Race car driver deaths article
06-25-2013, 03:16 PM
#31
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I agree with Eric re. spec racing. The inherently slower speeds give one an extra margin of safety. And often the racing is better 
Also agree with Eric that the best screening tool is a very thorough history. Americans do too many damn tests, many of which, as applied, have low pre-test probability, significant rates of false positives/negatives, and both direct and indirect potential for harm. Ok, rant off.
The screening ECG/EKG is not to risk stratify or identify who may have a heart attack. As Circuit mentioned it is virtually a useless test in that regard. There are rare exceptions that can be lifesaving to recognize (look up Wellen's syndrome), but those cases don't statistically support the costs and inconvenience of a screening program. Yes, the intersection of economics and public health
The purpose of the screening ECG is fourfold:
1) To identify those who have already had a heart attack.
2) To identify those who have clinically significant conduction blocks and/or may have an arrhythmia syndrome (Brugada, WPW, etc.).
3) To identify those who may have structural problems, i.e. significant left ventricular wall thickening from unrecognized/untreated high blood pressure, or an outflow obstruction due to septal wall mass (HOCUM).
4) Perhaps most importantly to provoke people to reflect about their cardiac risk factors, fitness, and have an appropriate discussion with their doc.
Italy has a well published series on their ECG sport screening program and there is good evidence to support it in terms of cost:benefit ratios. I think it's a good idea for us, especially since most of us have some degree of grey hair and therefore increased inherent risks from too-many-birthdays syndrome.
Also agree with Eric that the best screening tool is a very thorough history. Americans do too many damn tests, many of which, as applied, have low pre-test probability, significant rates of false positives/negatives, and both direct and indirect potential for harm. Ok, rant off.
The screening ECG/EKG is not to risk stratify or identify who may have a heart attack. As Circuit mentioned it is virtually a useless test in that regard. There are rare exceptions that can be lifesaving to recognize (look up Wellen's syndrome), but those cases don't statistically support the costs and inconvenience of a screening program. Yes, the intersection of economics and public health
The purpose of the screening ECG is fourfold:
1) To identify those who have already had a heart attack.
2) To identify those who have clinically significant conduction blocks and/or may have an arrhythmia syndrome (Brugada, WPW, etc.).
3) To identify those who may have structural problems, i.e. significant left ventricular wall thickening from unrecognized/untreated high blood pressure, or an outflow obstruction due to septal wall mass (HOCUM).
4) Perhaps most importantly to provoke people to reflect about their cardiac risk factors, fitness, and have an appropriate discussion with their doc.
Italy has a well published series on their ECG sport screening program and there is good evidence to support it in terms of cost:benefit ratios. I think it's a good idea for us, especially since most of us have some degree of grey hair and therefore increased inherent risks from too-many-birthdays syndrome.
06-25-2013, 05:18 PM
#32
Banned
This has partially been the reason why I've been racing with Skip Barber MX-5 Series for the last few years. The more I learn about all aspects of other racing alternatives (fun, competitiveness, risk, cost, hassle, etc.) the more I like it. Specifically from a risk perspective, the cars are low HP on street tires, fully caged, plus it must be easier for the mechanics to spot problems as they are looking at the same 30-40 cars all the time. It also must be cheaper to keep the fleet fresh, parts wise, due to economies of scale and deals with parts manufacturers. I intend to speak with management about halo seats, though.
Anyway, yesterday I "Nomexed up" head-to-toe online as a result of these couple of threads here. Will be using it for DE too going forward.
06-25-2013, 05:33 PM
#33
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This is a heck of a good reminder of what can happen especially to older/modified cars. Might not be a bad idea to show it at drivers meetings once in awhile.
06-25-2013, 08:46 PM
#34
Three Wheelin'
Some interesting points made, including those about EKG and racing. I am not sure any have described the actual cause(s) in terms of requirements by SCCA, NASA, PCA and other sanctioning bodies. I very much suspect that litigation risk reduction is a factor/driver.
I have quite a bit of experience with cardiology, but I have never read any literature (if it exists) about periodic EKG evaluation against a baseline for racers with risk factors, which seems to be the essence of the reqs. Not saying it does not exist in general as I suppose it is quite possible that there is literature, perhaps from large studies of specific populations. Heck, it is even possible that my late uncle published in this area, since he ran the Framingham study and helped lead the NIH non-invasive cardiology (EKG/ECHO) activities for years. I just doubt there would be published work specific to stress from auto racing. It would be interesting to know...
If there is no clinical rationale, so be it. But I think there is rationale for folks to have conversations with their HCPs about this hobby in general, especially if they have risk factors. And by hobby, I don't mean to rule out the group that enjoys DE, but not wheel-to-wheel racing. I am sure that at some point along the continuum, the CV stress is at least identical.
I have quite a bit of experience with the literature on heat stress, hydration and human performance. I can envision a scenario where health risks from wearing a layer of nomex underwear and a three layer suit on a 110 degree, 95% humidity day in a fully enclosed GT3 Cup in a club race for certain individuals could be pretty high compared to the same persons without all the gear. But of course they would be more exposed to the risk from injury if there is a fire. But of course we can address both risks so why not do so?
I have quite a bit of experience with cardiology, but I have never read any literature (if it exists) about periodic EKG evaluation against a baseline for racers with risk factors, which seems to be the essence of the reqs. Not saying it does not exist in general as I suppose it is quite possible that there is literature, perhaps from large studies of specific populations. Heck, it is even possible that my late uncle published in this area, since he ran the Framingham study and helped lead the NIH non-invasive cardiology (EKG/ECHO) activities for years. I just doubt there would be published work specific to stress from auto racing. It would be interesting to know...
If there is no clinical rationale, so be it. But I think there is rationale for folks to have conversations with their HCPs about this hobby in general, especially if they have risk factors. And by hobby, I don't mean to rule out the group that enjoys DE, but not wheel-to-wheel racing. I am sure that at some point along the continuum, the CV stress is at least identical.
I have quite a bit of experience with the literature on heat stress, hydration and human performance. I can envision a scenario where health risks from wearing a layer of nomex underwear and a three layer suit on a 110 degree, 95% humidity day in a fully enclosed GT3 Cup in a club race for certain individuals could be pretty high compared to the same persons without all the gear. But of course they would be more exposed to the risk from injury if there is a fire. But of course we can address both risks so why not do so?
06-26-2013, 05:27 AM
#35
Rennlist Member
Nomex is a must but where's the onboard fire system? I would think that buys more time than a suit.
06-26-2013, 08:41 AM
#36
Mr. Excitement
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I agree with the fitness part, and it is something I bring up in racing physicals in similar terms. You don't want racing to be your only fitness activity (or stress test!)
As far as the Nomex, the answer is better cooling and fitness, not giving up on Nomex. From a "public health" perspective, maybe a certain level of driver cooling should be mandated when racing above a given temperature. Some pro series require this.
As far as the Nomex, the answer is better cooling and fitness, not giving up on Nomex. From a "public health" perspective, maybe a certain level of driver cooling should be mandated when racing above a given temperature. Some pro series require this.
06-26-2013, 09:38 AM
#37
Rennlist Member
Along these lines, this site is a resource, very complete and historical:
http://www.motorsportmemorial.org/
http://www.motorsportmemorial.org/
06-26-2013, 09:49 AM
#38
Kinda missed this thread until this morning. I may be the only one from the PCA Med Committee that posts on Rennlist?
I'm fairly new to the Committee, and I asked several questions about our required physicals. As explained to me, ours were derived from a compilation of other, existing sanctioning bodies. I would assume that this occurred many years ago.
I do believe that EKGs play a role, but perhaps a secondary one. They are not useless, but for most I think would show nothing. Perhaps more thorough questioning from the provider about physical tolerance, such as something called METS, or Metabolic Equivalents, which then could lead to further testing. When we look at the volume of racers, and ultimately so relatively few health related significant driving/track issues, there is an element of economics involved. In Anesthesia, we recently went from ordering every test in the book to only tests that are specificially indicated for that patient. For example, 3 years ago we would order an EKG for any male over 50 for any procedure, and now we only order if there is a specific indication such as chest pain.
The PCA Med Committee is starting to review our forms, and what is really necessary based on modern knowledge. Clearly there's some highly educated folks on this thread that are more experienced in this field than me. We welcome and encourage everyone's input.
I'm fairly new to the Committee, and I asked several questions about our required physicals. As explained to me, ours were derived from a compilation of other, existing sanctioning bodies. I would assume that this occurred many years ago.
I do believe that EKGs play a role, but perhaps a secondary one. They are not useless, but for most I think would show nothing. Perhaps more thorough questioning from the provider about physical tolerance, such as something called METS, or Metabolic Equivalents, which then could lead to further testing. When we look at the volume of racers, and ultimately so relatively few health related significant driving/track issues, there is an element of economics involved. In Anesthesia, we recently went from ordering every test in the book to only tests that are specificially indicated for that patient. For example, 3 years ago we would order an EKG for any male over 50 for any procedure, and now we only order if there is a specific indication such as chest pain.
The PCA Med Committee is starting to review our forms, and what is really necessary based on modern knowledge. Clearly there's some highly educated folks on this thread that are more experienced in this field than me. We welcome and encourage everyone's input.
06-26-2013, 10:20 AM
#39
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Kinda missed this thread until this morning. I may be the only one from the PCA Med Committee that posts on Rennlist?
I'm fairly new to the Committee, and I asked several questions about our required physicals. As explained to me, ours were derived from a compilation of other, existing sanctioning bodies. I would assume that this occurred many years ago.
I do believe that EKGs play a role, but perhaps a secondary one. They are not useless, but for most I think would show nothing. Perhaps more thorough questioning from the provider about physical tolerance, such as something called METS, or Metabolic Equivalents, which then could lead to further testing. When we look at the volume of racers, and ultimately so relatively few health related significant driving/track issues, there is an element of economics involved. In Anesthesia, we recently went from ordering every test in the book to only tests that are specificially indicated for that patient. For example, 3 years ago we would order an EKG for any male over 50 for any procedure, and now we only order if there is a specific indication such as chest pain.
The PCA Med Committee is starting to review our forms, and what is really necessary based on modern knowledge. Clearly there's some highly educated folks on this thread that are more experienced in this field than me. We welcome and encourage everyone's input.
I'm fairly new to the Committee, and I asked several questions about our required physicals. As explained to me, ours were derived from a compilation of other, existing sanctioning bodies. I would assume that this occurred many years ago.
I do believe that EKGs play a role, but perhaps a secondary one. They are not useless, but for most I think would show nothing. Perhaps more thorough questioning from the provider about physical tolerance, such as something called METS, or Metabolic Equivalents, which then could lead to further testing. When we look at the volume of racers, and ultimately so relatively few health related significant driving/track issues, there is an element of economics involved. In Anesthesia, we recently went from ordering every test in the book to only tests that are specificially indicated for that patient. For example, 3 years ago we would order an EKG for any male over 50 for any procedure, and now we only order if there is a specific indication such as chest pain.
The PCA Med Committee is starting to review our forms, and what is really necessary based on modern knowledge. Clearly there's some highly educated folks on this thread that are more experienced in this field than me. We welcome and encourage everyone's input.
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06-26-2013, 11:12 AM
#40
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After reading the article and thread i was wondering if anyone who races here wears a heart monitor while in the car? On a side note i just received my scca license and will be running a SRF and have been training more than usual for the hot heat here in the Northeast. The trainer i am working with has me wearing a heart monitor at all times and said to try it in the car to see how my heart reacts to certain situations and the heat. Just wondering if any others do this and how you use it to train yourself mentally and physically for the heat.
God Speed all who were lost this past week. Im still upset about the Le Mans crash and feel they could have had the safety wall nascar uses in more areas. Motorcycle races on streets use bag systems, i know a car weighs more but to me the safety of the track at Le Mans in certain sections should be reviewed.
God Speed all who were lost this past week. Im still upset about the Le Mans crash and feel they could have had the safety wall nascar uses in more areas. Motorcycle races on streets use bag systems, i know a car weighs more but to me the safety of the track at Le Mans in certain sections should be reviewed.
06-26-2013, 11:36 AM
#41
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If there is no clinical rationale, so be it. But I think there is rationale for folks to have conversations with their HCPs about this hobby in general, especially if they have risk factors.
I have quite a bit of experience with the literature on heat stress, hydration and human performance. I can envision a scenario where health risks from wearing a layer of nomex underwear and a three layer suit on a 110 degree, 95% humidity day in a fully enclosed GT3 Cup in a club race for certain individuals could be pretty high compared to the same persons without all the gear.
I have quite a bit of experience with the literature on heat stress, hydration and human performance. I can envision a scenario where health risks from wearing a layer of nomex underwear and a three layer suit on a 110 degree, 95% humidity day in a fully enclosed GT3 Cup in a club race for certain individuals could be pretty high compared to the same persons without all the gear.
I think there is a clinical rationale. Despite the fact the pickup rate is low, the conditions I referred to (conduction block, arrhythmia syndromes, outflow obstruction) can cause a loss of consciousness with or without a pulse. Not a good thing to have happen in a car. And of course, identifying those with untreated hypertension or a previous heart attack (some of which are occult) are other subgroups re. risk of an event.
Absolutely agree with you re. heat stress/exhaustion/stroke risks. We spend lots of time putting extra oil/fluid coolers on our cars. We should do the same for our bodies and heads
Last edited by jdistefa; 06-26-2013 at 12:11 PM. Reason: grammar, ugh
06-27-2013, 12:53 PM
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06-27-2013, 01:18 PM
#43
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I often times wear a heart monitor when cycling, as many of us do. It really is a big help in knowing when to push and when you're maxing, a useful aid. But for car racing, I wouldn't even look at it.
06-27-2013, 01:52 PM
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06-27-2013, 02:07 PM
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[QUOTE=gums;10569990]I often times wear a heart monitor when cycling, as many of us do. It really is a big help in knowing when to push and when you're maxing, a useful aid. But for car racing, I wouldn't even look at it.[/QUOTEC]
Exactly. I use it when training on the bike as well, and heart rate / threshold training is invaluable for maximizing your performance in endurance sports...but not, as we seem to agree, for providing useful data (or detecting when your might be close to a stroke or heart attack) in a car racing environment.
Exactly. I use it when training on the bike as well, and heart rate / threshold training is invaluable for maximizing your performance in endurance sports...but not, as we seem to agree, for providing useful data (or detecting when your might be close to a stroke or heart attack) in a car racing environment.