An analysis of injuries resulting from professional horse racing in France during 1991-2001: a comparison with injuries resulting from professional horse racing in Great Britain during 1992-2001

Wearable technology may assist in reducing jockeys' injuries if integrated into their safety vests: a qualitative study

While the term "safety vests" has been used to capture these products to reduce the potential for harm in jockeys under the Personal Protective Equipment (PPE) umbrella, much of the research in this area has focused on factors typically echoing health, well-being, physiological and cognitive function, and performance of horse riders with very little work about examining how its design may reduce the severity of jockeys' injuries. Due to the recent advances in technology and wearable sensors, the author considered a qualitative study focusing on the analysis of a real-life example involving end and co-dependent users in the design development of jockeys' safety vests. This little article offers an overview of the most popular jockeys' injuries, why there is a need for better protection, and also describes how data were collected and present a summary of the key findings to encourage future research in this field, aiming to create a new prototype. High-impact sports may potentially create severe injuries or deaths to athletes: thus, there is a strong faith in the application of wearable sensor data and data science to also enhance jockeys' safety vest performance.

Sustainability and the Thoroughbred Breeding and Racing Industries: An Enhanced One Welfare Perspective

As society debates the use of animals in sport, entertainment, and leisure, there is an increasing focus on the welfare, social, and ecological impacts of such activities on the animals, human participants, people close to them, and the physical environment. This article introduces the "Enhanced One Welfare Framework" to reveal significant costs and benefits associated with Thoroughbred breeding and racing globally. In addition, relative to calls to ban horseracing and similar activities as part of sustainability approaches that focus chiefly on animals, the "Enhanced One Welfare Framework" is better positioned politically to guide discussions that renegotiate the conditions under which horses are used for sport and the impact racing has on humans and the planet. In 2020, the International Federation of Horseracing Authorities issued its minimum horse welfare standards based on the Five Domains model, positioning lifelong horse welfare as "fundamentally important to the viability and sustainability of the industry". In this article, we critique the One Welfare framework's historic lack of focus on sport and enhance it by including sport, leisure, and entertainment and framing it within the Five Domains model. We offer a novel extension of the Five Domains model beyond animal welfare to consider human welfare and the physical environmental impacts of the sport, leisure, and entertainment industries and propose innovations that may help thoroughbred breeding and racing assure a sustainable future.

Clinical and Blood Biomarker Trajectories after Concussion: New Insights from a Longitudinal Pilot Study of Professional Flat-Track Jockeys

There is a recognized need for objective tools for detecting and tracking clinical and neuropathological recovery after sports-related concussion (SRC). Although computerized neurocognitive testing has been shown to be sensitive to cognitive deficits after SRC, and some blood biomarkers have shown promise as indicators of axonal and glial damage, the potential utility of these measures in isolation and combination for assisting SRC diagnosis and tracking recovery is not well understood. To provide new insights, we conducted a prospective study of 64 male and female professional flat-track jockeys (49 non-SRC, 15 SRC), with each jockey undergoing symptom evaluation, cognitive testing using the CogSport battery, and serum biomarker quantification of glial fibrillary acidic protein (GFAP), tau, and neurofilament light (NfL) using a Simoa HD-X Analyzer. Measures were performed at baseline (i.e., pre-injury), and 2 and 7 days and 1 and 12 months after SRC. Symptoms were most pronounced at 2 days and had largely resolved by either 7 days or 1 month. CogSport testing at 2 days revealed cognitive impairments relative to both non-concussed peers and their own pre-injury baselines, with SRC classification utility found at 2 days, and to a slightly lesser extent, at 7 days. Relatively prolonged changes in serum NfL were observed, with elevated levels and classification utility persisting beyond the resolution of SRC symptoms and cognitive deficits. Finally, SRC classification performance throughout the 1st month after SRC was optimized through the combination of cognitive testing and serum biomarkers. Considered together, these findings provide further evidence for a role of computerized cognitive testing and fluid biomarkers of neuropathology as objective measures to assist in the identification of SRC and the monitoring of clinical and neuropathological recovery.

Consensus on a jockey's injury prevention framework for video analysis: a modified Delphi study

Professional horse racing is a high-risk and dangerous sport with a high incidence of falls and injuries. While falls in horse racing are considered somewhat inevitable and carry an inherent occupational risk, little is known about the actual mechanisms of jockey injuries. Establishing injury aetiology and mechanism is a fundamental step in informing the design and implementation of future injury prevention strategies. Despite the availability of horse racing video footage, the use of video analysis to examine injury mechanisms is an underused practice. Using an expert consensus-based approach, an industry expert steering committee was assembled to develop a framework for video analysis research in horse racing. The aim of the framework is to encourage and facilitate the use of video analysis in the sport and to ensure consistency and quality of future application. To achieve consensus, a systematic review and modified Delphi method study design was used. Responses of the steering committee to two open-ended questions regarding the risk factors of falls and injury were collated and combined with findings from a literature search strategy. Appropriate descriptors and definitions were then formulated that defined and described key features of a jockey fall in horse racing and grouped into six discrete phases of an inciting event. Each member of the steering committee then examined the framework of proposed descriptors and definitions and rated their level of agreement on the 5-point Likert scale. A consensus was achieved on a total of 73 horse racing-specific descriptors and 268 associated definitions. The framework outlined in this study provides a valuable starting point for further research and practice within this area, while the recommendations and implications documented aim to facilitate the practical application of video analysis in horse racing.

Injuries and Overuse Injuries in Show Jumping—A Retrospective Epidemiological Cross-Sectional Study of Show Jumpers in Germany

This retrospective cross-sectional epidemiological study deals with sport-specific injury patterns in show jumping. A total of 363 show jumpers of all levels (S) answered a retrospective questionnaire about injuries and overuse damages which occurred in the course of their careers. Demographic data and information on injuries in various body regions were collected. In addition to descriptive analysis, significance tests were performed. For better statistical comparability with other sports, exposure time was extrapolated with total career duration and weekly training hours, and injuries per 1000 jumping hours were calculated. The study included 251 (69%) women and 112 (31%) men, who were on average 26.9 ± 10.9 years old. The injury rate for the entire collective was 3.7 per 1000 h of exposure. The most frequently affected body region was the head (31%). Overuse complaints play a subordinate role and mainly affect the upper extremities (65%). The riders of the professional lower performance levels are less likely to injure themselves per 1000 h than riders of the higher performance levels. Riders who often or always wore a helmet suffered significantly fewer head injuries (p = 0.008) and had a significantly lower total injury duration than riders who did not wear a helmet (p = 0.006). Similarly, the study showed that riders who often or always wore a safety vest suffered significantly fewer spinal injuries (p = 0.017) and had significantly fewer injuries per 1000 riding hours (p = 0.031) than riders who did not wear a safety vest. Based on the present results, there should be an extension of the general helmet requirement and a requirement to wear safety vests in show jumping in general.

Risk Factors for Jockey Falls in Japanese Thoroughbred Flat Racing

Jockey safety is of paramount importance from welfare perspective and public perception. This retrospective case-control study aims to identify risk factors associated with jockey falls (JF) in flat races of Japan Racing Association (JRA). JF in 715,210 race starts by 74,328 horses at 10 racecourses from 2003 to 2017 were reviewed. Data were extracted from a database maintained by JRA and from official accident reports issued by race stewards. Seventeen possible risk factors were evaluated using multivariable logistic regression, to identify those significantly associated with JF. A total of 992 JF incidents were recorded, with an incidence rate of 1.39 falls per 1,000 starts (95% CI: 1.30-1.48). 6 risk factors were significantly associated with JF. Odds increased with horses that sustained catastrophic musculoskeletal injury (CMI) (OR: 203; CI: 169-241; P < 0.001). Increased odds were also associated with dirt track surfaces (OR: 1.99; CI: 1.74-2.29; P < 0.001), apprentice jockeys (OR: 1.43; CI: 1.21-1.68; P < 0.001), smaller track sizes (OR: 1.41; CI: 1.24-1.61; P < 0.001), larger fields (OR: 1.25; CI: 1.07-1.47; P = 0.005), and longer race distances (OR per 200 m: 1.05; CI: 1.01-1.09; P = 0.02). Since CMI was identified as a major contributing factor for JF, measures to minimize CMI may lead to improvement of jockey safety. The increased odds associated with apprentice jockeys may indicate the importance of jockey education and training. For jockey safety, proper staffing of medical professionals especially for races on dirt, smaller track, larger fields, and longer distances is recommended.

Epidemiology of race day injury in young professional jockeys in Great Britain from 2007 to 2018: a retrospective cohort study

INTRODUCTION

There are limited injury data in professional horse racing, particularly by sex.

OBJECTIVES

To describe injury incidence, characteristics and falls in male and female, flat and jump jockeys in Great Britain.

DESIGN AND SETTING

Retrospective cohort study of professional jockeys in Britain.

PARTICIPANTS

245 jockeys licensed between 2007 and 2017.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcome measure was injury on a race day. Injury incidence (per 1000 rides; per 1000 falls) was derived. Incidence-rate ratios (IRR) were calculated to compare incidence between flat and jump racing, male and female jockeys, and male flat and male jump jockeys for: (i) injury incidence, (ii) fall incidence and (iii) injuries per fall.

RESULTS

234 British professional jockeys were included. Jockeys were on average 19.5±2.0 years old at licence date, 79.9% male and 58.1% flat. The time of follow-up (racing in the study) was 3.7 (SD=2.3) years. There were 278 injuries, occurring in-race (81.7%), in the stalls (10.8%) or parade ring (6.1%). After one injury was removed to preserve anonymity, 57.2% were soft tissue injuries, 25.3% fractures and 10.5% concussion. There were 1634 falls, with 92% in male jump racing. The injury incidence was higher in jump racing (5.1 vs 1.0/1000 jockey rides). The falls incidence was 1.8/1000 rides in flat and 46.2/1000 rides in jump racing (IRR 0.04, 95% CI 0.03 to 0.04). There were over five times higher injuries/1000 falls in flat than jump racing (IRR 5.56, 95% CI 4.05 to 7.53). Male flat jockeys fell less than female flat (IRR 0.57, 95% CI 0.35 to 0.97).

CONCLUSION

Most injuries occurred in-race and were soft tissue injuries. Jump jockeys fell more often than flat, and female flat jockeys fell more often than male flat. Flat jockeys injured more frequently when falling. No sex differences were seen for injuries per fall.

Epidemiology of jockey falls and injuries in flat and jump races in Japan (2003-2017)

Jockey safety is of paramount importance from the standpoint of welfare and public perception. Thus, an understanding of the epidemiology and associated risk factors is necessary to implement measures to reduce the jockey falls (JFs) and jokey injuries (JIs). This descriptive epidemiological study investigated the occurrence of JFs and JIs in 715,210 and 25,183 rides in flat and jump races, respectively, from 2003 to 2017. In flat races, the incidence rates of JFs and JIs were 1.4 and 0.6 per 1,000 rides, respectively. In jump races, they were 44.4 and 18.1 per 1,000 rides, respectively. In flat races, 56.8% of JFs at corners resulted in JIs. In jump races, the major causes of JFs and JIs were lost balance and hampered by a fallen horse at an obstacle. Our findings provide a basis to design a future study analyzing risk factors for JFs.

Injuries among Maryland jockeys during thoroughbred racing: 2015-2019

Objectives

Our goal was to characterise jockey injuries at Maryland racetracks during thoroughbred racing activities over 4 years using medical records maintained by the sports medicine team.

Methods

Injury data were prospectively gathered by sports medicine physicians who were onsite for all thoroughbred racing activities in Maryland from 12 September 2015 to 5 May 2019 to evaluate and treat any injury to the jockeys. Descriptive statistics (frequencies, rates with corresponding 95% CIs and proportions) of injury types, body parts, mechanisms, severity and location on track were calculated.

Results

Over nearly 4 years of racing and 45 000 mounts, there were 204 injuries involving 184 incidents and 131 falls during those races. The vast majority of injuries (80%) was related to soft tissue, while 4% were concussions. Most injuries involved the lower extremity (31%) or upper extremity (26%) and typically resulted from a fall from the horse. Among all incidents, 79.3% (n=146) resulted in an injury, while 76.3% (n=100) of falls resulted in an injury. We identified a significant proportion of injuries (41%) in and around the starting gate. Over a quarter of incidents resulting in injury required further medical care in hospital or other medical facility, while surgery was required in 2.5% of injuries.

Conclusion

Access to a consistent group of sports medicine providers facilitated jockey injury reporting and tracking. The majority of jockey injuries is related to soft tissue and results from falls, while the starting gate area is associated with the greatest proportion of injuries.

Could a Compliant Foam Anvil Characterize the Biofidelic Impact Response of Equestrian Helmets?

The performance of equestrian helmets to protect against brain injuries caused by fall impacts against compliant surfaces such as turf has not been studied widely. We characterize the kinematic response of simulated fall impacts to turf through field tests on horse racetracks and laboratory experiments. The kinematic response characteristics and ground stiffness at different going ratings (GRs) (standard measurement of racetrack condition) were obtained from 1 m and 2 m drop tests of an instrumented hemispherical impactor onto a turf racetrack. The "Hard" rating resulted in higher peak linear accelerations and stiffness, and shorter impact durations than the "Soft" and "Heavy" ratings. Insignificant differences were found among the other GRs, but a strong overall relationship was evident between the "going rating" and the kinematic response. This relationship was used to propose a series of three synthetic foam anvils as turf surrogates in equestrian falls corresponding to ranges of GRs of (i) heavy-soft (H-S), (ii) good-firm (G-F), and (iii) firm-hard (F-H). Laboratory experiments consisted of a helmeted headform being dropped onto natural turf and the turf surrogate anvils using a monorail drop rig. These experiments revealed that the magnitudes and durations of the linear and rotational accelerations for helmeted impacts to turf/turf surrogates were similar to those in concussive sports falls and collisions. Since the compliance of an impacted surface influences the dynamic response of a jockey's head during a fall impact against the ground, it is important that this is considered during both accident reconstructions and helmet certification tests.

Incidence and risk factors for race-day jockey falls over fourteen years

OBJECTIVES

To determine the incidence of, and risk factors for, race-day jockey falls occurring in Thoroughbred flat and jumps (hurdle and steeplechase) racing.

DESIGN

Retrospective cohort study.

METHODS

Incidence rates for race-day jockey falls over 14 racing seasons in New Zealand (n=421,596 race-day starts) were calculated per 1000 rides. Univariable and multivariable analyses of jockey, horse and race level risk factors were conducted with Poisson regression in a generalized linear mixed model.

RESULTS

Most races (97%, n=407,948 race starts) were flat racing with 10 races/race-day, whilst most jumps races were longer and had 2 races/race-day. The rate of jockey falls was higher in steeplechase racing (99.9/1000, 95% CI 92.2-108.4) than hurdle (53.2/1000, 95% CI 48.7-58.3) and flat racing (1.2/1000, 95% CI 1.1-1.3, p<0.001). Experienced athletes (both horse and jockey) had lower IRR. In flat racing, IRR increased linearly with the number of race-day rides by the jockey. In jumps races, IRR increased with a fall in a previous race (IRR 1.5/1000, 95% CI 1.3-1.7, p<0.001). A shorter jumps race distance reduced the IRR of a jockey fall.

CONCLUSIONS

Athlete experience was associated with risk of jockey falls. The linearity of race ride number with IRR and longer distance in jumps racing, indicated that cognitive or physiological fatigue may play a role in the risk of a race-day fall. This data highlights the role sport-specific conditioning programmes may have on reducing risk.

Proposed injury thresholds for concussion in equestrian sports

OBJECTIVES

Equestrian helmets are designed to pass certification standards based on linear drop tests onto rigid steel surfaces. However, concussions in equestrian sports occur most commonly when a rider is thrown off a horse and obliquely impacts a compliant surface such as turf or sand. This paper seeks to elucidate the mechanics of such impacts and thereby propose corresponding thresholds for the occurrence of concussion that can improve equestrian helmet standards and designs.

DESIGN

The present study examined the biomechanics of real-world equestrian accidents and developed thresholds for the occurrence of concussive injury.

METHODS

Twenty-five concussive and 25 non-concussive falls in equestrian sports were reconstructed using a combination of video analysis, computational and physical reconstruction methods. These represented male and female accidents from horse racing and the cross-country phase of eventing.

RESULTS

The resulting thresholds for concussion [59g, 2700rad/s², 28rad/s, 0.24 (MPS), 6.6kPa and 0.27 (CSMD₁₀) for 50% risk] were consistent with those reported in the literature and represent a unique combination of head kinematic thresholds compared to other sports. Current equestrian helmet standards commonly use a threshold of 250g and a linear drop to a steel anvil resulting in less than 15ms impacts. This investigation found that concussive equestrian accidents occurred from oblique impacts to turf or sand with lower magnitude and longer duration impacts (<130g and >20ms). This suggests that current equestrian helmet standards may not adequately represent real-world concussive impact conditions and, consequently, there is an urgent need to assess the protective capacity of equestrian helmets under real-world conditions.

A sustainable structure for jockey injury data management for the North American horse racing industry

Jockey injuries in North American racing are not well understood. The types and severity of injuries as well as exposure need to be better characterized in order to reduce risk. We consider existing data sources and the opportunity to combine this data with a new data collection effort to better understand and potentially reduce risk to riders. Using a two-phase approach, data appears to be available which would allow useful information on jockey injuries that could inform efforts for risk reduction quickly and with modest resources. Initial successes can help to develop support for a more comprehensive data collection and risk reduction program.

Do equestrian helmets prevent concussion? A retrospective analysis of head injuries and helmet damage from real-world equestrian accidents

OBJECTIVES

To collect and analyse helmets from real-world equestrian accidents. To record reported head injuries associated with those accidents. To compare damage to helmets certified to different standards and the injuries associated with them.

METHODS

Two hundred sixteen equestrian helmets were collected in total. One hundred seventy-six helmets from amateur jockeys were collected via accident helmet return schemes in the UK and USA, while 40 helmets from professional jockeys were collected by The Irish Turf Club. All helmet damage was measured, and associated head injury was recorded.

RESULTS

Eighty-eight percent (189) of equestrian fall accidents returned an injury report of which 70% (139) reported a head injury. Fifty-four percent (75) of head injury cases had associated helmet damage while 46% had no helmet damage. Reported head injuries consisted of 91% (126) concussion, 4% (6) skull fractures, 1 (0.7%) subdural hematoma, 1 (0.7%) cerebral edema and 5 (3.6%) diffuse axonal injury (DAI). It is also shown that helmets certified to the most severe standard are overrepresented in this undamaged group (p <0.001).

CONCLUSIONS

It is clear that despite jockeys wearing a helmet, large proportions of concussion injuries still occur in the event of a jockey sustaining a fall. However, the data suggest it is likely that helmets reduce the severity of head injury as the occurrence of skull fracture is low. The proportion of undamaged helmets with an associated head injury suggests that many helmets may be too stiff relative to the surface they are impacting to reduce the risk of traumatic brain injury (TBI). It may be possible to improve helmet designs and certification tests to reduce the risk of head injury in low-severity impacts.

Pattern and Severity of Horse-Related Injuries Presenting to Emergency Room

Introduction

Horseracing-related injuries have not been studied before in Korea in any detail, although horseracing takes place very regularly in the country. The injury rate is understandably high, owing to the weight of the horses and the speed they can achieve. The purpose of this study was to identify the incidence and the injury patterns of severe equestrian trauma, as well as the associated risk factors.

Methods

All patients with equestrian injuries who visited the emergency department (ED) between June 2007 and May 2011 were reviewed retrospectively.

Results

During the study period, 288 patients presented to ED with horse-related injury. Two hundred and eighty patients were enrolled in this study. The most common cause of the injury was a fall (168, 60.0%). The most common region of the injury was the face (123, 43.9%). The intermediate value of NISS was 3 (1-75). Thirty-two patients (11.4%) were diagnosed as having moderate to severe injury. Thoracic injuries occurred less often in cases of a fall. Facial and thoracic injuries occurred more often, however abdominal and pelvic injuries were not very common in cases of a clash. When thoracic injuries were accompanied by injuries to other parts of the body, the incidence of moderate to severe injury was very high.

Conclusions

Horseracing is a much rougher sport than general horse-riding. Therefore, one recommendation from this study is that jockeys who participate in horseracing should wear additional protective equipment other than a helmet and boots. (Hong Kong j.emerg.med. 2014;21:387-391)

Epidemiology of Injury Due to Race-Day Jockey Falls in Professional Flat and Jump Horse Racing in Ireland, 2011-2015

CONTEXT

  Professional horse racing is considered a high-risk sport, yet the last analysis of fall and injury incidence in this sport in Ireland was completed between 1999 and 2006.

OBJECTIVE

  To provide an updated analysis of the fall and injury incidence in professional flat and jump horse racing in Ireland from 2011 through 2015, compare it with the previous analysis, and detail the specific types and locations of injuries.

DESIGN

  Descriptive epidemiology study.

SETTING

  A medical doctor recorded all injuries that occurred at every official flat and jump race meeting for the 2011 through 2015 seasons using standardized injury-report forms.

MAIN OUTCOME MEASURE(S)

  Injury and fall rates and their 95% confidence intervals (CIs) were reported for flat and jump racing. Incidence rate ratios and 95% CIs were calculated between flat and jump racing, between the 1999-2006 analysis and the current results, and between 2011 and 2015. The distribution of injuries for type and location of injury was reported.

RESULTS

  Compared with flat racing, jump racing had significantly more falls per 1000 rides (49.5 versus 3.8), injuries per 1000 rides (10.1 versus 1.4), and injuries per 1000 meetings (776.0 versus 94.1). However, the rate of injuries per 1000 falls was significantly higher in flat racing (352.8 versus 203.8). An increase in injuries per 1000 falls between 2011 and 2015 was found in flat racing ( P = .005). Since the previous analysis, a significant increase in injuries per 1000 rides and falls was noted in jump racing. Soft tissue injuries were predominant in flat and jump racing (61.54% and 68.80%, respectively), with fractures the second most common injury (15.38% and 18.06%, respectively). Concussions were more prevalent from flat-racing falls (incidence rate ratio = 0.30; 95% CI = 0.15, 0.61). The lower limb was the most frequent location of injury (32.89%) in flat racing; however, in jump racing, upper limb injuries (34.97%) were predominant.

CONCLUSIONS

  An update on professional flat- and jump-racing fall and injury epidemiology is provided. Further research to identify risk factors for injury, design and investigate the feasibility of injury-prevention strategies, and document their effects on fall and injury incidence is required.

Thoroughbred fatality and associated jockey falls and injuries in races in New South Wales and the Australian Capital Territory, Australia: 2009-2014

Monitoring racehorse fatality and associated jockey falls provides benchmarks for intervention strategies. The aims of this study were to describe the incidence of and reasons for fatalities in Thoroughbred horses during flat races in the Australian Capital Territory and New South Wales (NSW), Australia, and to describe reported jockey falls and injuries associated with racehorse fatalities. A cohort study identified all racehorse fatalities reported through Racing NSW for the 2009-2010 to 2013-2014 racing seasons. Risks of racehorse fatality, fatal musculoskeletal injury, spontaneous death (as distinct from euthanasia) and racehorse fatality associated jockey falls and injuries were calculated using Poisson regression. A total of 167 horse fatalities were reported, with an overall incidence of 0.59 deaths/1000 starts. Forty-nine reasons for horse fatality were reported, although post-mortem examinations were conducted on only 52/165 (31.5%) horses. Musculoskeletal injury accounted for 144/167 (86.2%) fatalities, with an incidence of 0.52/1000 starts. Fractures comprised 96/167 (57.5%) fatalities, with the fetlock or proximal sesamoid bones being the most common fracture location, comprising 36/96 (37.5%) fractures. Only 22/166 (13.3%) racehorse fatalities were due to spontaneous death, representing an incidence of 0.08/1000 starts. A total of 50 racehorse fatality associated jockey falls were reported (incidence of 0.18/1000 starts), with 32 reported jockey injuries (incidence of 0.12/1000 starts). Most racehorse fatality associated jockey injuries occurred to the limbs (17/32, 53.1%), particularly the upper limb. The estimates for both horse fatality and associated jockey injury were comparable with previous estimates from other jurisdictions internationally.

Paediatric horse-related trauma

AIM

This retrospective cohort study reported on the epidemiology of horse-related injuries for patients presenting to the only tertiary paediatric trauma hospital in Queensland. The secondary outcome was to examine the use of helmets and adult supervision. Traumatic brain injury (TBI) was examined in relation to helmet use. Morbidity and mortality were also recorded.

METHODS

Included were all patients presenting with any horse-related trauma to the Royal Children's Hospital in Brisbane from January 2008 to August 2014. Data were retrospectively collected on patient demographics, hospital length of stay (LOS), mechanism of injury (MOI), safety precautions taken, diagnoses and surgical procedures performed.

RESULTS

Included in the analysis were 187 incidents involving 171 patients. Most patients were aged 12-14 years (36.9%) and female (84.5%). The most common MOI were falls while riding horses (97.1%). Mild TBI (24.6%) and upper limb fractures (20.9%) were common injuries sustained. Patients who wore helmets had significantly reduced hospital LOS and severity of TBI when compared with those who did not wear helmets (P < 0.001 and P = 0.028, respectively). Morbidity was reported in 7.5% of patients. There were three deaths in Queensland.

CONCLUSION

Helmet use is recommended for non-riders when handling horses, in addition to being a compulsory requirement whilst horse riding. Prompts in documentation may assist doctors to record the use of safety attire and adult supervision. This will allow future studies to further investigate these factors in relation to clinical outcomes.

Epidemiology of racing injuries in Thoroughbred racehorses with special reference to bone fractures: Japanese experience from the 1980s to 2000s

This report describes the descriptive epidemiology of racing fractures that occurred from the 1980s to 2000s on racetracks of the Japan Racing Association (JRA). The incidence of racehorse fractures during flat racing was approximately 1–2%. Fractures occurring during a race are more likely to occur in a forelimb. Fractures mostly occur at the third and fourth corners of oval tracks and on the home stretch. They also occur more frequently at the time of changing the leading limb. Comparison of the incidence of racing fracture between before and after reconstruction of the geometrical configuration of a racetrack revealed that there was an outstanding reduction in the number of serious fractures in the year before and after reconstruction. It was postulated that the improvement in racing time, possibly influenced by reconstructing the geometrical configuration of the racetrack, was connected to the reduction in the number of fractures. Of non-biological race- and course-related factors, type of course (dirt or turf), track surface condition, differences between racecourses, and racing distance significantly influence racing time. By using an instrumented shoe, vertical ground reaction forces (VGRFs) on the forelimb during galloping and the relationships between a rough dirt and woodchip track surface and a smooth dirt and woodchip surface were measured. Relating the incidence of racing fractures with track conditions in general showed that track surface has significant effects on the incidence of fracture, with the incidence of fractures increasing as track conditions on dirt worsen and a tendency for the incidence of fractures to decrease as track conditions on turf worsen. It seems probable that track condition in general may affect the incidence of fracture. The incidence of fracture in horses during both racing and training decreased as the years progressed.

Analysis of Failure to Finish a Race in a Cohort of Thoroughbred Racehorses in New Zealand

The objective was to describe the incidence of failure to finish a race in flat-racing Thoroughbreds in New Zealand as these are summary indicators of falls, injuries and poor performance. Retrospective data on six complete flat racing seasons (n = 188,615 race starts) of all Thoroughbred flat race starts from 1 August 2005 to 31 July 2011 were obtained. The incidence of failure to finish events and binomial exact 95% confidence intervals were calculated per 1000 horse starts. The association between horse-, rider- and race-level variables with the outcomes failure to finish, pulled-up/fell and lost rider were examined with a mixed effects Poisson regression model. A total of 544 horses failed to finish in 188,615 race starts with an overall incidence of 2.88 per 1000 horse starts (95% CI 2.64-3.12). The incidence of failure to finish horses across each race year showed little variability. In the univariable analysis race distance, larger field size, season, and ratings bands showed association with failing to finish a race. The overall failure to finish outcome was associated with season, race distance and ratings bands (horse experience and success ranking criteria). In the multivariable analysis, race distance and ratings bands were associated with horses that pulled-up/fell; season, apprentice allowances and ratings bands were associated with the outcome lost rider. The failure to finish rate was lower than international figures for race day catastrophic injury. Racing and environmental variables were associated with failure to finish a race highlighting the multifactorial nature of race-day events. Further investigation of risk factors for failure to finish is required to better understand the reasons for a low failure to finish rate in Thoroughbred flat races in New Zealand.

Workplace Injuries in Thoroughbred Racing: An Analysis of Insurance Payments and Injuries amongst Jockeys in Australia from 2002 to 2010

BACKGROUND

There is no comprehensive study of the costs of horse-related workplace injuries to Australian Thoroughbred racing jockeys.

OBJECTIVES

To analyse the characteristics of insurance payments and horse-related workplace injuries to Australian jockeys during Thoroughbred racing or training.

METHODS

Insurance payments to Australian jockeys and apprentice jockeys as a result of claims for injury were reviewed. The cause and nature of injuries, and the breakdown of payments associated with claims were described.

RESULTS

The incidence of claims was 2.1/1000 race rides, with an average cost of AUD 9 million/year. Race-day incidents were associated with 39% of claims, but 52% of the total cost. The mean cost of race-day incidents (AUD 33,756) was higher than non-race day incidents (AUD 20,338). Weekly benefits and medical expenses made up the majority of costs of claims. Fractures were the most common injury (29.5%), but head injuries resulting from a fall from a horse had the highest mean cost/claim (AUD 127,127).

CONCLUSIONS

Costs of workplace injuries to the Australian Thoroughbred racing industry have been greatly underestimated because the focus has historically been on incidents that occur on race-days. These findings add to the evidence base for developing strategies to reduce injuries and their associated costs.

Descriptive epidemiology of race-day jockey falls and injuries in New Zealand

The objective of the study was to determine the incidence of race-day jockey falls and describe the reporting of injuries occurring during Thoroughbred racing in New Zealand. Details on jockey falls and injuries were extracted from official stipendiary stewards' reports and denominator data on all race starts were obtained for all races that occurred between 1 August 2008 and 28 February 2013. A fall included any event of the jockey being dislodged from the horse, once the jockey had mounted to start the race proceedings. Incidence rates for jockey falls stratified by type of race were calculated for race-level variables of interest: year, season, race number, race distance and track condition. During the study period there were 816 jockey falls, of which 92 occurred before the race and resulted in the horse being scratched (withdrawn) from the race. The incidence of jockey falls was 2.2 per 1000 rides (95% confidence interval (CI)=1.9-2.5) for flat races and 84.7 per 1000 rides (95% CI=76.6-93.5) for jump races. Just under half of the jockey falls in flat races occurred pre-race (195/418; 46.6%), 42% (179/418) of falls occurred during the race and 10.5% (44/418) of falls occurred post-race. In total, 19.1% (80/418) and 17.3% (69/398) of jockey falls resulted in injury to the jockey in flat and jump races, respectively. Nearly 90% (69/80) of jockeys injured in flat races were stood down from their next race and most injured jockeys required a medical certificate before racing again. The incidence of jockey falls was higher in jump races than flat races, but was comparable to those reported internationally. Incidence rates for falls in flat races were lower than those reported in Europe and Australia.

Jockey Falls, Injuries, and Fatalities Associated With Thoroughbred and Quarter Horse Racing in California, 2007-2011

BACKGROUND

Despite the popularity of the horse racing industry in the United States and the wide recognition that horse racing is one of the most hazardous occupations, little focused research into the prevention of falls by and injuries to jockeys has been conducted.

PURPOSE

To describe the incidence rates and characteristics of falls and injuries to Thoroughbred and Quarter Horse racing jockeys in the state of California.

STUDY DESIGN

Descriptive epidemiology study.

METHODS

Data on race-day falls and injuries were extracted from jockey accident reports submitted to the California Horse Racing Board from January 2007 to December 2011. Denominator data, number of jockey race rides, were obtained from commercial and industry databases. Jockey fall, injury, and fatality incidence rates and ratios in Thoroughbred and Quarter Horse flat races were estimated using Poisson regression. Characteristics of falls and injuries are described and compared.

RESULTS

In Thoroughbred races, 184 jockey injuries occurred from 360 reported jockey falls, 180,646 race rides, 23,500 races, and 3350 race meetings. In Quarter Horse races, 85 jockey injuries occurred from 145 jockey falls, 46,106 race rides, 6320 races, and 1053 race meetings. Jockey falls occurred at a rate of 1.99 falls per 1000 rides in Thoroughbred races, with 51% of falls resulting in jockey injury, and 3.14 falls per 1000 rides in Quarter Horse races, with 59% of falls resulting in jockey injury. The majority of falls occurred during a race, with catastrophic injury or sudden death of the horse reported as the most common cause in both Thoroughbred (29%) and Quarter Horse (44%) races. During the period studied, 1 jockey fatality resulted from a fall. Jockey fall rates were lower but injury rates were comparable to those reported internationally.

CONCLUSION

On average, a licensed jockey in California can expect to have a fall every 502 rides in Thoroughbred races and every 318 rides in Quarter Horse races. While jockey fall rates were lower, injury rates were similar to those in other racing jurisdictions. The high proportion of jockey falls caused by horse fatalities should be further investigated.

Injuries associated with recreational horse riding and changes over the last 20 years: a review

Objective

To assess the incidence and distribution of recreational equestrian injuries seen in the Kent and Sussex region and review the available literature on this subject.

Design

This is a retrospective case series with historical controls.

Setting

Kent and Sussex region, England.

Main outcome measurement

Injuries related to horses in the recreational setting.

Methods

Subjects were selected from our acute injury database. Notes of all patients presenting with horse riding-related injuries between January and December 2010 were reviewed. Skeletal injuries were confirmed using our Picture Archiving and Communications Systems (PACS) system. Data were tabulated and grouped using Microsoft Excel software. Statistics were calculated using Graph Pad software.

Results

During the study period, 155 patients presented with a total of 199 injuries related to horses, accounting for 0.3% of all presentations; 69% were soft tissue injuries. The most commonly affected areas were the extremities (77 patients, 49.7%) followed by injuries to the head (38 patients, 24.5%) and trunk (36 patients, 23.2%). Seventeen patients (11%) were admitted. Patients presenting with head injuries suffered significantly more injuries compared to other groups (1.65 compared to 1.4 injuries, p < 0.0002).

Conclusion

A larger number of persons were riding for a longer period of the year compared to previous studies in the United Kingdom. There was also a shift in the patterns of injury seen in this population over the last two to three decades.

Only falls and horses: accidents and injuries in racehorse training

BACKGROUND

The horseracing training industry has largely been ignored in terms of active occupational health research.

AIMS

To provide baseline statistics on the specific nature and type of accidents that occurred in English horseracing stables during 2008.

METHODS

All 716 training yards/stables registered with the British Horseracing Authority were contacted in April/May 2009 to complete the Racing Injury Accident Statistical Survey. The survey asked respondents to detail all recorded accidents and injuries during 2008.

RESULTS

Two hundred and fifty-six yards (36%) provided usable responses. The proportion of different-sized yards was highly comparable with the sizes of yards in the national population. Employees per yard ranged from 1 to 121 (mean = 9 ± 14), with a total of 2293 employees (30% of the total 7558 UK yard staff). At the point of survey, participating yards housed between 0 and 243 horses (mean = 6 ± 32), with 6420 horses covered in this survey. One hundred and thirty yards (51%) reported no accidents. Of the remaining 126 yards, 665 accidents were reported, ranging from 1 to 58 accidents per establishment, equalling 5 accidents per yard (± 7) or 3 accidents per yard for the entire sample. There was a mean of 53 horse-related accidents per month, and 96% were horse-related. Medical treatment was required for 50% of accidents.

CONCLUSIONS

This representative sample covers the broad range of hazards, accidents and injuries in this difficult-to-access but unique industry. Recommendations for the management of accidents are made.

Predictors of race-day jockey falls in jumps racing in Australia

Thoroughbred jumps racing jockeys have a fall rate greater than their flat racing counterparts. Previous studies have focused on factors that contribute to falls by horses but, to date, there has not been a study of risk factors for falls to jockeys in jumps races. Data on race-day falls were extracted from stipendiary stewards reports lodged with Principal Racing Authorities following each race meeting. Denominator data were provided by Racing Information Services Australia on races conducted from August 2002 until July 2009. Univariable and multivariable analyses, estimating incidence rate ratios, were conducted using Poisson regression. In multivariable analysis in hurdle racing, important predictors of falls were higher club level, larger field size, greater prize money, provisionally licensed jockeys and older jockeys. There were significant interactions between jockey licence and prize money; jockey age and previous rides this meeting; race grade and race distance; horse age and field size; and club level and field size. In steeplechase racing, important predictors were type of jump with lowest fall rates in races over Mark III jumps compared to standard fences, provisionally licensed jockeys, jockeys having had previous rides at a meeting, and larger field size. There were significant interactions between the number of previous starts by the horse and field size; race distance and prize money; and race distance and previous rides this meeting. This study has identified factors for falls in jumps racing that could form the basis for targeted strategies to improve occupational health and safety standards.

Separating a horse from the social group for riding or training purposes: a descriptive study of human-horse interactions

The aim of this study was to investigate how difficult it was to halter and separate a horse (Equus caballus) from a group for riding or training purposes and to describe how human-horse interactions could affect this common procedure. A total of 20 different horse groups, with a minimum of five horses in each, were studied on 14 farms in Norway, from June to October 2007. On each farm, information about the facilities, the horse and the handler was recorded. In each group, the horse owner or keeper (handler) was asked to enter the group, approach his/her horse, halter it and lead it out through the gate, then keep the horse standing out of sight from other horses for two minutes. The entire procedure was video recorded and the behaviour of the target horse, handler and other horses was subsequently scored. Only one of the 100 horses moved away from the handler when approached. Ninety-six percent of the target horses followed their handler without showing any resistance. In 75% of the tests, the other horses did not interact with the target horse and/or handler. At the gate, 26% of the handlers did not turn the target horse around before closing the gate, thereby placing themselves in a vulnerable position, with their body in very close proximity to the horse's hind legs. In conclusion, separating a horse from its group can be considered relatively safe and unproblematic, provided good management practices and trained handlers.

Fall and injury incidence rates of jockeys while racing in Ireland, France and Britain

This article presents and analyses injury incidence rates for amateur and professional racing jockeys in Ireland, France and Britain by means of a retrospective study and review of published data. Amateur jump racing was seen to have the highest fall risk in these three countries (between 115 and 140 falls/1000 rides). Jump racing also had the highest rates of injury/ride amongst both amateur and professional jockeys. Flat racing, however, had the highest rates of injuries/fall (34-44%). Of all the injuries in both jump and flat racing populations of amateur and professional jockeys, 15% were concussive head injuries, and more than half of these involved loss of consciousness. Professional jump jockeys in Ireland fell less frequently than those in France or Britain. Their injury/fall rate and injury/ride rate were highest in Britain. Professional flat racing jockeys in France had the lowest rates of injuries/fall and injuries/ride, while those in Ireland had the highest.

High bone turnover in Irish professional jockeys

SUMMARY

Professional jockeys are routinely exposed to high impact trauma and sustain fractures frequently. We found that jockeys restrict their caloric intake in order to maintain regulation weights, and that bone turnover is high. There are significant health and safety implications for the racing industry.

INTRODUCTION

Professional jockeys routinely sustain fractures from high impact falls. Jockeys maintain a low percentage body fat and a low body mass index (BMI) to achieve low weight targets in order to race. We evaluated dietary habits and bone metabolism in jockeys.

METHODS

Bone mineral density (BMD) was measured in 27 male jockeys of the 144 jockeys licensed in Ireland. Fourteen (52%) had BMD T score below -1.0, of whom 12 consented to clinical review, nutritional survey, endocrine studies, and bone turnover markers (BTM). BTM were compared to age- and sex-matched controls (n = 16).

RESULTS

BMI was 20.6 +/- 1.7 kg/m(2); previous fracture frequency was 3.2 +/- 2.0 per rider. All had normal endocrine axes. The jockeys' diet as determined by a 7-day dietary recall was deficient in energy, calcium, and vitamin D intake. Compared with the control group, the jockey group had evidence of increased bone turnover.

CONCLUSIONS

A substantial proportion of the professional jockeys in Ireland have low-normal BMD, low BMI, and high bone turnover that may result from weight and dietary restrictions. These factors seem to have a deleterious effect on their bone health and predispose the jockeys to a high fracture risk that should be remediated.

The incidence of race-day jockey falls in Australia, 2002-2006

OBJECTIVES

To describe rates of occurrence of falls, injuries and fatalities to horse-racing jockeys in Australia.

DESIGN AND SETTING

Retrospective analysis of data on race-day falls from stewards' reports provided by the Principal Racing Authority of each state and territory of Australia, August 2002 - July 2006.

MAIN OUTCOME MEASURES

Fall, injury and fatality incidence rates; comparison with overseas rates.

RESULTS

There were 3360 jockey falls from 748 367 rides. Falls occurred at a rate of 0.42 per 100 rides in flat races and 5.26 per 100 rides in jumps races. In flat racing, 54.6% (1694/3101) of falls occurred before the start of the race and 11.1% (344/3101) of falls occurred post-race. The 34.3% (1063/3101) of falls that occurred during flat races resulted in 61.7% (516/836) of the injuries sustained. In jumps racing, most falls occurred at a jump and 9.7% (25/259) of jockeys who fell were transported to hospital and/or declared unfit to ride. There were five fatalities resulting from falls during the study period, all in flat racing. Fall and injury rates were comparable with those found in the United Kingdom, Ireland, France and Japan.

CONCLUSIONS

Being a jockey carries a substantial risk of injury and death. Although rates of injury in Australia are not exceptional by international standards, there can be improvement to safety standards in the Australian racing industry.

Injuries in the Victorian thoroughbred racing industry

There is increasing concern in Australia about safety in the thoroughbred racing industry, but there has been no reported analysis of injury data. This review analyses injury and workers' compensation data recorded in Victoria. On the basis of the results, it is recommended that the injury and incident data collection systems are improved such that they are not only more complete but also accumulate more detailed information about the location of an incident or injury event, the activity at the time of the incident or injury event, and factors that may have influenced the occurrence.

Injuries in amateur horse racing (point to point racing) in Great Britain and Ireland during 1993-2006

OBJECTIVES

To provide a breakdown of injury incidence from amateur jump racing (also known as point to point racing) in Great Britain and Ireland during 1993-2006 and to compare the injury epidemiology with professional horse racing in Great Britain, Ireland and France.

DESIGN

Retrospective review.

SETTING

Great Britain and Ireland.

PARTICIPANTS

Amateur jockeys.

MAIN OUTCOME MEASURES

Injury rates.

RESULTS

Injury data suggest that point to point racing is more dangerous from an injury point of view than professional jump racing, which has previously been shown to be more dangerous than flat racing. Amateur jockeys have more falls than their professional counterparts, and this in turn puts them at greater risk of sustaining more serious injuries.

CONCLUSIONS

Amateur (point to point) jockeys represent a sporting population that previously has been little studied. They represent a group at high risk of injury, and hence formal injury surveillance tracking and counter measures for injury prevention are recommended.