Hypothesised mechanisms of swimming-related death: A systematic review

Chad A. Asplund, Lawrence L. Creswell

Research output: Contribution to journalReview article

6 Citations (Scopus)

Abstract

Background Recent reports from triathlon and competitive open-water swimming indicate that these events have higher rates of death compared with other forms of endurance sport. The potential causal mechanism for swimming-related death is unclear. Objective To examine available studies on the hypothesised mechanisms of swimming-related death to determine the most likely aetiologies. Material and methods MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews (1950 to present) were searched, yielding 1950 potential results, which after title and citation reviews were reduced to 83 possible reports. Studies included discussed mechanisms of death during swimming in humans, and were Level 4 evidence or higher. Results A total of 17 studies (366 total swimmers) were included for further analysis: 5 investigating hyperthermia/hypothermia, 7 examining cardiac mechanisms and responses, and 5 determining the presence of pulmonary edema. The studies provide inconsistent and limited-quality or disease-oriented evidence that make definitive conclusions difficult. Conclusions The available evidence is limited but may suggest that cardiac arrhythmias are the most likely aetiology of swimming-related death. While symptoms of pulmonary edema may occur during swimming, current evidence does not support swimming-induced pulmonary edema as a frequent cause of swimming-related death, nor is there evidence to link hypothermia or hyperthermia as a causal mechanism. Further higher level studies are needed.

Original languageEnglish (US)
Pages (from-to)1360-1366
Number of pages7
JournalBritish journal of sports medicine
Volume50
Issue number22
DOIs
StatePublished - Nov 2016

Fingerprint

Pulmonary Edema
Hypothermia
Fever
MEDLINE
Sports
Cardiac Arrhythmias
Databases
Mortality
Water

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Hypothesised mechanisms of swimming-related death : A systematic review. / Asplund, Chad A.; Creswell, Lawrence L.

In: British journal of sports medicine, Vol. 50, No. 22, 11.2016, p. 1360-1366.

Research output: Contribution to journalReview article

Asplund, Chad A. ; Creswell, Lawrence L. / Hypothesised mechanisms of swimming-related death : A systematic review. In: British journal of sports medicine. 2016 ; Vol. 50, No. 22. pp. 1360-1366.
@article{1d483952221140608ef7ddb9514db2c3,
title = "Hypothesised mechanisms of swimming-related death: A systematic review",
abstract = "Background Recent reports from triathlon and competitive open-water swimming indicate that these events have higher rates of death compared with other forms of endurance sport. The potential causal mechanism for swimming-related death is unclear. Objective To examine available studies on the hypothesised mechanisms of swimming-related death to determine the most likely aetiologies. Material and methods MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews (1950 to present) were searched, yielding 1950 potential results, which after title and citation reviews were reduced to 83 possible reports. Studies included discussed mechanisms of death during swimming in humans, and were Level 4 evidence or higher. Results A total of 17 studies (366 total swimmers) were included for further analysis: 5 investigating hyperthermia/hypothermia, 7 examining cardiac mechanisms and responses, and 5 determining the presence of pulmonary edema. The studies provide inconsistent and limited-quality or disease-oriented evidence that make definitive conclusions difficult. Conclusions The available evidence is limited but may suggest that cardiac arrhythmias are the most likely aetiology of swimming-related death. While symptoms of pulmonary edema may occur during swimming, current evidence does not support swimming-induced pulmonary edema as a frequent cause of swimming-related death, nor is there evidence to link hypothermia or hyperthermia as a causal mechanism. Further higher level studies are needed.",
author = "Asplund, {Chad A.} and Creswell, {Lawrence L.}",
year = "2016",
month = "11",
doi = "10.1136/bjsports-2015-094722",
language = "English (US)",
volume = "50",
pages = "1360--1366",
journal = "British Journal of Sports Medicine",
issn = "0306-3674",
publisher = "BMJ Publishing Group",
number = "22",

}

TY - JOUR

T1 - Hypothesised mechanisms of swimming-related death

T2 - A systematic review

AU - Asplund, Chad A.

AU - Creswell, Lawrence L.

PY - 2016/11

Y1 - 2016/11

N2 - Background Recent reports from triathlon and competitive open-water swimming indicate that these events have higher rates of death compared with other forms of endurance sport. The potential causal mechanism for swimming-related death is unclear. Objective To examine available studies on the hypothesised mechanisms of swimming-related death to determine the most likely aetiologies. Material and methods MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews (1950 to present) were searched, yielding 1950 potential results, which after title and citation reviews were reduced to 83 possible reports. Studies included discussed mechanisms of death during swimming in humans, and were Level 4 evidence or higher. Results A total of 17 studies (366 total swimmers) were included for further analysis: 5 investigating hyperthermia/hypothermia, 7 examining cardiac mechanisms and responses, and 5 determining the presence of pulmonary edema. The studies provide inconsistent and limited-quality or disease-oriented evidence that make definitive conclusions difficult. Conclusions The available evidence is limited but may suggest that cardiac arrhythmias are the most likely aetiology of swimming-related death. While symptoms of pulmonary edema may occur during swimming, current evidence does not support swimming-induced pulmonary edema as a frequent cause of swimming-related death, nor is there evidence to link hypothermia or hyperthermia as a causal mechanism. Further higher level studies are needed.

AB - Background Recent reports from triathlon and competitive open-water swimming indicate that these events have higher rates of death compared with other forms of endurance sport. The potential causal mechanism for swimming-related death is unclear. Objective To examine available studies on the hypothesised mechanisms of swimming-related death to determine the most likely aetiologies. Material and methods MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews (1950 to present) were searched, yielding 1950 potential results, which after title and citation reviews were reduced to 83 possible reports. Studies included discussed mechanisms of death during swimming in humans, and were Level 4 evidence or higher. Results A total of 17 studies (366 total swimmers) were included for further analysis: 5 investigating hyperthermia/hypothermia, 7 examining cardiac mechanisms and responses, and 5 determining the presence of pulmonary edema. The studies provide inconsistent and limited-quality or disease-oriented evidence that make definitive conclusions difficult. Conclusions The available evidence is limited but may suggest that cardiac arrhythmias are the most likely aetiology of swimming-related death. While symptoms of pulmonary edema may occur during swimming, current evidence does not support swimming-induced pulmonary edema as a frequent cause of swimming-related death, nor is there evidence to link hypothermia or hyperthermia as a causal mechanism. Further higher level studies are needed.

UR - http://www.scopus.com/inward/record.url?scp=84994762976&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84994762976&partnerID=8YFLogxK

U2 - 10.1136/bjsports-2015-094722

DO - 10.1136/bjsports-2015-094722

M3 - Review article

C2 - 26941276

AN - SCOPUS:84994762976

VL - 50

SP - 1360

EP - 1366

JO - British Journal of Sports Medicine

JF - British Journal of Sports Medicine

SN - 0306-3674

IS - 22

ER -