Horse-related Injuries Research Articles

Horse‐Related Injuries Among Agricultural Household Members: Regional Rural Injury Study II (RRIS‐II)

To determine the incidence, associated consequences, and potential risk factors for horse-related injuries among youth and adults residing in Midwestern agricultural households. Demographic, injury, and exposure data were collected for 1999 and 2001 among randomly selected agricultural households within a 5-state region. A causal model facilitated survey design, data analysis, and interpretation of results; directed acyclic graphs guided multivariate modeling. From 7,420 households (84% response of eligible), involving 32,601 persons, 5,045 total injury events were reported; 1,016 were animal-related injuries, of which 215 (21%) were horse-related (rate, 6.7 events per 1,000 persons per year). Seventy-seven percent (77%) required health care; comparing those under age 20 and those 20 and older, 49% and 54%, respectively, lost work time on their operation (28% and 26%, one week or more), as a result of injuries largely associated with horse riding activities (70% and 56%). Multivariate analysis for youths under age 20 indicated: increased risks in North and South Dakota, for >0 hours worked, and for having a history of prior agriculture-related injury; and decreased risks for males. For those 20 and older, increased risks were identified for a prior injury history and less than high school education. Horse-related injuries, primarily associated with riding activities, are a significant problem among agricultural communities, and greatly impact their operations.

Body Mass Index and Serum γ‐glutamyltransferase Level as Risk Factors for Injuries Related to Professional Horse Racing: A Prospective Study

Prevention of horse-related injuries is considered difficult because horse behavior is unpredictable. Therefore, risk factors for injuries related to professional horse racing need to be investigated. We conducted a study to determine whether body mass index (BMI) and gamma-glutamyltransferase (GGT) levels are associated with professional horse racing-related injuries. A baseline healthy survey of 546 male grooms and exercise riders aged 40-70 yr working at Miho Training Center, the largest racing-horse training facility in Japan, was performed in May 2003. A total of 93 occupational injuries occurred from June 1, 2003 to December 31, 2005. The Cox proportional hazards model was used to examine associations between the risk of injury and BMI and GGT. Grooms and exercise riders with BMI <20 kg/m2 or with BMI > or =25 kg/m2 compared to BMI=20.0-22.9 kg/m(2) had 2.5 to 3.5-fold higher age-adjusted risks of injuries. The multivariate hazard ratios (95% confidence interval) after adjustment for age, GGT, smoking habit, and history of injuries were 3.5 (1.5 to 8.4) and 2.4 (1.2 to 4.8) for grooms, 3.1 (1.2 to 8.2) and 1.9 (0.4 to 10.1) for exercise riders, respectively. The age-adjusted hazard ratio of injuries for persons with GGT > or =100 IU/l was 2.0 to 2.5-fold higher than for those with GGT <60 IU/l. The multivariate hazard ratios were 1.9 (1.0 to 3.6) for grooms and 2.5 (1.0 to 6.2) for exercise riders. Low and high BMI and high GGT were associated with professional horse racing-related injuries.

Accidentes graves provocados por caballos. Alertas y pautas de prevención

Introduction Children's equestrian activities in the domestic, play activities, sports and educational areas are relatively frequent, and are not exempt from risks. Nevertheless, there is a lack of data on horse-related injuries, their circumstances and the key points for their prevention. Method Retrospective and descriptive study of pediatric equestrian injuries admitted to Hospital between July 1997 and September 2008. Results A total of 17 patients with ages between 4 and 17 years were analyzed. There were 14 accidental falls, 2 kicks and 1 bite, and 8 patients had lost consciousness after the accident. Only 1 patient used a protective helmet. There were 3 skull fractures, 4 intracranial haemorrhages, 1 pneumoencephalus and 2 diffuse axonal injuries. There were also 4 long bone fractures, 1 jaw fracture, 1 vertebral wedging and 1 partial ear avulsion were recorded. A total of 8 patients required intensive care, 2 underwent neurosurgery due to an intracranial haematoma and 4 surgical fracture reduction. Conclusions Horse handling by children and teenagers can be a high risk activity. In our cases brain trauma was the most common and severe injury. Due to the poor use of protection devices by our patients, we believe it is now necessary to take measures to increase safety in equestrian activities.

Equestrian-Related Injuries: Implications for Treatment in Plastic Surgery

Equestrian activities have always been popular in the United States. As safety guidelines have become more stringent, horse-related injuries have diminished by 40 percent over the past 20 years. Although perhaps less critical than in the past, injuries to equestrians most frequently involve the face, upper extremity, and lower extremity and are commonly evaluated by the plastic surgeon. The purpose of this study was to determine the characteristics of these equestrian-related injuries. The National Electronic Injury Surveillance System database is a stratified probability sample of hospitals in the United States. The database was queried for mechanisms of equestrian-related injuries, and probability estimates were obtained based on 1200 cases reported for the year 2005 in the United States. Based on the National Electronic Injury Surveillance System query, the most commonly injured areas are the upper extremities, lower extremities, and face. Common mechanisms of injury include fall from a horse (60 percent), stepped on by a horse (11 percent), kicks (11 percent), and bites (3 percent). The authors present four illustrative case reports seen in their institution. Equestrian injuries are commonly seen by plastic surgeons. Proper evaluation of the characteristics and mechanisms of injury can lead to optimal care and outcomes.

Analysis of horse-related injuries in children

The purpose of the present study was to investigate factors affecting the nature, characteristics, severity and outcome of horseback and horse care injuries in paediatric patients and to create guidelines for injury prevention. Detailed clinical records of 265 children sustained horse-riding related injuries have been analysed. Questionnaires were mailed to provide follow-up information for patients who have been treated in either Department of Paediatric Surgery in Pécs, Hungary, or Department of Paediatric Surgery in Graz, Austria between 1999 and 2003. Those 112 children (42%) who answered the questionnaire were included in the study and further analyses were performed. Female to male ratio of the 112 patients was 101/11. Trauma occurred during horseback riding accounted for 76.8% of all cases; these injuries represented more severe cases comparing to those which happened while handling a horse (23.2%). The mechanism as well as the localisation of injury displayed a close association with age. Prevention strategies targeting horse-related injuries at children should appreciate the age-dependent nature of injury as well as the fact that injury severity is not necessarily associated with the experience of the rider.

Paediatric and adolescent horse‐related injuries: Does the mechanism of injury justify a trauma response?

To identify the frequency, variety and disposition of horse-related injury presentations to the ED and to use this information to evaluate the existing institutional trauma team activation criteria following horse-related injuries. A retrospective case analysis was performed of all horse-related injury presentations to the ED of Women's and Children's Hospital, Adelaide, Australia, in the 5 year period between January 1999 and December 2003. A total of 186 children presented with horse-related injuries during the 5 year study period. The median age of injury was 9 years (range 1-17 years), with 81% of presentations female and 60% of patients hospitalized. The mechanism of injury was divided into four groups: 148 falls (79%), 28 kicks (15%), 7 tramples (4%) and 5 bites (3%). There was one death. Seven presentations rated an Injury Severity Score >15, with full trauma team activation occurring for two of these presentations. Although horse-related injury presentations are uncommon, severe injuries do occur. Patients presenting with severe horse-related injuries do not always activate a full trauma team response based on current trauma team activation criteria. These severe injury presentations are supported by a limited trauma team response, which activates on the mechanism of injury. The effectiveness of this as a contingency system needs to be evaluated.

Injuries and Illnesses of Big Game Hunters in Western Colorado: A 9-Year Analysis

The purpose of this study was to characterize big game hunter visits to a rural hospital's emergency department (ED). Using data collected on fatalities, injuries, and illnesses over a 9-year period, trends were noted and comparisons made to ED visits of alpine skiers, swimmers, and bicyclists. Out-of-hospital hunter fatalities reported by the county coroner's office were also reviewed. Cautionary advice is offered for potential big game hunters and their health care providers. Self-identified hunters were noted in the ED log of a rural Colorado hospital from 1997 to 2005, and injury or illness and outcome were recorded. Additional out-of-hospital mortality data were obtained from the county coroner's office. The estimated total number of big game hunters in the hospital's service area and their average days of hunting were reported by the Colorado Division of Wildlife. The frequencies of hunters' illnesses, injuries, and deaths were calculated. A total of 725 ED visits--an average of 80 per year--were recorded. Nearly all visits were in the prime hunting months of September to November. Twenty-seven percent of the hunter ED patients were Colorado residents, and 73% were from out of state. Forty-five percent of the visits were for trauma, 31% for medical illnesses, and 24% were labeled "other." The most common medical visits (105) were for cardiac signs and symptoms, and all of the ED deaths (4) were attributed to cardiac causes. The most common trauma diagnosis was laceration (151), the majority (113) of which came from accidental knife injuries, usually while the hunter was field dressing big game animals. Gunshot wounds (4, < 1%) were rare. Horse-related injuries to hunters declined while motor vehicle- and all-terrain vehicle (ATV)-related injuries increased. The five out-of-hospital deaths were cardiac related (3), motor vehicle related (1), and firearm related (1). Fatal outcomes in big game hunters most commonly resulted from cardiac diseases. Gunshot injuries and mortalities were very low in this population. Knife injuries were common. Hunters and their health care providers should consider a thorough cardiac evaluation prior to big game hunts. Hunter safety instructors should consider teaching aspects of safe knife use. Consideration should be given to requiring and improving ATV driver education.

Non-fatal horse related injuries treated in emergency departments in the United States, 2001–2003

Non-fatal horse related injuries treated in emergency departments in the United States, 2001–2003

Five year analysis of Jockey Club horse-related injuries presenting to a trauma centre in Hong Kong

Professional horse riding-related injuries have not been studied before in Hong Kong, although horse racing takes place very regularly in the territory. In addition, the equestrian events of the 2008 Beijing Olympic Games will come to Hong Kong. This study analysed the pattern of horse-related injury among patients who presented to a trauma centre in a teaching hospital in Hong Kong. Information from the trauma centre database was analysed retrospectively. The database includes trauma patients who had sustained potentially severe injuries that warranted initial assessment and resuscitation in a trauma resuscitation room (triage category 1 or 2). Data analysed included demographic variables, causes and mechanisms of injury, anatomical injuries, anatomical and physiological trauma scores, and patient outcome. Between January 2001 and June 2005, 2312 trauma patients were entered into the database. Thirty-six (1.6%) patients had sustained horse-related injuries (mean age 34 years, range 17-54; male to female ratio 32:4), all whilst at work in the Jockey Club. Twenty-two patients were injured between midnight and 09:00 h. This group stayed in the resuscitation room for longer prior to admission compared with patients presenting between 09:00h and midnight (median time 127 min (interquartile range [IQR] 57-183) versus 58 min (IQR 43-83), p=0.06). Twenty-five patients fell from horseback, whilst 11 were kicked by the horse. Twenty patients had a single injury and 16 patients had multiple injuries. Eighteen patients had injuries to the thorax, abdomen, thoracolumbar spine or pelvis. Eleven patients had head, face and cervical spine injuries and 11 had limb injuries. Twenty-five patients were admitted, including four admitted to the intensive care unit (ICU). Ten patients required surgery. Median (standard deviation [S.D.]) probability of survival was 0.996 (0.052) and median revised trauma score (RTS) (S.D.) was 7.841 (0.624). There were no fatalities. Potentially serious horse-related injuries presented once every 6 weeks. Most injuries are minor and affect the trunk but occur out of hours. Helmets, face shields and body protectors should be worn when riding or handling horses.

Non-fatal horse related injuries treated in emergency departments in the United States, 2001–2003

Objective: To characterise and provide nationally representative estimates of persons with non-fatal horse related injuries treated in American emergency departments. Methods: The National Electronic Injury Surveillance System All Injury Program...

Horse-Related Injuries and Deaths in North Carolina, 1995-1999

Horse-Related Injuries and Deaths in North Carolina, 1995-1999

Injuries to Youth Living on U.S. Farms in 2001with Comparison to 1998

To obtain sustained injury surveillance data for youth on farms, the National Institute for Occupational Safety and Health developed the Childhood Agricultural Injury Survey (CAIS) in collaboration with the U.S. Department of Agriculture. The first CAIS collected data for youth less than 20 years in 1998 through a regionally stratified telephone survey of 50,000 U.S. farm households; a second CAIS for 2001 was conducted using the same methodology. In 2001, there were approximately 1.2 million youth living on U.S. farms. These youth suffered an estimated 19,397 injuries (15.7/1,000 household youth). Approximately 60% (11,571) of the household youth injuries were to males. For all household youth, 10-15 year olds experienced the most injuries (49%, 9,486). In addition to providing estimates of demographics, injuries, and injury rates for household youth from the 2001 CAIS, this article provides a comparison to results from the 1998 CAIS. The number of household youth injuries on farms from 1998 to 2001 decreased by almost 30% (27,321 vs. 19,397). The results of this study show an overall decrease in the injury rate for youth living on the farm from 1998 to 2001 (18.8/1,000 household youth vs. 15.7/1,000 household youth). However, there was a considerable increase in the number of injuries to household females less than 20 years of age during this same time period. There was also an increase in the number of all terrain vehicle (ATV) and horse-related injuries. Continued surveillance is needed to assess if these are significant trends or the result of changing farm demographics.

Horse-related Injuries and Deaths in Western Montana

Horse-related Injuries and Deaths in Western Montana

A Review of Horse-Related Injuries in a Rural Colorado Hospital: Implications for Outreach Education

The literature contains many studies on the types of injuries sustained in horseback riding incidents. Most advocate the use of equestrian helmets to prevent head trauma. However, information is limited on other specific prevention strategies. A 4-year, retrospective, and prospective review of medical records pertaining to horse-related injuries in a southwestern Colorado hospital yielded a sample of 85 patients who had been injured while riding or tending to horses. In addition to the record review, patients were interviewed during ED discharge, inpatient treatment, or in a follow-up telephone call to determine the types, causes, and mechanisms of injuries, and the circumstances surrounding the incidents. Operators of 7 guest ranches and outfitters within a 30-mile radius of the hospital plus 3 ranches in Oklahoma and an additional ranch in Colorado were contacted with the study results and suggestions for injury prevention. Patients ranged in age from 2 to 77 years. Fifty-five percent were inexperienced or beginner riders, 10% were novice riders, and 35% were experienced riders. Seventy percent were injured during recreational pursuits. The average Injury Severity Score for all patients was 8.5, with an average length of stay of 72 hours. Injuries were related to rider inexperience, equipment problems, or unpredictable horse behavior. Thirty-eight percent of the horse-related injuries were preventable. All operators of the guest ranches and outfitters were receptive to hearing or reading the study information. 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.

Horse-Related Injuries: a Local Scene

Objectives To study the characteristics and nature of injuries relating to horse riding in the local setting and to compare the findings with those reported in the medical literature. Methods A prospective survey of patients with horse-related injuries attending the accident and emergency department of a public district hospital in Hong Kong within the year 2002. The data were analysed and compared with previous studies. Results Fifty-five patients were collected in the study. The mean age was 32.7 years. Forty-four (80.0%) of them were riders and 11 (20.0%) were non-riders. Thirteen (23.6%) were grooms. Fifteen patients (27.3%) were admitted and seven (46.7%) of those admitted required operations. There was no fatality. Thirty-nine patients (70.9%) suffered from single injury while the rest (29.1%) had multiple injuries. Most injuries (60.0%) were minor but fractures or dislocations occurred in 16 patients (29.1%). Isolated head and facial injuries occurred in 14.5% of patients. Most were simple concussion. Thirteen patients (23.6%) suffered from isolated upper limb injuries, with more than half sustaining fractures or dislocations. Falling from horse (60.0%) was the most frequent mechanism of injury. Among the non-riding patients, 72.7% were kicked or trodden by horse. There was no association between rider's status, previous riding or injury experiences, or the presence of supervision at the time of riding with the rate of admission. Conclusion Horse riding and working with horses can be an occupation or recreation with potential dangers. In our study, characteristics of patients, mechanisms and types of injuries were similar to other western studies. However, professional riders and those with more riding experiences were not exempted from severe injuries requiring admission. Moreover, previous injury experiences and the presence of supervision did not help reduce the admission rate either. Perhaps, as suggested by other studies, the quality of horsemanship and supervision appeared to be more important to reduce accidents. Further proper large scale controlled epidemiological studies will definitely help to improve the understanding of horse-related injuries.

Factors affecting the severity of horse-related injuries

Horse riding and handling are uniquely dangerous. Knowledge of the risk factors of horse-related injuries is essential to prevent them. We aimed to define the factors that affect the severity of horse-related injuries and the length of hospital stay. A number of 231 patients (136 females and 95 males) with horse-related injuries were studied. A generalized linear model was used to test the effect of age, sex, cause of injury, complexity of the mechanism of injury, year, place of injury and profession of the injured, on the injury severity score (ISS) and the hospital stay. Fall from a horse was the most common cause of injury (67%). Most of the patients were non-professional (153, 66%). Females were significantly younger than males ( P<0.001, t-test). Statistical analysis showed that the primary mechanism of injury ( F=2.73, P=0.014) and the complexity of this mechanism ( F=4.47, P=0.013) significantly affected the duration of hospital stay. None of the studied variables affected the injury severity score. The mechanism of the horse-related injuries and their complexity significantly affected the duration of hospital stay but not the injury severity score.

Non-fatal animal related injuries to youth occurring on farms in the United States, 1998

Objective—To provide data on the magnitude and patterns of animal related on-farm injuries to youth in the United States. Data source—A survey of 26 000 farm households conducted for the...

Horse-related injuries in children.

To identify the frequency, spectrum and outcome of horse-related injuries in children. Retrospective case series of horse-related injuries in children admitted to the Children's Hospital at Westmead (CHW) from January 1988 to December 1999, the John Hunter Children's Hospital (JHCH) from January 1991 to December 1997 and deaths reported to the New South Wales Paediatric Trauma Death (NPTD) Registry from January 1988 to December 1999. Circumstances of injury; helmet use; adult supervision; type and number of injuries identified. 232 children were admitted with horse-related trauma, 97 to the CHW over 12 years and 135 to JHCH over seven years, with one death at each hospital. There were six deaths reported to the NPTD Registry over 12 years. The median age was 11 years (range, 1-17). Girls accounted for 65% of those injured and 75% of children were injured while riding. Falls caused the injury in 76.3% of cases. Head and upper-limb trauma accounted for 216 of the injuries (73%). Five out of six children with severe head injuries died. In the CHW group, helmet use was documented in only 24 riders (38%) and adult supervision in 22 (22.9%). Horse-related trauma accounts for a considerable number of deaths and injuries in children in NSW. The use of a Standards-approved helmet for riding or horse-related activities might have decreased the severity of head injuries.

Horse-related injuries in a thoroughbred stabling area in Japan.

To investigate the demographic details and patterns of injuries related to horse handling, we reviewed 637 horse-related injuries in 581 stable- or stud-workers in a representative area of thoroughbred stabling in Japan. We found that (1) injuries occurred most frequently in a group of a relatively young workers, with a seasonal variation; (2) the principal mechanism of injury was kicks, which accounted for 39.2% of all injuries, including 11 serious and one lethal visceral injuries; (3) the upper half of the body was more frequently involved than the lower half; and (4) the peripheral bones (hand and foot) and the ribs accounted for more than half of 148 fractures. These findings are distinct from those in horse-riding injuries reported in the literature and emphasize the importance in developing preventive strategies specifically for workers in horse stables.

Horse-related injuries in pediatric patients

Purpose: The aim of this study was to describe the characteristics, nature, severity and outcome of injuries from horse-related trauma in pediatric patients, aged of 19 years or younger. Methods: Retrospective analysis was conducted of 315 patients recorded in the National Pediatric Trauma Registry from February 1995 to August 1999. Results: A total of 62% of the 315 patients were girls. The median age of injury was 10 years. Sixty-five percent of the patients were injured while mounted on a horse, and the most common mechanism of injury was falling off the horse. The most frequent reason for hospital admission was skeletal fractures followed by head injuries. The head, neck, and face area was the most commonly injured anatomic site, followed by the upper extremity, the abdomen, and then the lower extremity. The median length of stay in the hospital was 2 days. Forty percent of the patients needed treatment in the intensive care unit with a median length of stay of 2 days. Thirty-nine percent of patients underwent surgical procedures. The Injury Severity Score ranged from moderate to critical in 31.5% of the children. There were 8 deaths, 2.5% of the injured children. The most common cause of mortality was head injuries. Of the 307 survivors, 3% were discharged to a rehabilitation center, and 2% of the children had 1 or more functional impairments lasting longer than 7 months after discharge. Conclusions: Horse-related trauma is frequent in children and can cause severe injuries resulting in death and long-term disability. Awareness of the nature of injuries is important to avoid underestimation of their severity. J Pediatr Surg 35:1766-1770. Copyright © 2000 by W.B. Saunders Company.