Is Injury an Occupational Hazard for Horseracing Staff?

'It's only a flesh wound' - Understanding the safety culture in equine, production animal and mixed veterinary practices

The veterinary industry has some of the highest rates of non-fatal work-related injuries, yet safety culture remains unexplored. Utilising a survey distributed to all UK employees of a consolidated group of veterinary practices, this study aimed to describe the prevalence of work-related injuries in equine, production animal, and mixed veterinary practices, and to understand the behaviours of injured persons. There were 144 respondents. Over 90 % of clinicians experienced injury during their careers, versus a third of non-clinical staff. Injuries to equine veterinarians were predominately kicks to the leg or head, and usually involved the examination of a horse's distal limb, with most not wearing hard hats. Production animal veterinarians' injuries included crushed hands and feet, and kicks to legs. Injuries often lead to hospital attendance (>25 % equine, >40 % production animal), yet few took time off work. Veterinarians avoided taking time off work after injuries. Reasons included; minimisation of injury severity, not wanting to 'let the team down', and feelings of guilt. Many planned behaviour change post-injury, including using protective headwear, increasing awareness of surroundings, and using better restraint. Most injuries went unreported due to lack of awareness, acceptance of injury risk, time constraints, and believing reporting would have no impact. This study exposes a culture in large animal veterinary workplaces that normalises injuries and undervalues safety. The lack of protective measures and the tendency to continue working despite serious injuries, highlight a need for urgent cultural and systemic change. Improved safety practices, practice leadership commitment, and comprehensive training are essential to address this deep-seated issue and fostering a safer work environment.

Epidemiology of horse trauma: a literature review

PURPOSE

Horses are used for many recreational and occupational activities. They are large, strong, temperamental, and unpredictable animals and people involved with them are at risk for injuries, from minor abrasions to severe injuries that may lead to death. This review reports on horse trauma in relation to the characteristics of injured equestrians, characteristics of horse trauma, and clinical outcomes.

METHODS

A literature search was conducted from health-related electronic databases to identify studies from 2018 to 2023. The search returned 115 relevant full-text articles but after screening and assessment for eligibility, 39 were included in this review for a detailed examination of horse trauma epidemiology. Most studies were undertaken in the USA and the most used method was a retrospective review of hospital or trauma registry data.

RESULTS

There have only been very slight changes in horse trauma numbers and outcomes over the past 5 years. Most injuries often follow falls and kicks. Females in their late-20 s to mid-30 s who are recreational equestrians are the group most represented in the data. The commonest injuries include fractures, and head, thoracic, and abdominal trauma. Most individuals with horse trauma were treated in the Emergency Department and discharged. For the equestrians who were admitted to hospital, around one-third required surgery. Mortality rates are very low.

CONCLUSION

The popularity of occupational and recreational horse activities does not seem to wane and horse trauma continues to represent a significant concern for the health system. Health care workers need to be cognizant of the scope of trauma presentations as the mechanisms of injury can be complicated putting the equestrian at a high risk of associated injuries that may be life-threatening.

Incidence of staff injury and illness at the Tokyo 2020 and Beijing 2022 Olympic and Paralympic Games

Objective

To report epidemiological data regarding injury and illness among the Team USA staff during the Tokyo 2020 Summer Olympic and Paralympic Games and Beijing 2022 Winter Olympic and Paralympic Games.

Methods

A retrospective review of all Team USA staff (total staff, N=1703 (62.5% female); total staff days (SD)=34 489) medical encounters during the Tokyo 2020 Games and Beijing 2022 Games was conducted. Details related to injury and illness were evaluated. Incidence with 95% CI per 1000 staff days were calculated.

Results

A total of 32 illnesses (incidence [95% CI] 0.9 [0.6, 1.2]) and 23 injuries (incidence 0.7 [0.4, 0.9]) were sustained by the Team USA delegation staff members during the Tokyo 2020 Games and Beijing 2022 Games. Female staff reported more illnesses (illnesses proportion (IP) 2.9%; incidence 1.4 [0.8, 2.0]), while male staff incurred more injuries (IP 1.8%; incidence 0.9 [0.5, 1.3]). When stratified by physiological system, dermatological and infectious were the most common systems involved with illness (IP 0.5%; incidence 0.2 [0.1, 0.4]). Injuries to the upper limb were most common (IP 0.3%; incidence 0.3 [0.1, 0.5]).

Conclusion

Injury and illness rates among the Team USA staff during the Tokyo 2020 Games and Beijing 2022 Games were low, but notable. Knowledge of injury and illness risks contributes to staffing decisions and prevention strategies for staff supporting athletes during competition.

The Physiological Requirements of and Nutritional Recommendations for Equestrian Riders

Equestrian sport is under-researched within the sport science literature, creating a possible knowledge vacuum for athletes and support personnel wishing to train and perform in an evidence-based manner. This review aims to synthesise available evidence from equitation, sport, and veterinary sciences to describe the pertinent rider physiology of equestrian disciplines. Estimates of energy expenditure and the contribution of underpinning energy systems to equestrian performance are used to provide nutrition and hydration recommendations for competition and training in equestrian disciplines. Relative energy deficiency and disordered eating are also considered. The practical challenges of the equestrian environment, including competitive, personal, and professional factors, injury and concussion, and female participation, are discussed to better highlight novelty within equestrian disciplines compared to more commonly studied sports. The evidence and recommendations are supported by example scenarios, and future research directions are outlined.

Anxiety and Depression in British Horseracing Stud and Stable Staff Following Occupational Injury

Horseracing has identified several factors influencing staff wellbeing; however, the relationship between injury, anxiety, and depression is yet to be established. This study investigated anxiety and depression scores and their association to pain management, coping, and help-seeking behaviour in injured British horseracing staff. An online retrospective survey was completed by 175 participants, identifying injury prevalence, coping strategies, occupational risk factors, and Hospital Anxiety and Depression Scale (HADS) scores. Analysis identified 65.14% (n = 114) of staff reported anxiety scores above the threshold (≥8) and 59.52% (n = 104) of staff reported depression scores ≥8. Median anxiety and depression scores were higher for staff who viewed their employer as unhelpful (anxiety p = 0.001; depression p = 0.020). Heightened anxiety and depression were associated with an increased likelihood to use pain medication to manage at work, including non-steroidal anti-inflammatory drugs (NSAID's), alcohol, nicotine, and prescription drugs (p < 0.05). Implications for staff wellbeing is evident; anxiety and depression risks are high following injury, which may influence help-seeking behaviour, perceived job security, and coping mechanisms. This paper suggests it is vital to continue to investigate poor mental health and injury in racing staff and the implications for equine welfare.

Cars dent, horse riders break: Analysis of police-recorded injury incidents involving ridden horses on public roads in Great Britain

INTRODUCTION

Police-recorded road injury data are frequently used to approximate injury risk for different road user groups but a detailed analysis of incidents involving ridden horses has not previously been conducted. This study aims to describe human injuries resulting from interactions between ridden horses and other road users on public roads in Great Britain and identify factors associated with severe to fatal injuries.

METHOD

Police-recorded road incident data involving ridden horses (2010-2019) were extracted from the Department for Transport (DfT) database and described. Multivariable mixed-effects logistic regression modeling was used to identify factors associated with severe/fatal injury outcomes.

RESULTS

A total of 1,031 injury incidents involving ridden horses were reported by police forces, involving 2,243 road users. Out of 1,187 road users injured, 81.4% were female, 84.1% were horse riders, and 25.2% (n = 293/1,161) were in the 0-20 year age category. Horse riders represented 238/267 serious injuries and 17/18 fatalities. Vehicle types involved in incidents where horse riders were seriously/fatally injured were mostly cars (53.4%, n = 141/264) and vans/light goods vehicles (9.8%, n = 26). Horse riders, cyclists, and motorcyclists had higher odds of severe/fatal injury compared to car occupants (p < 0.001). Severe/fatal injuries were more likely on roads with 60-70 mph speed limits versus 20-30 mph roads, while odds of severe/fatal injury increased with increasing road user age (p < 0.001).

CONCLUSIONS

Improved equestrian road safety will largely impact females and young people as well as reducing risk of severe/fatal injuries in older road users and those using modes of transport such as pedal-cycles and motorcycles. Our findings support existing evidence that reductions in speed limits on rural roads would help reduce the risk of serious/fatal injuries.

PRACTICAL APPLICATIONS

More robust equestrian incident data would better inform evidence-based initiatives to improve road safety for all road users. We suggest how this can be done.

Incidence of concussions and helmet use in equestrians

OBJECTIVES

Equestrians have a high risk of concussions per hospital records. However, most concussions occur in private settings where concussions are not tracked. We determined concussion incidence by self-report, expressed per 1000 h of exposure, and determined helmet usage and concussion knowledge.

DESIGN

Descriptive epidemiological study.

METHODS

Equestrians were recruited using a snowball method of sampling in which enrolled participants recruited more equestrians. Participants completed a survey of equestrian experience and history of concussion, symptoms and provided estimates of hours spent in various equestrian activities. From these data, incidences of concussions were calculated. In addition, they answered questions regarding helmet usage and willingness to take risks when concussed.

RESULTS

210 participants (203 women) reported 27 ± 14 years of equine experience and 728 concussions, 3.47 ± 5.34 per person (0-55). Incidence while riding was 0.19/1000 h which was greater than the incidence while driving (0.02/1000 h) or handling horses (0.03/1000 h). Riders were helmeted at the time of injury 85% of the time. While concussion knowledge was high, most reported willingness to risk permanent injury by continuing to work with horses while injured.

CONCLUSIONS

To our knowledge this is the first study to document incidence of concussions in equestrians: incidence is higher while riding than during football or rugby training. Helmets were far more commonly worn at the time of concussion than reported in hospital data, suggesting that helmets effectively reduce concussions severe enough to warrant urgent medical care.

The psychological responses of British amateur point-to-point jockeys to personal injury

Previous research has reported significant psychological consequences of injury on rehabilitation success, performance, and wellbeing in athletes, although little is known within horse-based sports. There is a high prevalence of injury reported in point-to-point (P2P) jockeys, but despite this, comparatively little research exists examining the psychological implications resulting from physical trauma within horseracing. The aim of this study was to investigate the psychological responses to personal injury in British amateur P2P jockeys. Five amateur P2P jockeys (two male, three female, x- age 25 years old) were interviewed about their experiences post an injury sustained during racing in the preceding 12 months. Interview questions explored their pre-injury career, the rehabilitation phase, pre-return to racing phase issues and coping strategies used by jockeys. Thematic analysis revealed three higher order themes: emotional responses, coping strategies, and factors affecting recovery. Subjects universally cited negative emotional responses following injury, including grief, a sense of loss, and frustration, and all experienced denial at the onset of injury. Typical coping strategies included strong support networks of family, friends and racing staff, and goal setting. Fear of reinjury was identified by all athletes, particularly on return to the saddle, and the attitudes towards injury management, such as denial, seen in this study may provide opportunities to develop targeted education campaigns for P2P jockeys on injury services. Targeted marketing for P2P jockeys on available injury support is recommended, such as seen for professional jockeys, as well as the creation of career development resources to offer alternative routes for P2P jockeys following injury.