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Since becoming an Olympic event in 2008, open water swimming has become one of the fastest growing mass participation sports worldwide; events have taken place with over 25 000 participants. With these numbers comes an inherent risk of adverse medical events. The recently released USA Triathlon (USAT) Fatality Incidents Study1 reviewed data from 2003 to 2011 and reports that over that period 43 athlete fatalities were recorded during race events. Of these, five were considered ‘traumatic’, caused during cycling; of the remaining 38 deaths, 30 occurred during the swim.
These data suggest that a swim represents the greatest relative hazard associated with mass participation sports events. Despite this, the mechanism and cause of death remains something of a mystery; in the USAT Fatality Incidents Study, autopsy information was not reviewed, but it is concluded that ‘available data indicates the swimming fatalities appear to be caused by episodes of sudden cardiac death (SCD)’—having not found enough evidence of deaths caused by swimming-induced pulmonary edema …
Competing interests None.
Provenance and peer review Not commissioned; internally peer reviewed.