Mortality in Ironman Races
I got curious about how people die in these races and how often.
Surprise! I expected much more skew to older people. But average age of a competitor is 44, mean and median age of death in a race is 45. Standard deviation is high, 14.2 years. It’s pretty evenly distributed.
Oldest death is 80. Youngest death is 15 on a bike.
Another surprise! There is a skew to youth for heat stroke, with average age of 36 and median of 31. I guess the younger ones are pushing to win, or maybe its that “I’m immortal” feeling of youth. I really did not expect younger people to be more likely to die that way.
Since 1986, there have been 171 deaths. 122 during swim (71.3%), mostly drowning with some heart attacks. 26 during bike (15.2%).
8 deaths during the run (4.7%) and 12 deaths after (7%) (which is probably from the run, which is the hardest on the body — more likely to trigger rhabdomyolysis). Only one case of death from rhabdomyolysis.
17 from probable heat stroke (9.9%) which overlaps with death after the race. (i.e. collapse, unknown, foaming at the mouth, suddenly fell off bike, cardiac arrest w/o heart attack).
Once past the swim, 34.5% of deaths in an Ironman are heat stroke. But heat exhaustion is probably a factor in many of the other the bike event accidents as well, because heat exhaustion saps judgment, slows reaction time, and interferes with coordination. Trust me. I’ve experienced this. You do something like move your hand and miss the handlebar, or think you want to shift and squeeze the brake instead. You are not as aware of surroundings, and your world narrows to a void zone of the wheels and pedals.
It’s a common misconception that heat stroke and dehydration are the same thing — they are not. Dehydration will hasten heat stroke, and in a superbly conditioned athlete dehydration is very likely to be how they develop heat stroke. However, a fully hydrated person can get heat stroke! Other risk factors include higher BMI — which includes muscle. Whether its worse to have excess fat or muscle is unclear. Fat insulates, but it doesn’t metabolize much. Muscle weight results in more effort because it’s excess weight, and it will contribute to heating the body even if it just sits there.
So what’s the risk level overall for Ironman? 22 died in 2019. (So far 2 deaths in 2021. Both drowning.) So I will use that as the most recent year.
About 95,000 people compete in Ironman races each year. Using the 2019 figures, it’s about 23 per 100,000. That’s up there with base jumping, which has 43 per 100,000. We can say the range is in the 20 per 100,000 competitors ballpark.
What’s the risk of Ironman if you remove the swim? That’s a lot lower, about 6 per 100,000 competitors. This is probably comparable to risk from ultramarathons, although those stats are higher because of the occasional disaster like the 21 competitors who died in a hailstorm. However, I don’t have the data to do a real analysis.
Note that triathlon as a whole does not have this level of risk. I don’t know what it is exactly, but short form triathlon doesn’t seem to.
Marathon running has 0.67 deaths per 100,000.
I love triathlon as a sport. I can’t do it, because my knees and back can’t handle the run, and that cycling posture isn’t ok for my herniated discs. (Long story. Accidents mostly.) But I swim, bike and hike. This risk for Ironman is manageable if you are intelligent about it. The vast majority of the danger is in the swim. I have thought for a long time that there should be rescue divers in the water looking at the swim from below just to make sure. I did a lot of swimming, hours at a time in lakes. Water is like flying for swimmers — you can’t just stop and sit down, you have to keep floating.
And then there’s this guy, who did 50 Ironman Triathlons in 50 days.
He’s now going for 100 days with 100 Ironman distances. (Same course each day.) So clearly, the long format triathlon itself is fine if you are in shape for it. However, this guy is in real pain and probably harming his legs and hips for life trying for 100 Ironman type courses in 100 days. (Yes, Ironman people — we know he’s not sanctioned. Cheers.)
If you do a full Ironman race, do it right. Be in shape for the swim. Really. Have good bike control. Be smart about heat stroke, hydrate and maintain electrolytes.
