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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 Study 1 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 (SIPE)-a popular theory of cause of death in the media and specific triathlon forums. There was also no clear evidence that swimming ability, anxiety, wet suit-related factors or medical problems such as stroke, seizure or syncope were responsible for the deaths during swimming. Furthermore, from other media reports, those that die are often regarded as being fit and healthy.
From the USAT study, swim death rates do...