The data comes from a variety of sources – the US National Registry of Sudden Death in Athletes, as well as news sources and other records. That said, there may be some risk of undercounting here.
By and large, we’re not talking about ironman competitions here. Nearly 50% of the deaths occurred in short-distance triathlons. And the majority of deaths, 67%, occurred in the swimming portion of the race – which is usually the first part of the triathlon. Most of those who survived cardiac arrest had a cardiac arrest during the land-based segments of the races. The implication is clear – the ability to get rapid medical treatment to stricken individuals may be critical, making swimming, and particularly open water swimming, a unique danger in triathlon not seen in other endurance sports.
Overall, the authors calculate a death rate of 1.74 per 100,000 triathlon competitors. That may seem like a vanishingly small number, but realize that the rate of sudden death in otherwise healthy athletes is 0.5 per 100,000 individuals per year. Put another way, running a triathlon elevates the risk of sudden death by a factor of more than 1000.
I don't mean to be alarmist – overall the risks here are really small. Triathlon is a relatively safe activity. But the risks cluster in certain individuals, as you can see from this graph.
HatsofftoJJ on September 19th, 2017 at 12:09 UTC »
I can't tell you how many times I've been at the start of an event and listened to guys practically gloating at the fact that they haven't swam or barely swam to prepare for it. Like it's some kind of joke. I honestly find it to be flat out stupid. If you haven't prepared to some extent for the event, why are you even there?
scotty675 on September 19th, 2017 at 10:43 UTC »
So skydiving is statistically safer than participating in a triathlon? The 2016 stats for skydiving has 21 fatalities with 3.2 million jumps.
Source: http://www.uspa.org/facts-faqs/safety
mcscreamy on September 19th, 2017 at 01:02 UTC »
Link to manuscript
Background: Reports of race-related triathlon fatalities have raised questions regarding athlete safety.
Objective: To describe death and cardiac arrest among triathlon participants.
Design: Case series.
Setting: United States.
Participants: Participants in U.S. triathlon races from 1985 to 2016.
Measurements: Data on deaths and cardiac arrests were assembled from such sources as the U.S. National Registry of Sudden Death in Athletes (which uses news media, Internet searches, LexisNexis archival databases, and news clipping services) and USA Triathlon (USAT) records. Incidence of death or cardiac arrest in USAT-sanctioned races from 2006 to 2016 was calculated.
Results: A total of 135 sudden deaths, resuscitated cardiac arrests, and trauma-related deaths were compiled; mean age of victims was 46.7 ± 12.4 years, and 85% were male. Most sudden deaths and cardiac arrests occurred in the swim segment (n = 90); the others occurred during bicycling (n = 7), running (n = 15), and postrace recovery (n = 8). Fifteen trauma-related deaths occurred during the bike segment. Incidence of death or cardiac arrest among USAT participants (n = 4 776 443) was 1.74 per 100 000 (2.40 in men and 0.74 in women per 100 000; P < 0.001). In men, risk increased substantially with age and was much greater for those aged 60 years and older (18.6 per 100 000 participants). Death or cardiac arrest risk was similar for short, intermediate, and long races (1.61 vs. 1.41 vs. 1.92 per 100 000 participants). At autopsy, 27 of 61 decedents (44%) had clinically relevant cardiovascular abnormalities, most frequently atherosclerotic coronary disease or cardiomyopathy.
Limitations: Case identification may be incomplete and may underestimate events, particularly in the early study period. In addition, prerace medical history is unknown in most cases.
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.
Primary Funding Source: Minneapolis Heart Institute Foundation.