Many years ago, a good friend of mine ... then in his early 40s ... died in a single car crash without a seat belt. The autopsy showed he had a heart attack and the doctor inferred he most likely removed the seat belt as he felt the constriction on his chest. He was an excellent, long time, local class runner.

I go back and forth between racing IM in the U.S. and Europe. Without question, there are a lot more grossly obese people participating or at least attempting Ironman in the U.S. But I'm seeing more in Europe over time. Last summer, I saw an enormous young man in IM Norway. I marveled that he was able to complete the bike course with over 6500 ft net gain. He didn't make the final cut-off, but who knows, he might end up like some of those people who have lost a hundred or more pounds and eventually completed. And yet, these are generally NOT the people I read about dying in the swim.

Case in point: the woman at Lifetime NYC a number of years ago. Very accomplished swimmer.

You'd really need to plot known speed abilities against deaths to figure that out and that just sounds like an unquantifiable thing.

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36 kona qualifiers 2006-'23 - 3 Kona Podiums - 4 OA IM AG wins - 5 IM AG wins - 18 70.3 AG wins
I ka nana no a 'ike -- by observing, one learns | Kulia i ka nu'u -- strive for excellence
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then what is the individual responsibility of the athlete to properly prepare for the event, and conditions?

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36 kona qualifiers 2006-'23 - 3 Kona Podiums - 4 OA IM AG wins - 5 IM AG wins - 18 70.3 AG wins
I ka nana no a 'ike -- by observing, one learns | Kulia i ka nu'u -- strive for excellence
Garmin Glycogen Use App | Garmin Fat Use App

This was part of the case put forth by the family of the deceased in the IM Florida case. By their measure there should have been a kayak for every athlete or 2. While it doesn't get after the merits of the water safety ratio and whether that would have saved him it was later discovered that the dude never went to swim practice for months in advance of the event. Thereby reinforcing the personal responsibility and inherent risk involved with such and event.

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36 kona qualifiers 2006-'23 - 3 Kona Podiums - 4 OA IM AG wins - 5 IM AG wins - 18 70.3 AG wins
I ka nana no a 'ike -- by observing, one learns | Kulia i ka nu'u -- strive for excellence
Garmin Glycogen Use App | Garmin Fat Use App

I don’t even understand how that’s rewarding for a person, knowing you half-assed your training and didn’t come close to reaching your potential. It’s just checking the race off some list. I get that life happens and interrupts training but swimming once is a joke.

You missed my point, which is that if something goes wrong in open water, nobody is going to see you. The guy that posted about masters swimming, well, in a pool everyone can see you if you stop swimming when you have a heart attack. Or if a shark eats you. And I am plenty comfortable in the water.

In my very limited experience here in the U.S., I've noticed that Europeans and Asians who have moved here to live are almost always much thinner and in shape than their American counterparts of similar age and gender. In fact I can't recall ever seeing an overweight Asian or European, and certainly never an obese one.

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"Anyone can be who they want to be IF they have the HUNGER and the DRIVE."

Agree 100%!!! I asked my friend why his brother did not swim more and IIRC, he gave some mealy mouthed excuse about how they both hated swimming. I just didn't say anything further. :)

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"Anyone can be who they want to be IF they have the HUNGER and the DRIVE."

I understand that OW is generally pretty dark but you've got your brightly colored swim cap to show where you are. Seriously though, apparently the safety personnel usually are able to rescue everyone who is in trouble. Maybe I missed it but I'm not aware of any races where someone had a heart attack and/or drowned but was not recovered until hours after all the other swimmers were out.

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"Anyone can be who they want to be IF they have the HUNGER and the DRIVE."

It seems that most IM races do have quite a lot of safety people on kayaks/boats but I can tell you that it is easy for me to envision someone going down and never being recovered. When I did the Swim/Run Casco Bay (Long Course), we swam 1 mile in the Hussey Sound to get to the next Island. There were very few people around during that stretch and it was the furthest straight swim. You had to account for current and it comes later, not earlier, in the race. How can you protect people in an Ocean? You can't...

*from my Garmin
https://connect.garmin.com/.../activity/1915913563

But that is why you have your partner, right??? Now I guess you could both go down together but that would be unusual. In any case, going back to the original purpose of this thread, I think it is clear that tri has a swimming problem b/c most entrants just don't train enough for the swim. And certainly, your point about men over a certain age needing a heart screening is well taken, but still these people need to swim more.

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"Anyone can be who they want to be IF they have the HUNGER and the DRIVE."

Tragically 2 more swim deaths. Is it time triathlon considers prescreening some athletes?

https://www.nbcnews.com/...3-triathlon-n1016861

A 2017 study shows that there are at least "1.7 deaths per 100,000 participants"
https://www.ncbi.nlm.nih.gov/pubmed/28975231 "CONCLUSION:
Deaths and cardiac arrests during the triathlon are not rare; most have occurred in middle-aged and older men. Most sudden deaths in triathletes happened during the swim segment, and clinically silent cardiovascular disease was present in an unexpected proportion of decedents."

"Harris hopes triathlons will begin instituting mandatory health screenings for certain high-risk individuals, such as those over 50, before they are cleared to participate. He advises those interested in entering a triathlon to talk to a doctor who can properly assess their health status before jumping into the race. “Know your body, know what you can do, and get everything checked out."

Sadly, it was 3, not 2, deaths.

https://swimswam.com/...n-central-wisconsin/

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2020 National Masters Champion - M50-54 - 50m Butterfly

Pre-screening will come, just a matter of time and federations getting all their info lined up and how to actually handle the volume of the information. Elites, juniors and U-23 athletes already have to get pre-screened for ITU.

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Brooks Doughtie, M.S.
Exercise Physiology
-USAT Level II

This is a very interesting topic. It is hard to say weather or not it is simply tragic sudden medical conditions that are the cause of these deaths (as would be officially reported) or that it is the fact that the athlete is truly unprepared in all facets. An article on SwimSwam just recently reported:
"Between 1985 and 2016, 109 of those 135 events resulted in deaths, with 72 occurring in the swim, 20 occurring in the cycling portion, and 17 occurring in the run. Deaths in cycling events were primarily due to trauma caused by collisions."
This leads me to believe that the swimming conditions and the athlete's preparation to handle such conditions play a large factor in these deaths. As coaches in the sport we need to do all we can to prepare these athletes for what they will be encountering. Perhaps it is not a swimming problem but a swim coaching problem.


Precisionswimming.com
Guided swim training program

As coaches in the sport we need to do all we can to prepare these athletes for what they will be encountering. Perhaps it is not a swimming problem but a swim coaching problem.

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What percentage of athletes do you think have a tri/swim coach?

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Brooks Doughtie, M.S.
Exercise Physiology
-USAT Level II

It is hard to say weather or not it is simply tragic sudden medical conditions that are the cause of these deaths//

Do you think they are just getting tired and then drowning? I don't think it is hard to say at all, and the sudden medical condition whether it be heart attack, stroke, or other heart problem, seems pretty evident as the cause of most of these water deaths. Over and over it has been shown it is not really the ability level, it is not the group being escorted in the last few spots that are dying..Funny that way too, neither the pro group at the front either...


But I agree, everyone should get better at swimming faster and better, and get more OW experience before race day. Certainly no harm in that...

Hello, I am an MD and a triathlete. These deaths are certainly almost always cardiac in etiology. This would include development of cardiac arrhythmia or myocardial infarction during the swim. The sympathetic response that you get during the beginning of the race is likely a major contributing factor as it can predispose to the development of both of these. Anxiety from swimming in open water and a tight fitting wetsuit certainly exacerbate this "fight or flight response". Here would be my suggestions:

1. Ensure that the race has available swim warmup and educate competitors on the multitude of benefits from appropriate swim warmup. I wonder how many of these athletes who died during the swim went directly from putting on their wetsuit to 100% all out effort...

2. Disallow people from competing if they have known history of cardiac arrhythmia or MI, unless they have a written note from their physician approving competition. Cardiac screening of athletes over the age of 40 would be a good idea as well.

3. Have a minimum amount of swim training practice in open water required for new athletes/athletes who have not swam in open water for some time. It would be great to have more guided open water swims available which are not "races", but rather a chance for people to get practice swimming in open water as a group.

I am not claiming that it is only being unprepared that is the cause of these deaths. I am just simply pointing out the correlation of the high number of swimming deaths compared to the other two domains. This correlation does seem to point to the fact that there is something about swimming in particular that is effecting these athletes at a larger percentage.

Precisionswimming.com
Guided Swim Training Program

Besides a good warmup, I think an in water start would help ease these. I feel the excitement and adrenaline of the rush from shore into the water exacerbates the issue. Deep water, treading start may help a bit, and be far less aggressive to all participants.

I agree with you that lack of preparation is likely a contributing factor. However, if you are having an MI while you are biking or running, you can stop. If you develop an MI during the swim, your symptoms may occur quite suddenly, which in addition to chest pain include air hunger, confusion, and weakness. You may not have the wherewithal to call for help, and it is possible that no one notices you given the nature of an open water swim race.

Great point. Madison had open swim before the race, but then you lined up in a hot column of swimmers for 5-50 minutes, then boom, in the water. I imagine that if you were just chilling in the water for several minutes without actually swimming this would help some.

Of course, you can take the first several minutes easy like I did, but that forces you to make the choice between potential safety and hurting your swim time.

Thanks. Having done a few in water starts in my day, I have found them to be far less aggressive and everyone seems to be a bit more warmed up and finds their "space". The old Schu's race in Benton Harbor, MI was always a ball with the starter out in the 4' swells, megaphone in hand starting each wave. Kona does it, the old Madison mass start for IM was that way and there were seldom issues.

This issue is complicated with many facets to discuss. The big one is that if you have a heart attack when running or biking you are not also in a position to drown. And, its much more obvious to competitors and bystanders that action needs to be taken. Even in a pool at a swim meet it would be obvious to everyone watching that something wasn't right and pull the victim out. Not so much in open water.


My main suggestion would be for more lifeguards on the swim course. Maybe there should be a required ratio of X# guards to swimmers.


It is very hard to recognize someone that is truly drowning VS someone that is distressed and needs help.

Someone that is actually drowning there is No yelling, No waving. Just a silent gasping for air and 20 to 60 seconds later, submersion. And someone has drowned, maybe in plain site. "Drowning is not the violent, splashing call for help that most people expect," That happens before you start to drown.

Why someone starts drowning can be from any number of issues. Many of which have been addressed in some way on this forum. Some are;

Poor fitness/Skill? IMO If you are in a wetsuit, its a lot harder to drown for these reasons. Its not from lack of buoyancy where you exhaust yourself and sink. While this may happen it may be the least likely. I'm not suggesting it doesn't happen because people have drowned with a life preserver on or in a shallow tub.

SIPE - This is real but only happens in a small number of cases. It is often preceded by a very obvious coughing situation. This is where having more lifeguards on course could make a big difference where there are clear signs of trouble.

Cardiac or other sudden issue that is unknown and unforeseen even by the very fit athlete. What is anyone supposed to do about this? Go back to the "silent drowning" issue. Only if they are lucky and flag at first sign of their own distress or they have an aware competitor or life guard is there a chance to save and resuscitate.

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Tri is my Tribe! "Sometimes you need to slow down in order to go fast."