the ground, can no longer run marathons and have moved to triathlons. Their problem is the swimming leg. I have noticed that most of them, if not all of them, have taken one of the TI courses given at our pool and they have improved noticeably. I haven't seem them in open water but in the pool they look relaxed. I wouldn't really call them swimmers. They only swim freestyle and their goal is basically to have a reasonable tri swim and not disgrace themselves.

__steve__
April 22nd, 2010, 09:07 AM
Keep thinking of how their families felt from the news. Hopefully every competitor really understands associate death rates prior to signing the waiver - like it may be a little more important than the one signed for the 5K.

However, would be nice to have more specific details other than gender, distance, and underlying health and circumstance. For instance:

1. Their 50 and 500 times without pull bouy, paddles, etc.
2. Their ability to sight fwd, left, and right while maintaining speed as well as other factors relating to being H2O confident.
3. Temperature of water/air
4. Perscription history, even if they took ritalin as a kid (not claiming anything, just curious because I took it)
5. If they over/undertrained for the event
6. Type of suit used
7. Diet, if they include vegetables and fruits in every meal or were they replaced with suppliments.
8. Etc

I have a few acquaintances who participate in local triathlons. They seem to have an inferior swimming ability compared to folks who attend meets, or even me. Next time I see one I plan to investigate how much they are aware of this and to what extent. Sad thing is there will be more case.

cantwait4bike
April 23rd, 2010, 06:00 PM
Along with those reasons to panic, add in the fear of swimming in a cold dark lake with little to no visibility underwater, and not being able to get a full breath due to the chest compression caused by a wetsuit. And all of those panic factors are happening at the same time! Typical chatter on the beach before a sprint triathlon:

"So have you been doing any swimming?"
"No, I haven't been in the water since that event we did 3 months ago."
:confused::confused::confused::confused::confused:

100% correct

one added factor though...race directors and USAT have 100% interest in money and 0% interest in safety. very similiar to the same people who run oil refineries or coal mines. wasn't like this back in the 80's or early 90's. :sad:

E=H2O
April 23rd, 2010, 06:35 PM
100% correct

one added factor though...race directors and USAT have 100% interest in money and 0% interest in safety. very similiar to the same people who run oil refineries or coal mines. wasn't like this back in the 80's or early 90's. :sad:

I have to politely disagree. When the swimming leg is cancelled it is the athletes that get upset. It is a triathlon afterall

That Guy
April 24th, 2010, 12:45 AM
Although I appreciate the +1 to my earlier post, the safety remark doesn't match my experience. Of all the tris I've participated in, I can't think of one that wasn't well-staffed with lifeguards for the swim, police officers for the bike, volunteers at aid stations, etc. One in particular stands out in my mind - the race was run idiotically (in the official results, the winner had a negative swim time... need I say more?) but there were plenty of people ensuring safety out there. I have not experienced a cancelled swim leg. I have heard of some tri companies that put on dangerous races (particularly those that cater to n00bs) but have not been in any of those myself.

Lui
April 24th, 2010, 05:19 AM
It seems that there is some weird allure of the triathlon to the crowd that "just got fit." I hear and see over and over people who have lost a little weight and have started working-out that they "are a triathlete" and are doing triathlons. Many have never done a brick workout and certainly haven't experienced anything like the sensory overload of a tri. I don't see this much with swimming, seems most people will wait extra long to do their first meet. But, for whatever reason some folks think they lose 10 pounds, buy a bike and a suit, go to a few spin classes and they are tri ready.


It wouldn't surprise me. I have been cycling for about 20 years and swimming for about 17 years(I also did some running). I have always been lean and healthy but still never competed in a triathlon. If I would decide to compete I would still make sure to properly prepare myself for the event because there are several things to consider besides swimming in a pool, cycling by yourself and running: you have to combine and coordinate all three disciplines, you have to swim among a huge crowd in open water, you have to cycle among a bunch of other cyclists which considers a great deal of good cycling technique, stress factor etc.
On triathlon boards I read more than once that total beginners with 0 experience immediately want to compete. Their post usually sounds something like this: "Hi, I've just started running 3 months ago to lose weight. Now I want to do triathlons and just bought a new road bike yesterday. I'm planning to compete in a triathlon in 2 months but I can't swim freestyle. Does anybody know how I can learn to swim in two months?"
90% of the responses go like this:"Great! Have fun at the competition. Don't worry about swimming. Just swim the best you can".
If I suggest "wouldn't it be better to take the time and learn how to swim and really prepare yourself for a triathlon without the pressure of needing to compete in 2 months?"
The typical response to that is:"why?, it isn't important to win your first race. The main thing is to have fun".

Well, I agree to some point but there is a reason why so many runners and triathletes have constant injuries. Sudden death is just the most extreme result of the lack of preparation.
I always think "What's the big rush?:confused:

E=H2O
April 24th, 2010, 02:20 PM
As a swimmer I never thought I'd be in the position of defending triathletes. Instead let me throw some facts out.

While many may say they compete in triathlons, in fact most do it for fun and to complete it. It is a different kind of sport than pool swimming. It is more akin to a fun open water swim when the locals come out to see if they can do it, which in places around the world can mean thousands.

If they don't feel comfortable doing freestyle some just simply do breaststroke. No shame in that: there have been channel crossings by people doing just breaststroke (there have also been some done only fly but those folks are just plain nuts.)

Have you ever swam in a wetsuit? You bob up and down like a cork. I just don't know how you can drown in one unless you are already suffering a heart attack.

You do not (and many don't) need to swim in a pack. People start on the sides and in the back. Some wade in waiting for everyone else to leave. The rest just have to make sure their head is right which has more to do with relaxing than swimming. Also a mass start is the exception. Most of the time the swimmers are broken into heats based on age. This limits the size of the crowd. Ironman races are the exceptions.

Sprint triathlons only take about 1 1/2 to 2 hours to complete. This approaches the typical length of a workout for some. In early season races some only have a 250 - 500 yard indoor swim. Walls are always available. Many starting to do triathlons start with these. The bike is 12 miles and you are not allowed to draft. If you can ride a bike 5 miles you can ride 25 miles. Just coast between pedal strokes if you really have to. And finally the 3 mile run. If you can't run the 3 miles there is no shame in walking. It's completely acceptable in the sport. The course for many Sprint Triathlons is flat.

So if you have to float wearing a wetsuit, coast on your bike and walk the run, why bother doing a triathlon at all. Very simply because it is just so much fun and people are friendly and supportive.

rtodd
April 24th, 2010, 07:48 PM
You do not (and many don't) need to swim in a pack. People start on the sides and in the back.

That doesn't work. Many tri's are wave start and the waves are not based on ability. As a result, the fast in later waves climb over the slow in earlier waves......big time! You can't get out of the way by starting in the back of your wave. I can't believe how many panic struck people I pass as they are sometimes rudely overtaken from behind. I'm telling you, I've seen some real panic struck people who are not even swimming at all. Obviously totally gassed out.

__steve__
April 25th, 2010, 12:41 AM
Sounds like you gotta be able to sprint close full speed for about 100M and be able to maintain your distance pace after a breif recovery.

Can you draft in the swim?

SolarEnergy
April 25th, 2010, 12:57 PM
If they don't feel comfortable doing freestyle some just simply do breaststroke. No shame in that: there have been channel crossings by people doing just breaststroke (there have also been some done only fly but those folks are just plain nuts.) I agree with all that you wrote, except the thing on Breaststroke.

Performing BS in a pack is kind of selfish. Very safe for the breaststroker, immensely dangerous for those that follow. Being hit hard by a breaststroke kick in the middle of a 3.8 swim can make a lot of damage.

If you can't swim the free, take swim lessons and stay away from triathlon until you're clear with it.


Can you draft in the swim? I think I just answered your question?

Yes you draft. And it's kind of a gamble most of the time because you may draft a pack shorcutting a buoy. Mass Pack DQs are fairly common. Best triathletes can swim the free switching from normal free to water polo free without loosing any speed:

YouTube- Freestyle Stroke Analysis: Pro Triathlete Scott Neyedli

Look for his second length, btw that is his open water 3.8k race pace turnover rate. 44min for 3.8k

E=H2O
April 25th, 2010, 03:55 PM
Great Video. Funny my first thought when watching it was the same as the written comment. Sometimes what works for you is not the theoretically perfect stroke.

debaru
April 26th, 2010, 12:38 AM
I agree with all that you wrote, except the thing on Breaststroke.

Performing BS in a pack is kind of selfish. Very safe for the breaststroker, immensely dangerous for those that follow. Being hit hard by a breaststroke kick in the middle of a 3.8 swim can make a lot of damage.

If you can't swim the free, take swim lessons and stay away from triathlon until you're clear with it.



Hey, if people can swim all over you at the start of race, which can wreak havoc on some folks, swimmers had better be sighting enough to know that someone is swimming directly in front of them, regardless of stroke.

slknight
August 7th, 2011, 10:13 PM
Yet another triathlon death during the swim:

http://www.nytimes.com/2011/08/08/sports/man-dies-during-new-york-city-triathlon.html

orca1946
August 8th, 2011, 01:01 PM
Any large events in any sport will bound to have some bad outcomes. Swimming is just not a sport that you can coast to get your breath back!!!!

notsofast
August 14th, 2011, 07:21 PM
This (http://www.nytimes.com/2011/08/15/sports/rise-in-first-time-triathletes-raises-safety-concern.html?_r=1&hp)just up at New York Times:

The deaths of two athletes stricken by cardiac arrest in the Hudson River during the New York City Triathlon on Aug. 7 has focused attention on the dangers of the open-water portion of such events.
Officials at USA Triathlon, the sport’s governing body in the United States, said Friday that heightened safety measures were continuing “to be discussed and evaluated,” but that no changes were imminent.

I was kind of surprised that there was no certification that triathletes could swim. New York's open water swimming group requires you to swim something like 2.5 miles in a pool, even for a 600-yard swim across the East River:


Organizers of the race said last week that they were considering requiring open-water swim certifications from 2012 entrants, as well as certification of a recent medical checkup showing a clean bill of health. But a spokesman indicated that USA Triathlon was less far along on such considerations.

swimshark
August 15th, 2011, 07:58 AM
I understand that some people have genetic predisposition for heart issues that come out during exercise (think Len Bias). I'm curious as to why the deaths seem to happen during triathlons and not during just an open water swim? I personally have never heard of a death during open water. I wonder what the difference is. Is it the training an OW swimmer does in the water vs what a triathlete does?

I come from a family of triathletes. Even at 71 my dad is still competing and both he, my sister and brother-in-law train in the water in preparation for a race (both have competed in pool meets as well). Is the lack of training for OW the cause of these deaths?

That Guy
August 15th, 2011, 10:19 AM
I understand that some people have genetic predisposition for heart issues that come out during exercise (think Len Bias). I'm curious as to why the deaths seem to happen during triathlons and not during just an open water swim? I personally have never heard of a death during open water. I wonder what the difference is. Is it the training an OW swimmer does in the water vs what a triathlete does?

I come from a family of triathletes. Even at 71 my dad is still competing and both he, my sister and brother-in-law train in the water in preparation for a race (both have competed in pool meets as well). Is the lack of training for OW the cause of these deaths?

Preparation is probably a factor, but consider the sheer numbers of how many triathletes there are versus open water swimmers. Big open water events like the Chesapeake Bay swim are rare, whereas there are plenty of triathlons that attract thousands of competitors each.

Bobinator
August 15th, 2011, 11:37 AM
I recently discovered I have a Long Q Interval and am undergoing genetic testing to determine if my arrythmia is the type that causes sudden death with over-exertion. The strange thing is I have never had a symptom. I have been a marathoner (2:54 pr), triathlete, ow swimmer, and pool swimmer all my life. I can easily see how someone could have this disorder and not know it. The only reason I learned of my condition was through the routine ekg my Dr. gives with yearly check-up.
I have also learned there is some type of correlation between water and sudden death in Long Q Interval patients. I don't think they really know what it is but it has effected divers, people in the bathtub, and even people walking in shallow water along shorelines. Oh, it is a genetically passed problem as well. :(

jroddin
August 15th, 2011, 12:00 PM
I understand that some people have genetic predisposition for heart issues that come out during exercise (think Len Bias). I'm curious as to why the deaths seem to happen during triathlons and not during just an open water swim? I personally have never heard of a death during open water. I wonder what the difference is. Is it the training an OW swimmer does in the water vs what a triathlete does?

I come from a family of triathletes. Even at 71 my dad is still competing and both he, my sister and brother-in-law train in the water in preparation for a race (both have competed in pool meets as well). Is the lack of training for OW the cause of these deaths?

I remember one fatality during the Chesapeake Bay Swim in the mid 90s (it was just a couple minutes into the start) and I thought there was one this year, too.

pmccoy
August 15th, 2011, 12:48 PM
This thread gave me nightmares before my triathlon last weekend. I kept dreaming about having a heart attack 200 yards off shore. Irrational fears aside, it's helpful to remember from time to time that any body of water is a hostile environment to humans. When something goes wrong on the bike or run, you can just stop. Even if you fall off a bike at 20mph, you are very likely to survive and have help within a few seconds. On a swim when something goes wrong you can easily panic, take in some water and start making bad decisions. Suddenly, the shoreline looks miles away, the murky water hundreds of feet deep and your already high heart rate spikes. Confidience in the water may push the odds of survival in your favor but it can happen to any of us... not just the newbies.

orca1946
August 15th, 2011, 07:25 PM
Pool swimmers do not think open water is any different !!! Wrong !!

Bobinator
August 28th, 2011, 10:23 PM
There was a death today during the swim portion of the Louisville Ironman. No information available yet except that the victim died of heart failure.

orca1946
August 29th, 2011, 01:03 AM
How can someone that trains for an Ironman have a heart attack during the race? It does not seem as if that should be !

Bobinator
August 29th, 2011, 06:54 AM
The swimmer probably had an unknown heart arrythmia such as a long Q interval. :( Perhaps everyone should get an ekg before participating in open water swimming.

GMM
August 29th, 2011, 08:18 AM
... everyone should get an ekg before participating in open water swimming....

In Italy is impossible do this kind of race without a complete EKG, after exhaustion. So...this kind of medical check is absolutely so far than an ironman race... if someone has physical problems maybe the Doctor can't find any

Bobinator
August 29th, 2011, 06:24 PM
Apparently his heart episode happened 8 minutes into the swim. This article says he did indeed have a long Q episode. I read somewhere else that he suffered from hypertension and probably had a heart attack. The stories don't jive.




LOUISVILLE, Ky. (WDRB) -- As Ironman athletes pack to leave Louisville with the satisfaction of completing another race, many of their thoughts are with the one who won't return home.

46-year-old Mark Wezka of Lancaster, New York suffered cardiac arrest and drowned during competition. His autopsy showed an underlying heart condition.

Ironman competitor Mike Manno explains, "It's so sad because this is sort of a health-conscious event. Everyone here eats right and trains hard and to hear of people actually dying during the event -- it's sad."

It happened during the 2.4 mile swim through the Ohio River -- the first, and what Manno calls the most intense, part of the triathlon: "When you jump into the water and people are hitting you, it's the hardest part of the race to just calm down and do your race and unfortunately it just seems to get people."

Unfortunately, dying during a triathlon is not unusual, but it turns out it almost always happens to triathletes during the swimming portion of the race. Thirteen of the 14 triathlon-linked deaths reported in the U.S. between 2006 and 2008 happened during the swim.

A study in the Journal of American Medical Association found these athletes twice as likely to die during competition than marathon runners. Cardiologist Dr. Rita Coram explains it's due to, "something called long QT syndrome, which is an innate abnormality in the electrical system of the heart cell....there's one type that is inherited and if one has it, they wouldn't know about it, but they do have a tendency to go into sudden cardiac death when they jump into cold water."

Another competitor, Manuel Sanchez, says, "it takes two to three weeks just to get the human system and whole body to re-energize."

Sixty-five competitors from the Louisville competition advance to the Ironman World Championship.

Racers say Wezka was part of a culture that you'd have live to understand. Competitor Mark Nelson says, "my heart goes out to his family, but this man died doing something he loved. You can't get any better than that."

Ironman is known as the most challenging of all triathlons, with a 140-mile course.

KatieK
August 29th, 2011, 07:38 PM
It bothers me that swimming gets so much press for being a dangerous sport.

These triathlon swim deaths are extremely tragic and upsetting. As was the death of Fran Crippen. They definitely raise the question of how safety protocols can be improved.

But swimming is not a dangerous sport. Thirteen deaths in a 2-year period is a low number. Don't get me wrong--I wish with all my heart the number were zero. But I wonder how many triathletes died in car accidents during that time period.

I know a lot of people who have been in bad cycling accidents in the past year. None who have been in a swimming accident. But I see a lot more press on swimming accidents.

A few weeks ago, the Arizona Republic ran an article about the dangers of adults swimming alone. There was a spate of adult drownings. Mostly drunk people in hot tubs. All of the deaths had a medication or alcohol component. So the moral of that story is that I shouldn't go in the pool by myself? I'm a bazillion times safer swimming laps by myself than I am driving to the grocery store or, God forbid, cycling in traffic.

Allen Stark
August 30th, 2011, 12:30 PM
It bothers me that swimming gets so much press for being a dangerous sport.

These triathlon swim deaths are extremely tragic and upsetting. As was the death of Fran Crippen. They definitely raise the question of how safety protocols can be improved.

But swimming is not a dangerous sport. Thirteen deaths in a 2-year period is a low number. Don't get me wrong--I wish with all my heart the number were zero. But I wonder how many triathletes died in car accidents during that time period.

I know a lot of people who have been in bad cycling accidents in the past year. None who have been in a swimming accident. But I see a lot more press on swimming accidents.

A few weeks ago, the Arizona Republic ran an article about the dangers of adults swimming alone. There was a spate of adult drownings. Mostly drunk people in hot tubs. All of the deaths had a medication or alcohol component. So the moral of that story is that I shouldn't go in the pool by myself? I'm a bazillion times safer swimming laps by myself than I am driving to the grocery store or, God forbid, cycling in traffic.

Good point.I personally know of 3 people who have died biking on training rides.That seems much more dangerous than swimming.

E=H2O
August 30th, 2011, 01:19 PM
There has never been a time when I ventured out into open water (most of the time by myself) that the risks inherent in the sport were not on my mind. However, I must admit in a race I never think of it. Nevertheless, during my preparation for a race I always make sure my training addresses all of the possibilities (good & bad) that I might encounter in the race.

When I ride my bike on the road I am always thinking of what I would do when an approaching car "brushes" me off the highway. This has never stopped me from riding but it does spur me on to ride in rural areas. I also don't ride in the rain (unless I get caught out on a ride) because I don't like the risks. However, I am aware of the risks of descending out of the mountains at 40 to 50 mph as well. I understand the risks, and take them because I feel that my training and experience provide a base with which to minimizes the risk. But, as I quantify the risks and minimize them through experience and effort, I am also very aware that if something unexpected happens that it will result in a not insignificant injury.

Putting all of that aside, barring a massive heart attack, if a person has an attack on the road they may get beat up by the fall (or actually slow down enough they don't get injured), but there is a good chance someone will be able to get them to a hospital. It is a completely different scenario in open water. It's not swimming in open water that is risky, it's not carrying your cell phone, emergency floatation device and location beacon that is.

swimshark
September 12th, 2011, 02:12 PM
We've talked about people dying during the swim. This weekend it happened during the bike. http://www.washingtonpost.com/local/cyclist-dies-in-washington-triathlon/2011/09/11/gIQAaAwbLK_story.html

Redbird Alum
September 12th, 2011, 04:55 PM
We've talked about people dying during the swim. This weekend it happened during the bike. http://www.washingtonpost.com/local/cyclist-dies-in-washington-triathlon/2011/09/11/gIQAaAwbLK_story.html

In the article they said the swim portion was cancelled due to rough water, so technically it was a BI-athelon.

One suspects that this gentleman may not have made it through the swim, had it been done.

swimshark
September 13th, 2011, 07:22 AM
In the article they said the swim portion was cancelled due to rough water, so technically it was a BI-athelon.

One suspects that this gentleman may not have made it through the swim, had it been done.

Would it be a BI or a DU? The swim was cancelled due to bacteria in the river.

notsofast
September 13th, 2011, 11:04 AM
It sure sounds like open-water swimming is a more dangerous organized activity - that's where most triathlon deaths occur.
But it's pretty clear that bicycle training is quite a bit more hazardous than swim training. Hang around cyclists and you'll hear about lots and lots of severe injuries (broken bones, severe gashes) and a couple of deaths.
This kind of makes sense. The swim portion of a triathlon sounds much more taxing than a typical swim (athletes jostling). But the bike portion sounds safer than training - the route is monitored and even if the route isn't closed off, having lots of bikers around means motorists are more likely to see and avoid them.

smontanaro
September 13th, 2011, 11:47 AM
But it's pretty clear that bicycle training is quite a bit more hazardous than swim training.

I can attest to that. While I have had ongoing tendinitis issues with my right shoulder (and haven't been in the water in quite awhile), I swam for several years with no issues. I commute by bike regularly and have had a number of small crashes in the past year or so, the most recent one being yesterday on my commute home (car didn't see me coming and turned left in front of me). This crash only resulted in bumps and scrapes on my legs, but the previous two didn't help my shoulder issues at all.

Skip

orca1946
September 13th, 2011, 12:23 PM
I also have been hit on my bike,that turned into a hit & run! A lady got his lic. # & I had him arrested & his "high risk pool" ins. company paid big time for every bike repair that the shop could come up with!

Bobinator
September 13th, 2011, 02:54 PM
I also have been hit on my bike,that turned into a hit & run! A lady got his lic. # & I had him arrested & his "high risk pool" ins. company paid big time for every bike repair that the shop could come up with!

Way to go Orca! I love it when the "Bad Guy" or gal gets caught!