Tuesday, August 16, 2011

follow-up: regarding recent fatalities

this is a follow-up to my last post: regarding recent fatalities.

someone forwarded me this recent piece from the New York Times that discusses efforts in triathlon sports bodies in response to the recent deaths at the New York Triathlon:
if the link doesn't work, i've put the full text at the bottom of this post.

it's interesting to see the different ideas mentioned in the article. it references proposals for mandatory open-water swim certification, better training, and changes in race format. i'm certainly curious in the statement from USA Triathlon, which is connected to many of the triathlon races in the United States. the quote from USA Triathlon makes it sound like they're having internal discussions about policies to mitigate the risks of swim casualties. i'm interested in what those discussions are considering.

personally, i'm all for anything that increases safety and reduces the risk of death or injury in any sporting event. no one wants to participate in a sport knowing that efforts were not made to protect athlete welfare, especially if those efforts involve actions that were readily feasible. and no one decides to make a lifestyle change to greater physical fitness thinking it's going to increase dangers to personal health. i think that the goal of sports, either in terms of competitive performance or individual self-development, is not served by ignoring the issues of safety.

having said that, i also think it's important to understand how potential policies may affect the nature of the sport. there are consequences for every action. even with the ones mentioned in the article, i can see collateral issues. so here are my (admittedly random--bear with me: this is off the top of my head and i'm currently sick with a fever) observations in no particular order:

with mandatory open-water swim certification, for example, i can see questions such as: what are the standards for certifying someone as qualified for open water? an ability to do a standard Navy SEAL or U.S. Marine Force Recon training swim of 5-6 miles would work, but are competitors going to do that just so they can be certified to participate in the 400-meter swim leg of a sprint triathlon? should there be graduated certification for different distance races? who will carry out the certification standards? how are the standards going to be enforced (e.g., people may qualify for certification for a race, but after 1-2 years of inactivity, may not be able to meet the standards again)? should we have renewal certifications?

i certainly would like to see better-trained competitors in the water. the growth of triathlon has definitely seen an expansion in the number of weekend warriors who participate without the level of training that has historically been expected and held in the past. and some of them just don't seem to know the risks of what they're pursuing. admittedly, it's hard to know what you don't know, and it's hard to ask if you don't know what to ask about, especially when you're a competitor who's never had coaching or acquaintances to explain the sport to you. but if there's going to be certification for open-water swimming, it should be done in a way that is consistent and relevant to the nature of the participants involved in triathlon--or at least, as triathlon is currently run.

with respect to the other ideas of changing away from mass swim starts and having staggered waves, that could alleviate some of the stress of race environments. especially given the increasing number of athletes involved--as the number of participants has risen over the years, i've seen race starts just explode in the mass of bodies struggling to get out the starting gate. however, i can see it would make it harder on race hosts to accommodate the extra time and resources necessary to conduct those kind of starts. i can also see that it still would leave open the issue of competitors who are just simply not ready for race day.

of course, another solution is to just make universal what Ironman races do: cap the total number of competitors to some quantity that race organizers and host cities deem manageable. the issue here is that it also caps the amount of revenue to both, and hence makes it more daunting to conduct races.

in addition, race fees could be increased to enable race organizers to pay for more rescue/safety personnel. but as New York Triathlon organizers pointed out following the recent deaths, it is extremely difficult to rescue swimmers in a marine environment, and it's not clear that additional staff would have been able to do more to find and reach swimmers in distress.

i'll finish by noting that i can foresee arguments that any measure to improve safety may have an unintended affect of intimidating people still making a decision to participate in triathlon, and hence discouraging them from the sport.

i can offer several responses: any more discouraging than death? and if we're trying to find ways to mitigate the risk of what happened at the New York Triathlon from happening again, don't we want people to be aware of the dangers and take appropriate steps to address them? don't we want them to be ready to race?

and more importantly, don't we want them to be ready to race again? as in: the rest of their lives?

Preparing Triathletes for the Chaos of Open Water
By Jeff Z. Klein
New York Times
August 14, 2011

The deaths of two athletes stricken by cardiac arrest in the Hudson River during the New York City Triathlon on Aug. 7 have focused attention on the dangers of the open-water portion of such events.

Officials at USA Triathlon, the sport’s governing body in the United States, said Friday that heightened safety measures were continuing “to be discussed and evaluated,” but that no changes were imminent.

Nevertheless, the dangers, mostly related to the stresses of breathing in open water amid a mass of swimmers, have long been known to triathlon coaches. And their training of triathletes incorporates ways to cope with an environment not found in the neat confines of a pool.

“What do you do if you hyperventilate?” said Neil Cook, the head multisport coach with Asphalt Green Triathlon Club at the Asphalt Green amateur sports center on Manhattan’s Upper East Side. “What do you do if your goggles come off? If you bump into a boat? If someone swims over you? If any of these things happen in the open water and you’re not prepared for it, you can panic and can get into real trouble.”

A 2010 study published in The Journal of the American Medical Association showed that 13 of the 14 deaths in triathlons from 2006 to 2008 took place during the swim legs. Autopsies on nine of the victims found that seven had heart abnormalities, which researchers think were exacerbated by the stress of swimming in open water.

The risk of sudden death in a triathlon is 1.5 deaths per 100,000 participants compared with 0.8 deaths per 100,000 participants in a marathon.

“So many things can go wrong in an open-water swim,” Dr. Stuart Weiss, the New York City Triathlon medical director, said last week. “There’s some combination of water, adrenaline, pushing yourself hard, and all these things somehow work together to put people into an abnormal heart rhythm.”

Autopsies were inconclusive on the man and the woman who died after being pulled from the 1,500-meter swim, the first leg of the New York City Triathlon.

Organizers of the race said last week that they were considering requiring open-water swim certifications for 2012 entrants, as well as certification of a recent medical checkup showing a clean bill of health. But a spokesman indicated that USA Triathlon was less far along on such considerations.

“The topics of athlete certification, as well as its feasibility, and the current requirements for swim starts continue to be discussed and evaluated, and we will consider all options moving forward,” the spokesman, Chuck Menke, said.

Cook said that swim certification was necessary.

“You need some form of certification that says this person can swim in open water for, say, one hour,” he said. “If they don’t pass it, they shouldn’t be let in the race.”

The rising numbers of untrained first-time triathletes comes as part of the sport’s phenomenal growth in recent years. USA Triathlon had fewer than 16,000 members in 1993; over the next seven years, that number grew steadily, but unspectacularly, to a little more than 21,000.

But since 2000, membership has skyrocketed, hitting 58,000 by 2005 and 140,000 in 2010. In those same 10 years, the number of triathlon clubs in the United States grew to 869 from 50, and the number of officially certified coaches rose to 1,800 from 229.

The surge reflects a change in perception. Not long ago, the notion of doing a long-distance swim, followed immediately by long-distance cycling and running, seemed impossible for all but the most elite endurance athletes.

But now triathlons are often seen as the province of weekend warriors, albeit especially fit ones. That in turn has attracted first-time triathletes who often lack specific training. The number of one-day memberships in USA Triathlon, which one needs to compete in its sanctioned events, rose to 326,732 in 2010 from 100,000 in 2000.

Cook teaches a 10-session class for triathletes. In one session, he removes the lane dividers from an Olympic-size pool and has the class — about 20 students — swim together in a circle for two 20-minute periods. That results in numerous collisions, kicks in the face and other unpleasantness.

“Some people get out of the water and say, ‘I can’t do this,’ ” Cook said. “But I talk to them, and they get back in for another 20-minute swim, and they’re fine. That’s because now they’ve experienced the chaos and are better able to deal with it.”

Another session takes place in the water off Brighton Beach, so students can learn to handle “not being able to see the bottom and having to sight without walls,” Cook said.

Such acclimatizing is important for newcomers, said Melissa Mantak, USA Triathlon’s coach of the year for 2010.

“Unfortunately, yes, I see a lot of people inadequately prepared for open-water swimming,” said Mantak, who has coached triathletes at all levels since 1998 and who said she paid special attention to swimming. “They don’t know how challenging it can be. I’ve seen fantastically gifted swimmers get into open water and freak out.”

Triathlon organizers are also aware of the dangers, typically assigning more lifeguards than the USA Triathlon minimum of one per 50 participants (one per 30 for ocean swims). They also are moving away from the especially chaotic mass starts. At the New York race, swimmers started in groups of 20 every few seconds, although that change was made because of choppy water.

“USA Triathlon-sanctioned events must meet the requirement of a minimum of three minutes between start waves and no more than 150 athletes per wave,” said Kathy Matejka, the event services director of USA Triathlon. “Time-trial starts, which include fewer than 20 athletes starting at shorter intervals, also are permitted.”

Tuesday, August 09, 2011

regarding recent fatalities

some of you may have caught the news recently about the 2 deaths at this past New York City Triathlon. it was somewhat lost among the surge of headlines regarding recent events in the world.

the deaths were Amy Martich (age 40, from Illinois) and Michael Kudryck (age 64, from New Jersey). along with 28 other swimmers, they were pulled out of the water during the swim portion of the race, both unconscious and under cardiac arrest. they were later pronounced dead. they were apparently experienced athletes and in good physical condition, and so their fatalities were a surprise to friends, family, and the race community. you can take time for condolences and learn more at the following:
their deaths should provide a moment for reflection regarding the risks in the sport. while low, they are still there. as ironic as it may seem, the pursuit of fitness does bring with it the danger of damage to personal health and even death. and deaths do happen, and a rate that seems to be higher relative to other sports like running: medical studies indicate that triathlons have had 1.5 deaths per 100,000 competitors, while marathons have had .8 deaths per 100,000 competitors.

i should caution that these are very low numbers, and show that the probability of something bad happening are minute, and that hence the decision to participate in any sport is still a laudable and beneficial endeavor.

having said this, i also want to note that the evidence found from studies is that the risk of dangers varies by athlete, and that each athlete may have individual pre-existing health factors that increase their personal risks. from the above articles, there were 14 deaths between 20062-2008. out of the 9 who were given autopsies, 7 were found to have heart conditions.

in addition, i also want to note that the relatively greater risks of fatalities in triathlon relative to running seem to be associated with swimming. 13 of the 14 deaths came from the swim portion of races.

swimming, particularly open-water swimming, is not a trivial endeavor. there is the shock of cold water, which constricts blood vessels and increase blood pressure. there is the disruption to breathing, which can induce hyperventilation or accidental choking. there is the stress of competing in mass disorganized field of competitors flailing through each other, with the danger of being hit or kicked and being left dazed or even unconscious. there is the general disorientation of a foreign environment, particularly if the water is choppy and waves are large. all of this, combined with the adrenaline of race day, can operate to escalate exertion levels and arouse panic attacks, which under certain conditions can be sufficient to overwhelm an athlete--even an experienced one. the result is fatigue, arrythmia, unconsciousness, cardiac arrest, with subsequent drowning or death...and it doesn't help that in the mass numbers of competitors on race day, it's hard to identify athletes in trouble in the water and retrieve them to shore.

people raise the question as to why there aren't comparable incidents of fatalities in long-distance swimming competitions, which are also often in open water. personally, i don't know, and i'm certainly curious as to the statistics for that. but i'd also point out that long-distance swimming is not as popular as triathlon, and so has fewer numbers of competitors, making race environments less crowded and so less disorienting. in addition, it's a somewhat esoteric sport, and so more of the competitors are elite athletes, with relatively lower risks of dangers to health.

so given all this, what lessons are there for the rest of us? i take it that we can start by evaluating ourselves for pre-existing health conditions. even if we don't know about them, that's even more reason to get checked--because it's the conditions that you don't know that are the most dangerous ones. and i take it that we can approach the sport with respect, with recognition of the dangers involved. this means knowing what the danger signs are of stress and panic, and then knowing what to do to prevent or mitigate them so they don't lead to fatigue, arrythmia, unconsciousness, cardiac arrest, or worse.

i can tell you that i always try to acclimate myself to the water temps before the race start on race day, so i don't get the shock of cold water. i also try to take some moments to calm myself down. and in the water, i always try to take a line out of the main field. and whenever i've started to feel disorientation or anxiety--and it has happened--i'll always stop and tread water until i get my bearings and composure back. does it affect my time? yeah, but it also means i stay alive--and alive to enjoy the rest of the day.

which to me is the entire point of race day. because by that time, you've already gotten all the health benefits and character development through training. the race should just be a reward and a passage point onwards to whatever comes next.

and we all want to be there to see that.