The wide-ranging report, prepared by Glenda Northey, drew upon hundreds of studies and investigations that explored riding injuries and safety issues surrounding riding.
One 1999 study quoted by Northey concluded that the rate of serious injuries per number of riding hours was estimated to be higher than motorcyclists and car racers.
Horse riding injuries, although only a small percentage of all claims, tended to be more severe than other leisure or sporting activities, the review found.
Horse riding claims were as expensive as motorcycle riding, and double that of rugby, according to recent ACC figures. Horse-related injuries in New Zealand in 2004 cost $NZ1.5 million for new claims and $NZ3.4 million for ongoing claims.
Sixteen people died - nine of them female - from horse-related injuries in New Zealand between 1993 and 1999, while research revealed that 9599 people were hospitalised for horse-related injuries between 1993 and 2003 - 64.4 per cent of them female.
Northey conducted an extensive search for literature on possible countermeasures and interventions, but found that most of the information on prevention was anecdotal.
"The effectiveness of many of the injury-prevention countermeasures suggested within the literature has still to be scientifically researched," Northey wrote.
"Until there was scientific proof that protective clothing does reduce injuries, many riders are still to be convinced of their worth."
Sport and Recreation New Zealand's 2001 data showed that 5 per cent of New Zealand adults had taken part in horse riding and equestrian sport and leisure activities in the preceding 12 months. The figure rose to 9 per cent for those aged 18 to 24. Horse riding was included in the list of top sports and activities undertaken by New Zealand women.
The equine industry in New Zealand was, according to research, employing more than 28,000 full-time and part-time workers. One study suggests the injury incidence was a remarkable 160 times higher for horse racing.
The head was found to be the most likely site of a horse-related injury, followed by upper extremities, in particular the arms. Those most at risk of injuries were young females between 10 and 19, who accounted for 22.6% of the injuries. A large number of the total injuries (38.8%) were to those under 19. Those between 10 and 29 accounted for 47.5% of all horse-related injuries. For over 50s, men were more likely to be injured than women, but the overall representation of this age group in the statistics was low.
The figures showed that 89 per cent of those injured were categorised as Pakeha/European/Other; while Maori account for 11 per cent, and Pacific Islanders 0.3 per cent. Among Maori victims, two-thirds were men. Among Pakeha/European accident victims, just 32 per cent were men, meaning females are effectively twice as likely to be injured as men in this group.
Northey noted that the location of more than 70 per cent of accidents was not specified in these figures, with the statistics showing farms at 6.3%, places of recreation and sport at 6.1%, streets and highways at 5%, and home at 5%.
Most injuries (72.5%) were sustained while riding; while 27.5% were suffered during non-riding activities (including tacking up or grooming). A significant number of riding injuries were the result of a fall, while injuries on the ground were often the result of being crushed between the horse and an object, or being stomped or trampled.
The data, she notes, failed to specify important details about safety clothing worn, the location of the accident, and in many cases what injury occurred. "Linking injury outcomes with these details would enable researchers to more accurately identify areas for injury prevention strategies," she said.
A 1984 overseas study suggested there are nine ways for horse-related injuries to happen: falling from a horse, being crushed by a horse, being kicked, striking an object (such as a tree branch) while riding, become entangled in a stirrup, becoming entangled in reins, receiving a blow from the animal's head, being stepped on, and being bitten.
Recent studies indicate that falls, or being thrown from a horse, accounted for 67% of injuries, while kicks account for 195. Being crushed accounted for 12%, while 4% were caused by motor vehicles.
A 2002 study, also from overseas, suggested that riders received 1 injury per 100 hours for leisure riding, 1 injury per 5 hours for amateur racing with jumps, and 1 injury per 1 hours riding when participating in cross country eventing. In the adventure and tourism industry it is suggested that the rate is as low as 1 per million participation hours.
Discussing safety strategies, Northey noted that many equestrian organisations in the industry have rules and regulations that dictate the conduct of those participating in the sport.
"The last decade has seen a significant number of safety publications published for the equine industry," she said. "These included manuals, strategies, codes of practice and guidelines all geared to provide riders with more information on the risks of riding and best practice guidelines.
"However, the effectiveness of many of the injury prevention countermeasures suggested within the literature has still to be scientifically researched."