PT - JOURNAL ARTICLE AU - Saycell, Jane AU - Lomax, Mitch AU - Massey, Heather AU - Tipton, Mike TI - How cold is too cold? Establishing the minimum water temperature limits for marathon swim racing AID - 10.1136/bjsports-2018-099978 DP - 2019 Sep 01 TA - British Journal of Sports Medicine PG - 1078--1084 VI - 53 IP - 17 4099 - http://bjsm.bmj.com/content/53/17/1078.short 4100 - http://bjsm.bmj.com/content/53/17/1078.full SO - Br J Sports Med2019 Sep 01; 53 AB - Objectives To provide a rationale for minimum water temperature rules for elite and subelite marathon swim racing and highlight factors that make individuals vulnerable to excessive cooling during open water swimming.Methods 12 lean competitive swimmers swam for up to 2 hours, three times in different water temperatures between 14°C and 20°C, wearing standard swimming costumes and hats. Rectal temperature (Tre), oxygen consumption, perception of cold and performance were measured.Results In 16°C, half the swimmers did not complete a 2-hour swim; four became (or were predicted to become) hypothermic within 2 hours. In 18°C, three-quarters completed the swim; three became (or were predicted to become) hypothermic. In 20°C, one swimmer was predicted to become hypothermic in under 2 hours. The mean linear rate of fall of Tre was greater in 16°C (−1.57°C/hour) than 18°C (−1.07°C/hour) (p=0.03). There was no change in swimming performance during the swims or between conditions. Most of the cooling rate could be explained by metabolic heat production and morphology for both 16°C (R2=0.94, p<0.01) and 18°C (R2=0.82, p<0.01) conditions. No relationship was observed between Tre and perception of thermal sensation (r=0.25, p=0.13), and there was a weak correlation between Tre and thermal comfort (r=0.32, p=0.04).Conclusion We recommend that 16°C and 18°C water are too cold for elite marathon swim racing. FédérationInternationale de Natation rules were changed in 2017 to make wetsuits compulsory below 18°C and optional below 20°C.