Swimmer Fran Crippen dies during race

Fran Crippen, a medal-winning open-water swimmer on the U.S. national team, died on Saturday during the FINA Open Water 10-kilometer World Cup in Fujairah, south of Dubai. The 26 year old was found just 400 meters from the finish line 2 hours later, when a search was launched when Crippen did not finish the race. Initial reports said that Crippen had died from a heart attack or from heat exhaustion, however an official cause of death has not been released. Race officials said a medical report and autopsy had been completed but declined to release details.

Concerns have been raised about the swimming conditions of the race. Although the local FINA officials claim that the water temperature was in the low 80’s, others claim that the temperature outside was 100 degrees and the water temperature was 87 degrees. The winner, German Thomas Lurz, has said:  “The water was amazingly hot…There were many swimmers who had serious problems in the water.” In fact, three other swimmers – two U.S. women and one Brazilian – were taken to a hospital. All were to be released by Monday.

Crippen’s sister, swimmer Maddy Crippen, speaking on Good Morning America this morning said her brother had safety concerns about FINA events:   “The one thing that I do know is that in the months leading up to this event my brother had written letters to different organizing committees about safety, the number of people that were there, the doctors that should be there, the support staff and the lack thereof.”  She plans to honor her brother’s legacy by continuing his push for greater safety measures in long distance races.

People suffer heat-related illness when the body’s temperature control system is overloaded. The body normally cools itself by sweating. But under some conditions, sweating just isn’t enough. In such cases, a person’s body temperature rises rapidly. Very high body temperatures may damage the brain or other vital organs. Several factors affect the body’s ability to cool itself during extremely hot weather. When the humidity is high, sweat will not evaporate as quickly, preventing the body from releasing heat quickly. Other conditions that can limit the ability to regulate temperature include old age, youth (age 0-4), obesity, fever, dehydration, heart disease, mental illness, poor circulation, sunburn, and prescription drug use and alcohol use.

A number of heat illnesses exist including:

  • Heat stroke – Heat stroke is the most serious heat-related illness. It occurs when the body becomes unable to control its temperature: the body’s temperature rises rapidly, the sweating mechanism fails, and the body is unable to cool down. Body temperature may rise to 106°F or higher within 10 to 15 minutes. Heat stroke can cause death or permanent disability if emergency treatment is not provided.

Warning signs of heat stroke vary but may include the following:

  • An extremely high body temperature (above 103°F)
  • Red, hot, and dry skin (no sweating)
  • Rapid, strong pulse
  • Throbbing headache
  • Dizziness
  • Nausea
  • Confusion
  • Unconsciousness

  • Heat exhaustion – Can be a precursor of heatstroke; the symptoms include heavy sweating, rapid breathing and a fast, weak pulse.
  • Heat syncope-body temperature above 40°C (104°F) with fainting. Often considered an earlier stage of heat stroke
  • Heat edema-swelling of the extremities associated with exposure to high temperatures
  • Heat cramps – Muscle pains or spasms that happen during heavy exercise in hot weather.
  • Heat rash – Skin irritation from excessive sweating.
  • Heat tetany – Usually results from short periods of stress in intense heat. Symptoms may include hyperventilation, respiratory problems, numbness or tingling, or muscle spasms.
Mark Boguski, M.D., Ph.D. is on the faculty of Harvard Medical School and is a member of the Society for Participatory Medicine, "a movement in which networked patients shift from being mere passengers to responsible drivers of their health" and in which professional health care providers encourage "empowered patients" and value them as full partners in managing their health and wellness.

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