Studies Explore Triathlon Swim Safety

British study concludes varying swim conditions can affect heart rate.

In the past five years, triathlons have become an increasingly popular activity for many young to middle aged athletes. However as the number of race participants increases, so does the incidence of triathlon deaths. Most fatalities occur in the swim portion, and professionals are still inconclusive about why exactly this is.

A study conducted by USA Triathlon of sanctioned events from 2003-2011 reported 45 total fatalities, 31 of which occurred during the swim portion of the race. Though these races consisted of different lengths, venues, and times of the year, all 31 of the swim fatalities took place in an open water setting.

However, the USA Triathlon study did not determine definite reasons why these deaths occurred. Many scientists who have studied this phenomenon believe that the majority of the victims experienced sudden cardiac death (SCD) while swimming. Yet, most of the victims were fit, healthy individuals, many long time triathlon veterans. For example, Austin resident Ross Ehlinger, who suffered an apparent heart attack during the swim of the Escape from Alcatraz triathlon in 2012, had competed in multiple triathlons before he passed away.

“We still feel the numbers (of fatalities) are very low,” said Rob Urbach, CEO of USA Triathlon. “There isn’t a pattern except they are happening in the water.”

UK professors Michael Tipton and Michael Shattock also conducted a study in 2012 to determine the cause of these triathlon fatalities. Their findings uncovered a set of unique bodily responses to the beginning of a triathlon, a phenomenon they dubbed “autonomic conflict.” This conflict consists of two conditions. The start of a race brings about stress, sudden physical activity, and submersion into cold water, activating the fight or flight response. This pumps adrenalin through the body and speeds up the heart rate. At the same time, going under water prompts the body to slow down the heart rate to conserve oxygen. These contradicting reactions could spell trouble for even the fittest athlete when combined.

“Normally, the two responses don’t happen at the same time, but when they do, the heart can go into abnormal rhythms, which can cause sudden death,” said Tipton in a commentary for the “British Journal of Sports Medicine.”

Other professional triathletes worry that race participants do not adequately prepare themselves for the swim portion. Most triathletes are primarily runners or bikers and view the swim portion as something to “get through.” Before a race, athletes should train in open water or obtain a swim certification, easy practices that could prevent dangerous circumstances in the water.

Last year, the World Triathlon Corp., which owns Ironman, launched the SwimSmart program to promote safety and swim education. The initiative launched new regulations for the swim portion of Ironman events, such as pre-race, in-water warm-ups, stagger wave starts instead of mass starts, and additional buoys, anchored rafts, and in-water personnel. The program also educates participants about reducing pre-race anxiety and encourages pre-screenings for potential health risks.

These issues are also surfacing as the average age of triathlon competitors increases. The 40-to-44 year old age bracket now holds more than 30 percent of USA Triathlon membership, which is up from just more than 17 percent in 2009. In the USA triathlon study, more than half of the triathlon fatalities were among participants age 40-59.

While triathlon deaths are uncommon, athletes should take the necessary precautions to prepare themselves for the swim. Warming up before the race, practicing in open water, and utilizing techniques to prevent pre-race anxiety are essential to maintaining a healthy heart. Ironman events now cancel or shorten the swim portion when water temperatures are below 52 degrees Fahrenheit or above 88 degrees Fahrenheit, but athletes should also use wetsuits and other gear to protect themselves from the elements. Beginning and veteran triathletes are also encouraged to visit their doctors to test for any heart conditions. 

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