This Fact Sheet has been collated by the Injury Prevention Research Centre, Department of Community Health, Faculty of Medicine and Health Science, The University of Auckland, Private Bag 92019, Auckland, New Zealand. Tel +64 9 3737599 Fax +64 9 3737503 . Sponsored by the Health Funding Authority, Northern Division. For a copy, please contact: injury@auckland.ac.nz

Recommendations

There is no such thing as a safe or 'bomb-proof' horse. Even a quiet animal can be spooked starting a series of events that leads to injury. In fact, being overly confident with a seemingly quiet horse may increase the risk of injury, if this is interpreted that routine safety measures can be ignored. Horses are unpredictable so interventions are difficult.

• Wearing protective clothing is the best policy. Protective gear such as helmets, non-slip gloves, the correct footwear, and safety stirrups will decrease chances of injury.
• Legislation for mandatory wearing of helmets, such as for cyclists, will help decrease serious head injury. A suitable helmet, which meets the aesthetic criteria of riders as well as fulfilling safety standards, will need to be designed. Children in the vicinity of a horse should wear a helmet, whether they are mounted or not.
• Ensure that the horse is matched with the rider's ability. No young or learner rider should ride a horse younger than five years and they should be supervised at all times. Older horses are best for beginners. 10-20 hours of instruction in horse handling and riding is the safest way to begin to enjoy horse riding.
• A high injury frequency during lessons indicates that an assessment of riding schools and facilities is needed. Accreditation by an external body would ensure adequate safety measures were in place.¹ Finch & Watt² suggest that an evaluation of teaching and use of falling techniques could provide a cheap method to reduce a variety of upper body injuries.
• Knowledge of horse behaviour and rider education are effective countermeasures as injuries also occur while grooming or moving around the horse. Lower and Wolfenden's study in a rural community showed that two thirds of the children knew the correct way to hold a lead, and ten percent were unaware that they should wear riding boots when leading a horse, as well as when riding³.
• Education of parents in riding safety should be encouraged particularly in areas where parents perform a high proportion of the supervision of child riders.

Mortality

• Between 1993 and 1997 eleven people died from equestrian injuries.
  
• Females accounted for 64% of these deaths.
  
• A large number of deaths occurred when the horse rolled on top of the rider (a horse outweighs a human by up to one thousand kilos).
  
• The regional area with a high number of deaths was Canterbury (36%).
  
• 27% of deaths occurred to those between 25 and 39 years. All were female.

• 3,731 New Zealanders were hospitalised through horse related injuries between 1993 and 1998.
  
• Horse related injuries decreased by 2.5% between 1993 (708) and 1998 (614).
  
• 57% of injuries were sustained by those aged between 10-29 years.
  
• Females between the ages of 10-19 years sustained the largest number of injuries (29%). This is not surprising as Reeder et al¹ found that 15 year old girls spent more time horse riding than any other sporting or leisure-time physical activity. Males between 10-19 years received only accounted for 7% of horse related injuries. Altogether 1366 persons between 10-19 years received hospitalisation. 1252 were serious enough to require hospitalisation for longer than one day.
  
• The inbalance between males and females juxtaposes with increased age. Balancing out by the mid 50s. Males in the 60+ age range received 77% of injuries for this age group.
  
• In 1994, 18% of injuries were from being kicked by the horse, by 1997 this had reduced to 12%².
  
• 30% of injuries were sustained on farms and sport and recreational facilities. Only 3.5% were received while on public roads.

• The highest number of horse related injuries were recorded in Canterbury (11.5%), the Waikato (11.4%), Bay of Plenty (9.7%), and Manawatu/Wanganui (9.2%).
• The highest injury rates per 100,000 population were Tairawhiti (50), Northland (30), Waiarapa (31), Bay of Plenty (37).

• Head (994) and neck/trunk (450) account for 39% of injuries. Arm fractures and dislocations (1004) were 27%, while leg injuries (578) were 15.5%.
• Females (29%) receive a higher number of head injuries than males (23%). Whereas males received more neck, trunk injuries and leg injuries (30%) than females (26.5%).

(ACC injury Statistics. Online www.acc.org.nz/injury-statistics.html (Accessed 21 Sept. 2000)) Epidemiological evidence indicates that although the incidence of equestrian injuries were only 10% of those claimed by rugby injuries, the outcome of equestrian injuries is often more severe and has long-term outcomes. ACC statistics are for entitlement claims only and do not include medical treatment, public health or ambulance costs. ACC claims only account for approximately 13-15% of injuries and are not adjusted for participation.

• ACC statistics indicate a decrease in the number of new claims from horse riding injuries between 1994/5 (770) and 1998/9 (446). The cost of new claims in 1994/5 was $1,209,000 and $849,000 in 1998. Ongoing claims rose from $3,262,000 in 1994/5 to $3,454,000 in 1998/9.
• Although horse-riding claims in 1997 (570) were only 1/6 of rugby claims (5184) the cost is higher per claim. The average on-going claims for horse riding injuries amounted to $6,426 per claim while rugby injuries received $3,943 per claim.

Method

Mortality and morbidity data are sourced from the NZHIS Minimum Dataset. Records were selected by choosing ICD -9 codes 827 'Animal drawn carriage accident', 828 'Accident involving animal being ridden' and 829 'Other road vehicle accidents', where the injured person was the rider of the animal or occupant of an animal drawn carriage.

While these codes may include incidents involving animals other than horses, these records are assumed to be minimal.

Morbidity records are for hospitalisation of three hours or more with a primary diagnosis of injury. Records were also included if the person survived the injury, and if the record was the first admission for an injury event.

Everyone who rides horses, no matter how experienced or how careful, eventually falls off. The key is to ensure that you protect yourself from serious injury in falls by wearing protective gear. Programmes designed to educate young people, particularly in rural areas, in safety behaviour have proved favourable. Awareness of the hazardous nature of horses increased along with more lesson taking and adult supervision.

HELMETS

An approved safety helmet should be replaced every 5 years. A good helmet is like an airbag for your brain, it should be properly fitted and worn one inch above the rider's eyebrows. Long hair should be tied back.

FOOTWEAR

Boots should have smooth heels and soles and be individually matched to the stirrup for size. Stirrups should be 2-3cm wider than the boot, too small and the foot maybe stuck, too large and the rider becomes unstable. Feet can be easily crushed with the horses weight so wear sturdy footwear to prevent serious injury.

GLOVES

Non-slip gloves should be worn to prevent friction injuries to the hands from a rope or reins.

STIRRUPS

Falling off a horse is dangerous enough without having your foot caught in the stirrup as the horse drags you along the ground, which can be fatal. Safety stirrups are designed to release your foot in the event of a fall. There are a variety of safety stirrups available.

CLOTHING

Baggy or loose clothing should not be worn while riding as it might catch on trees etc.

TACK

All equipment must be checked regularly for signs of fatigue and be correctly adjusted to fit.

HANDLING HORSES

On the Ground:

• The main safety rule is to let your horse know where you are at all times when you are handling it.
• Exercise caution around the rear of a horse - the hind legs are well designed for kicking.
• Do not hold reins or ropes in a loop that can trap fingers.

• Choose your mount carefully to suit your capabilities. An older horse is generally quieter and more predictable.
• Do not ride bareback unless completely skilled.
• Learn how to control your horse before leaving the safety of the paddock or lesson environment. Leave riding outside the paddock to the experienced riders.
• Maintain a horse length's distance behind other horses when travelling in groups.
• Travel in single file on the road. However, when crossing do so while abreast of each other.
• If riding through water or bush kick your feet out of the stirrups in case of a fall.