Play It Safe

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There must be something to it. Many national organizations insist that your clients wear ASTM/SEI-approved helmets while competing, along with padded vests for eventing. And many horse professionals work hard at home to ensure proper safety attire and precautions remain in place, because everyone knows that riding carries a certain amount of risk.

But, where’s the proof? We’ve rounded up the most relevant studies that confirm that riders can, and do, get hurt.

First, consider the report published in the American Journal of Surgery. This team of trauma surgeons and an occupational therapist from the University of Calgary/Calgary Health Region in Canada have recommend that everyone who rides wear helmets and vests to prevent major, life-altering injuries.

After reviewing the charts of 7,941 trauma patients treated at Foothills Medical Centre in Calgary between 1995 and 2005, the authors found that 151 people were severely injured while horseback riding during that 10-year period, with 45 percent of them requiring surgery.

And the group had an average of 27 years’ experience and were injured while riding horses that were also experienced. Ball cites an even more specific number derived from previous studies, which shows “the hospital admission rate associated with equestrian activity is .49/1,000 hours of riding. The rate when motorcycle riding is .14/1,000 hours.”

The study notes that “chest trauma has previously been underappreciated” and reports that most riding accidents occurred in “wide-open spaces (45%), and on relatively good footing surfaces (38% dry dirt and 37% uncultivated land), on sunny (87%), summer afternoons (55%).”

“Previous studies assumed that major accidents on horseback were caused by rookie riders on untrained horses or bad weather—something we now know is simply not true,” says Dr. Rob Mulloy, a clinical assistant professor of surgery in Univ. of Calgary’s Faculty of Medicine, and a Calgary Health Region trauma surgeon. Here’s the shocker: “While 64% of the riders we interviewed believe their accident was preventable, only 9% were wearing helmets.”

Trauma Drama

According to the Centers for Disease Control and Prevention (CDC), an estimated 30 million people ride horses each year in the United States, and horseback riding causes the highest proportion of traumatic brain injuries (11.7%) among sports-related recreational activities, followed by ice skating (10.4%), all-terrain vehicles (8.4%), tobogganing or sledding (8.3%), and bicycling (7.7%).

Specialists at that agency’s Office of Statistics and Programming, National Center for Injury Prevention and Control (NCIPC) in Atlanta, Georgia, set out to characterize and provide nationally representative estimates of persons with non-fatal horse-related injuries treated in American emergency departments between 2001 and 2003. They found that an estimated 102,904 persons with non-fatal horse related injuries were treated each year. Non-fatal injury rates were higher for females (41.5 per 100,000) than for males (29.8 per 100,000): Fair enough, as more women ride than do men.

Most patients were injured while mounted (66.1%), commonly from falling or being thrown—while not mounted, they were injured from being kicked. Body parts most often injured were the head/neck region (23.2%), lower extremity (22.2%), and upper extremity (21.5%). The most common principal diagnoses were contusions/abrasions (31.4%) and fractures (25.2%). For each year studied, an estimated 11,502 people sustained traumatic brain injuries from horse-related incidents. Overall, more than 11% of those injured were admitted to the hospital.

The conclusion states that horse-related injuries are a public health concern not just for riders, but for anyone in close contact with equines. “Prevention programs should target horseback riders and horse caregivers to promote helmet use and educate participants about horse behavior, proper handling of horses and safe riding practices.”

Protect the Head

Another excellent example appeared in the Journal of Emergency Nursing in 2005, reviewing horse-related injuries in a rural Colorado hospital and citing implications, not just for using headgear, but for needed outreach education. “The [medical] literature contains many studies on the types of injuries sustained in horseback riding incidents,” say the authors. “Most advocate the use of equestrian helmets to prevent head trauma. However, information is limited on other specific prevention strategies.”

Researchers reviewed four years of medical records pertaining to horse-related injuries in a southwestern Colorado hospital, and that yielded a sample of 85 patients, ages 2 to 77, injured while riding or tending to horses: 55% percent were inexperienced or beginner riders, 10% were novice riders, and 35% were experienced riders; 70% were injured during recreational pursuits, in other words, actually riding. The average “Injury Severity Score” for all patients was 8.5 (out of 10), with an average length of stay of 72 hours. Injuries were related to rider inexperience, equipment problems, or unpredictable horse behavior. The study concluded that 38% of horse-related injuries were preventable. Study authors encourage what you’re probably already doing as a responsible barn owner or trainer. “It is hoped that raising awareness and providing suggestions related to the screening of riders, prevention of injuries, and safety measures may decrease the numbers of horse-related injuries.”

Don’t Drink and Ride

Next comes an article published in the Scandinavian Journal of Surgery, by physicians at the Division of Trauma and Surgical Critical Care Services, Memorial Regional Hospital, Hollywood, Florida. The Florida authors state that between January 2000 and December 2003, the popularity of recreational horseback riding increased in south Florida, along with associated traumatic injuries.

The doctors identified 27 patients during the review period with an average age of 36 years. The injuries, they say, occurred during pleasure riding in 23 patients and Thoroughbred-related activities in 4 patients. Multiple severe injuries were common and documented in 24 patients, and all required an average 5-day hospitalization. Five patients had positive toxicology screens, but no deaths were documented.

The formal study conclusion will not surprise: “Horseback riding-related injuries tend to be serious. Alcohol and recreational drugs may exacerbate the extent of these injuries.”

Yes, accidents happen. But, hopefully, with an industry effort to address safety concerns, the accident rate can reach new lows.