BackgroundSwimming Induced Pulmonary Edema (SIPE) is life-threatening condition that can affect healthy triathletes. There have been several reported cases amongst triathletes, however the current estimation of incidence is derived from a survey of triathletes with self-reported symptoms suggestive of SIPE.ObjectiveTo investigate the incidence of SIPE and associated risk factors in mass participation Triathlon Competitions (TC).DesignA retrospective analysis of Competitors' Medical Records (CMR).Setting11 consecutive UK-based TCs between 2011 and 2016. The competitions involved elite and non-elite competitors who raced Super Sprint, Sprint, Olympic and Olympic Plus distances.ParticipantsCMR of patients presenting to Triathlon Medical Team (TMT) with medical complaints/injuries were analysed. Those diagnosed with SIPE were included. Diagnostic criteria included absence of water aspiration, acute onset of dyspnoea, cough and/or expectoration of frothy sputum, with evidence of pulmonary oedema on physical examination.Assessment of Risk FactorsPatients' Age, gender, race distance, co-morbidities and medical management were recorded.Main Outcome MeasurementsThe incidence of SIPE in TCs.Results68557 competitors started the TCs and 429 competitors presented to the TMT. Five case of SIPE were recorded, giving rise to an incidence of 0.73/10,000 competitors and 1.2% of all presentations to the TMT. Mean age was 42 (21–58) and a third were female. All were non-elite athletes competing in a variety of race distances; one patient had pre-existing cardiac comorbidities; and in 3 cases participants were competing in their first triathlon. All required supplementary oxygen and transfer to hospital for definitive management.ConclusionThis report is the first to describe the incidence of SIPE in mass participation triathlon competitions. Event organisers and TMTs should be prepared for competitors developing SIPE which appears not to be bound by age, gender, race distance or co-morbidities. Further research is required to identity those who are at risk of SIPE.
BackgroundTriathlon is an increasingly popular mass-participation endurance sport which incorporates swimming, cycling and running stages over a variety of distances. Overuse injuries during triathlon training are common (Zwingenberger et al. 2014; Korkia et al. 1994) however the incidence of illness and injury during triathlon races is less well described. A clear understanding of this data is valuable in planning medical care for mass-participation triathlon races.ObjectiveTo describe the epidemiology of illness and injuries during triathlon races in the UK.DesignRetrospective analysis of competitors' medical records (CMRs).SettingTwo large summer triathlons over 5 years.ParticipantsAll triathlon competitors requiring treatment by the triathlon medical team (TMT) for illness or injury (excluding first aid).Assessment of Risk FactorsAge, gender, race distance, race experience, mechanism of injury, co-morbidities, and medical management was recorded.Main Outcome MeasurementsNumber of cases of medical illness, musculoskeletal (MSK) injury, and topical injury (e.g. abrasions) treated by the TMT.ResultsThere were 68557 starters and 67270 finishers across Supersprint, Sprint, Olympic and OlympicPlus distances (2.3% did not finish) from 11 consecutive events. The TMT treated 429 competitors (0.62%, 1/161 starters) for complaints including falls, fractures, breathlessness and collapse. Medical illness was the most common complaint (44.1%), followed by MSK injury (27.1%) and topical injury (24.8%). There were three cardiorespiratory arrests during the swim leg including two successful resuscitations (1/34279 starters) and one fatality (1/68557). The run leg was responsible for most MSK injuries (41.4% of all injuries) and nearly a third (11/38) of all hospital transfers.ConclusionsTriathlons have a high incidence of both illness and injury. The swim leg had the most serious medical conditions whilst the run accounted for most injuries. Triathlon organisers should be aware of these findings to ensure optimal medical care and competitor safety at mass-participation triathlon races.
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