In the recently released USA Triathlon Fatality Incidents Study, the concept of Shared Responsibility was described.

Steven Munatones, a member of the Review Board of the Study, reported, “We believe this concept is a prudent, wise attempt to enhance the level of safety and to minimize the level of risks in the sport of triathlon. By collecting, discussing, analyzing and debating this concept among athletes, coaches, physicians, researchers, administrators and race directors, USA Triathlon developed a welcomed Path Forward.“

This Shared Responsibility concept was separated and shared among three constituencies in the triathlon community: Athletes, Event Organizers and Governing Body (USA Triathlon in this case). Each of the constituencies shared responsibility for the overall safety of the participants in their sport. USA Triathlon’s study described these responsibilities as follows:

• Athletes Responsibilities: Show up for the race healthy, fit, and prepared.
• Event Organizers Responsibilities: Design, plan, and conduct the event with athlete safety as a foremost priority.
• USA Triathlon Responsibilities: Provide tools, resources, education, oversight, and monitoring.

The responsibilities of each constituency was further broken down in concrete steps:

Athlete Responsibilities:

• Visit your doctor for a physical examination with an emphasis on heart health before participating. Unrecognized heart problems are the primary cause of sports-related sudden cardiac death.
• Consult with your doctor about any warning signs during training such as chest pain/discomfort, shortness of breath, lightheadedness, or blacking out.
• Your health, fitness level, and preparation should guide your selection of an appropriate race or event.
• Your race plan should be consistent with your health, fitness level, and preparation.
• Choose an event because it places an emphasis on athlete safety, and is sanctioned by USA Triathlon.
• Practice and prepare for open water swim venues. Race day must not be your first exposure to an open-water swim competition.
• Thoroughly review the race’s website and all pre-race communications so you are knowledgeable on the timetable for race day arrival and preparations.
• Utilize all checklists and information from the event, USA Triathlon and your coach to mentally prepare for the competition.
• Make certain your equipment is safe and working properly. Make certain your wetsuit fits properly. Get your bike checked before the event.
• During the event, STOP at the first sign of a medical problem such as chest pain/discomfort, breathing difficulties, lightheadedness, or unusually high heart rate and seek medical attention. Your life may depend on it. This is particularly important during a race swim, in which rescue poses unique challenges.
• During the event, tend to a fellow athlete who has a medical problem.
• Learn CPR and be prepared to use those skills when needed. Ask your family and other supporters to do the same.
• Visit usatriathlon.org for more information.

Event Organizer Responsibilities:

• The approved safety plan should account for unique features of an event’s location, weather and participants.
• The safety plan should pay particular attention to the possibilities of bike crashes with serious, life-threatening injuries; and sudden cardiac death at any point during the race. There should be rehearsed responses to each of these contingencies.
• The safety plan for the swim portion of an event should be extraordinarily robust so that victims can be identified immediately (within seconds), rescued promptly (within one minute), and CPR and defibrillation can be provided (within minutes).
• The swim course should be designed to meet the goals of quick identification, rescue, and CPR/defibrillation. Looped and close-to-shore courses should be given special consideration. Far-from-shore courses will require additional on-water rescue resources and enhanced communications systems.
• A communication system should be implemented so that on-water rescuers, swim course director, race director, and EMS personnel may coordinate the rescue of a victim of cardiac arrest.
• A mandatory pre-race safety briefing is recommended during which athletes are provided information about the safety plan and reminded about their responsibilities for race safety.
• Provide up-to-date race information to all participants, volunteers and support personnel. Provide spectator information on your website so logistics and other stress inducing details are readily available.
• Design and plan the event to include warm-up opportunities, especially the swim portion.
• Sanction your event with USA Triathlon and follow all rules, guidelines and policies. Visit usatriathlon.org for more information.

Governing Body (USA Triathlon) Responsibilities:

• Provide education about race-related fatalities, causes, and potential solutions in curricula for coaches, race directors, and officials during respective certification courses and the annual USA Triathlon Race Director Symposium.
• Distribute information about the current review to USA Triathlon members, race directors, coaches, and officials and to the wider triathlon community through its entire communications platform.
• Develop an educational series of webinars on topics such as: athletes and heart health; sports-related sudden cardiac death; pre-race anti-anxiety strategies; pre-race warm-up strategies; swimming-induced pulmonary edema (SIPE); bike maintenance; triathlon race swimming for the new triathlete.
• Develop a set of Best Practices tools for athletes and event directors, including: safety considerations for swim course design; race-day communications for emergency medical responses; guidelines for athlete preparedness for races; pre-race safety checklist for athletes. Make these tools available online.
• Conduct a thorough review of sanctioning requirements, including: on-water rescue personnel requirements; communication systems for emergency response; consideration of tiered system of required support, depending upon swim course design; standards for on-water rescue personnel; deployment of AED’s.
• Conduct ongoing review of each new fatality and “near miss” at the time of occurrence. Develop appropriate data collection tools. Relevant data may include air/water temperatures, wind/wave conditions, athlete experience, and compliance with safety plan.
• Review new relevant scientific information and data/recommendations from other National Governing Bodies. Review feedback from all constituents.
• Report annually on event fatalities, injuries, and major medical problems so that athletes, race directors, sponsors, and venues can be aware of the potential risks.

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