Horse-related Injuries Research Articles

Farm Youth and Horse-Related Injuries

ABSTRACT Horses are found on many farms and are used by children and youth for recreation and farm work. This presence increases exposure to activities that carry inherent risks for injuries from bites, kicks, and falls from horses. This paper advocates the use of safety helmets as a passive measure to prevent severe injuries, such as head trauma, that result from horse-related incidents. We use data drawn from members of eight 4-H horse clubs in Kentucky to explore possible explanations for low rates of helmet use. The results are compared with findings from existing literature, and intervention strategies for increasing use of safety-approved equestrian helmets are outlined. We suggest that the participant's risk perception involved in assessing the dangers for any given riding activity correlates with the person's view of helmet use. Further, helmet use is not only a function of risk perception associated with the riding activity, but the negative stereotypical image of helmets as well.

Capodanno senza danno: The effects of an intervention program on fireworks injuries in Naples : P. D'Argetiio, L. Cafaro, F. Santonastasi, F. Taggi, N. Binkin. American Journal of Public Health, 86(1), 84–86

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 09:00 h 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.

Accidents with horses: what has changed in 20 years?

Horse riding is a dangerous pastime with more accidents occurring per hour than during motor-cycling. Since a prospective survey of horse-related injuries conducted at a major centre in 1971–1972 2, equestrian groups and the medical profession have encouraged improvements in training and protective riding wear. By conducting a similar study at the same centre 20 years later we hoped to assess the effects of these measures on the pattern of injuries resulting from contact with horses. Patient and injury details were recorded prospectively for all those presenting to the Accident Service at Oxford during the whole of 1991. Total admissions fell by 46 per cent on average. Most of the decrease was due to a near fivefold fall in those admitted with head injuries (P < 0.001). A reduction in the severity of such injuries was associated with an increased use of riding helmets. However, the most commonly injured group remained amateur young female riders suggesting the need for increasing awareness and training of this group. In seven cases, severe digital injuries were caused by the habit of entwining reins around the fingers. This practice should be discouraged. Up to 12 per cent of all injuries might have been prevented if adequate footwear had been worn.

Pediatric Equestrian Injuries: Assessing The Impact of Helmet Use

To assess the impact of helmet use on the pattern, and severity of pediatric equestrian injuries. A prospective observational study of all children less than 15 years of age who were brought to the University of Virginia children's Emergency Department with horse-related injuries. During the two-year period of the study, 32 children were evaluated. Two children were injured when a horse stepped on them. Thirty children fell from or were thrown from a horse. Of these, 20 were wearing a helmet. Head injuries were more frequent in those patients not wearing helmets. The mean Modified Injury Severity Scale (MISS) score for riders without a helmet (12.9) was significantly higher (more severe) than that for helmeted riders (2.8). All three patients with a Glascow Coma Score < 15 on arrival were not wearing a helmet at the time of injury. The frequency of hospitalization was significantly higher for those not wearing a helmet. Compared with other common mechanisms of childhood injury the mean Modified Injury Severity Scale score of injured riders was exceeded only by that of pedestrians struck by a car. Equestrian injuries are more severe than those suffered from other common pediatric mechanisms. Helmet use is associated with decreased frequency and severity of central nervous system injury.

PEDIATRIC EQUESTRIAN INJURIES

Using data from four sources, horse-related injuries are summarized for persons younger than 25 years of age. Head injury caused 57% of deaths. The upper extremity was the most common area injured, with the next most frequent areas the lower extremity (National Park Service data) and the head (United States Pony Clubs [USPC] data). Injured females outnumbered injured males and had a greater percentage of participants injured (USPC data). Injuries occurred at home in 41% (National Electronic Injury Surveillance System data). USPC figures suggest that greater knowledge may reduce the severity of horse-related injuries. Previous horse-related injury had occurred in 1 of 4 of those injured (USPC data). One third of accidents occurred during lessons (USPC data). Riding instructors should be certified by a recognized organization, and parents should evaluate an instructor's personal riding and their safety records with students. The pediatrician's role should be in counseling parents with children who ride and in offering recommendations for safety to governing boards of youth horse activities.

Pediatric Equestrian Injuries

Using data from four sources, horse-related injuries are summarized for persons younger than 25 years of age. Head injury caused 57% of deaths. The upper extremity was the most common area injured, with the next most frequent areas the lower extremity (National Park Service data) and the head (United States Pony Clubs [USPC] data). Injured females outnumbered injured males and had a greater percentage of participants injured (USPC data). Injuries occurred at home in 41% (National Electronic Injury Surveillance System data). USPC figures suggest that greater knowledge may reduce the severity of horse-related injuries. Previous horse-related injury had occurred in 1 of 4 of those injured (USPC data). One third of accidents occurred during lessons (USPC data). Riding instructors should be certified by a recognized organization, and parents should evaluate an instructor's personal riding and their safety records with students. The pediatrician's role should be in counseling parents with children who ride and in offering recommendations for safety to governing boards of youth horse activities.

Common Injuries in Horseback Riding

The most common location of horse-related injuries is the upper extremity (24% to 61%) with injuries to the lower extremity second in frequency (36% to 40%). The head and face sustain 20% of horse-related injuries. The most common type of injury is a soft tissue injury (92% to 1%), followed by a fracture (57% to 3%). Concussion is the third most common type of injury (63% to 2%). The most frequent cause of hospitalisation is concussion (38% to 4%) with fracture second. The most common injury which leaves residual impairment is injury to the central nervous system. The age at which most injury occurred is less than 21 years. In the latest NEISS report (1987-1988), injuries have decreased in the younger riders, but have increased in the older riders (above 24 years). More women are injured than men, but over the age of 44 years more men are injured than women, with the difference more marked in the 1987-1988 NEISS report. Previous horse-related injuries are reported frequently (37% to 25%). In mortality studies from Australia and the United States, head injuries caused the majority of deaths (78% and 60%), followed by chest injuries (9%). In the Australian study each sex had 50% of the deaths. In the United States, 60% were male, 40% female. Above the age of 24 years male deaths increasingly predominate, being 15 male deaths to 1 female above the age of 64. Concussion is divided into 3 divisions of severity which require different medical evaluation and treatment: mild in which rider is stunned or disoriented for a brief period; moderate in which there is loss of consciousness for less than 5 minutes; and severe in which there is a loss of consciousness for more than 5 minutes. Investigative need is cited in the areas of previous horse-related injury, lessons, experience vs knowledge, epilepsy, drowning, gender, deaths, safety helmets, stirrups, and body protectors. No horse is a safe horse; some are safer than others but the horse is a potentially lethal animal. Prevention of accidents and injuries is dependent upon using knowledge previously obtained from studying horse activities. Much more information is available than in the past through the medical studies that have been done and the recommendations made by these investigators. The medical community has a responsibility to educate the horse riding public and to participate in investigations requested by the horse organizations.(ABSTRACT TRUNCATED AT 400 WORDS)

Riding and other equestrian injuries: considerable severity.

All horse-related injuries presenting to an Accident Service over a two-year period were investigated. 237 patients presented. The injuries were not considerable in absolute number but were in severity. There was a high morbidity with 22% of all patients requiring admission to hospital, 50% of all admissions because of head injuries. At least seven life-threatening injuries were identified and there were other severe pelvic and spinal injuries. The wearing of protective head gear remains the most important safety measure.

Head Injuries in the Equestrian Sports.

In brief: Head injuries are the most frequent and most severe of all injuries in equestrian sports. It has been estimated that head injuries make up approximately 20% of all horse-related injuries. They can be prevented or their severity can be reduced by wearing properly fitted and secured headgear. A good helmet must be secured from loss, protect the head from the impact or compression of a fall, and resist penetration. The author recommends that the medical community continue to work to make the most protective riding helmet acceptable to the equestrian community.

Horse-play: survey of accidents with horses.

Horse-riding is increasing in popularity. During 1971 and 1972 154 patients had horse-related injuries of sufficient severity to warrant admission to the Radcliffe Infirmary. The injuries sustained are more common and more severe than generally appreciated and are comparable to those sustained by motor-cyclists. Supervision of children is often insufficient and protective leg and head gear is commonly quite inadequate, even when worn.