Audit of animal-related injuries at UK veterinary schools between 2009 and 2018

BACKGROUND

Animal-related injuries pose a significant risk to the veterinary profession. This study aimed to describe the incidence, demographics, context and consequences of animal-related injuries at UK veterinary schools.

METHODS

A multicentre audit of accident records (2009-2018) across five UK veterinary schools was performed. Injury rates were stratified by school, demographics and species. The context and cause of the injury were described. Multivariable logistic models explored factors associated with medical treatment, hospital visits and time off work.

RESULTS

An annual rate of 2.60 (95% confidence interval 2.48-2.72) injuries per 100 graduating students was calculated, varying between veterinary schools. Injuries were more frequently recorded in staff than students, and there were significant differences between staff and students in the activities performed preceding injury. Cats and dogs were associated with the highest number of reported injuries. However, injuries associated with cattle and horses were the most severe, with significantly higher hospital attendances and more time off work taken.

LIMITATIONS

Data were based on reported injuries and likely underestimate the true injury rate. The population at risk was hard to quantify as population size and exposure were variable.

CONCLUSION

Further research is recommended to explore the clinical and workplace management, including recording culture, of animal-related injuries among veterinary professionals.

A Cross Sectional Survey of International Horse-Racing Authorities on Injury Data Collection and Reporting Practices For Professional Jockeys

Jockey injuries are common in professional horse-racing and can result in life-threatening or career-ending outcomes. Robust injury data are essential to understand the circumstances of injury occurrence and ultimately identify prevention opportunities. This study aimed to identify jockey injury surveillance practices of international horse-racing authorities (HRAs) and the specific data items collected and reported by each HRA. A cross-sectional survey of representatives (e.g. Chief Medical Officer) from international HRAs was conducted. An online and paper questionnaire was designed comprised of 32 questions. Questions considered the barriers and facilitators to data collection within each HRA, and where available, what data were collected and reported by HRAs. Representatives from 15 international racing jurisdictions were included, of which 12 reported collection of race day injuries or falls, using varied definitions of medical attention and time loss. Six HRAs did not have a definition for a jockey injury, and eight HRAs had no parameters for describing injury severity. Race day exposure was collected by two HRAs. Results were commonly presented by HRAs as the number of injuries (n = 9/15) or proportion of injured jockeys (n = 6/15). The lack of a designated role for collection, collation and reporting of data was the main barrier for injury surveillance. Twelve HRAs agreed that mandatory collection would be a strong facilitator to improving practice. Enhancement and standardization of international jockey injury surveillance is required to move forward with evidence informed prevention. Concurrent investigation of how reporting practices can be best supported within existing HRA structures is recommended.

An Internet survey of risk factors for injury in North American dogs competing in flyball

A survey was used to investigate injuries in dogs competing in flyball. Complete surveys were obtained from 272 respondents with 589 dogs. In the past year, 23.3% of dogs were injured, with 34.1% injured during their career to date. Common injury sites were paws/digits, back, shoulder, and iliopsoas muscle/groin. Injury in previous years, modified by weight:height ratio, was a significant risk factor for injury. Dogs > 2 y of age had increased risk of injury, as did dogs with best times < 4.0 s. Canadian dogs had increased risk of injury (30.7% injured) compared to United States dogs (20.1% injured). This relationship was modified by participation in other sports, which generally reduced risk of injury in Canadian dogs. Further investigation of risk factors should include differences in training and competition between the United States and Canada, as well as injury prevention strategies.

Successful medical management and rehabilitation of exercise-induced dorsal scapular luxation in an ultramarathon endurance sled dog with magnetic resonance imaging diagnosis of grade II serratus ventralis strain

Dorsal displacement of the scapula in dogs is rare and often traumatic. This report describes dorsal luxation of the scapula in a sled dog. This case is unique given the injury was sport-related. Magnetic resonance imaging helped direct therapy and monitor healing; and medical management with rehabilitation resulted in full recovery and return to sport. One year after injury, the dog completed both a 482 km and a 1600 km endurance race, placing among the leading teams in the 1600-km race.

Characterization and comparison of injuries caused by spontaneous versus organized dogfighting

OBJECTIVE To characterize and compare injuries found in dogs involved in spontaneously occurring dogfights with those of dogs used in illegal organized dogfighting. DESIGN Retrospective case-control study. ANIMALS 36 medium-sized dogs evaluated following spontaneous fights with a dog of the same sex and similar weight (medium dog-medium dog [MDMD] fights), 160 small dogs examined following spontaneous fights with a larger dog (big dog-little dog [BDLD] fights), and 62 dogs evaluated after being seized in connection with dogfighting law enforcement raids. PROCEDURES Demographic characteristics and injuries were recorded from medical records. Prevalence of soft tissue injuries in predetermined body surface zones, as well as dental or skeletal injuries, was determined for dogs grouped by involvement in BDLD, MDMD, and organized dogfights. The extent of injuries in each location was scored and compared among groups by 1-factor ANOVA. Patterns of injuries commonly incurred by each group were determined by use of prevalence data. RESULTS Mean extent of injury scores differed significantly among groups for all body surface zones except the eye and periorbital region. Mean scores for dental injuries and rib fractures also differed significantly among groups. Organized fighting dogs more commonly had multiple injuries, particularly of the thoracic limbs, dorsal and lateral aspects of the head and muzzle or oral mucosa, dorsal and lateral aspects of the neck, and ventral neck and thoracic region. CONCLUSIONS AND CLINICAL RELEVANCE To the authors' knowledge, this was the first study to compare injuries incurred during spontaneous and organized dogfighting. Establishing evidence-based patterns of injury will help clinicians identify dogs injured by organized dogfighting and aid in the prosecution of this crime.

Rib fracture in a horse during an endurance race

We describe a fatal case, in which a horse suffered a fall and as a consequence, rib fractures. Diagnosis was made postmortem and the horse died without showing clear signs of respiratory dysfunction. The retrospective reports of injuries can be important to reduce these traumatic events and to avoid fatalities.

Regenerative medicine for the treatment of musculoskeletal overuse injuries in competition horses

PURPOSE

Tissue repair in musculoskeletal injuries is often a slow and sometimes incomplete process. Regenerative medicine based on the use of growth factors (GFs) and cell therapy is aimed at improving the quality and speed of tendon and ligament healing. The aim of this study was to evaluate the potential for the administration of a combination of autologous platelet-rich plasma (PRP) and freshly isolated bone marrow mononucleated cells (BMMNCs) in 13 competition horses affected by overuse musculoskeletal injuries (suspensory ligament desmopathy and superficial flexor tendinopathy) and refractory to other therapies.

METHODS

After ultrasonographic localisation of the lesion, the autologous BMMNC suspension and PRP were injected directly into the core lesion. BMMNC and platelet count as well as growth factors in PRP were measured to determine factors influencing the clinical outcome.

RESULTS

Horses showed a marked improvement in their degree of lameness and 84.6% were able to return to competition. Among all the factors studied, the platelet concentration predicted the healing time: significantly faster recovery (p = 0.049) was observed in cases of PRP with more than 750 × 10(3)/μl platelets.

CONCLUSIONS

Competition horses are involved in highly demanding activities, thus being a similar model for the high mechanical overload typical of human athletes. The promising results obtained suggest that this combined biological approach may be useful even for the treatment of recalcitrant overuse musculoskeletal injuries in highly demanding patients if the appropriate dose of cells and GFs is applied.

Risk factors for musculoskeletal injuries of the lower limbs in Thoroughbred racehorses in New Zealand

AIM

To investigate risk factors for injury to musculoskeletal structures of the lower fore- and hind-limbs of Thoroughbred horses training and racing in New Zealand.

METHODS

A case-control study analysed by logistic regression was used to compare explanatory variables for musculoskeletal injuries (MSI) in racehorses. The first dataset, termed the Training dataset, involved 459 first-occurrence cases of lower-limb MSI in horses in training, and the second, the Starting dataset, comprised a subset of those horses that had started in at least one trial or race in the training preparation that ended with MSI (n=294). All training preparations for horses that did not suffer from MSI for which complete data were available were used in the analyses as controls, and provided 2,181 and 1,639 preparations for the Training and Starting datasets, respectively. Multivariate logistic regression was used to evaluate risk factors, and results were reported as odds ratios (OR) and 95% confidence intervals (CI).

RESULTS

Horses aged > or =5 years were at higher risk of injury than 2-year-olds. Elevated odds of MSI occurred in horses in the Starting dataset that were training in the 1997-1998 year compared with the 1999-2000 year, and in those horses where trials comprised >20% of all starts in a preparation. Training preparations that ended in winter, and horses in their third or later training preparation, had lower odds of MSI compared with those ending in other seasons or the first preparation, respectively. Reduced odds of MSI were observed in preparations in which starts occurred compared with those that had no starts, and in the Starting dataset, preparations that included more than one start had a reduced likelihood of MSI compared with preparations that had only one start. In the Training dataset, preparations longer than 20 weeks were associated with reduced odds of MSI compared with those shorter than 20 weeks. Cumulative racing distance in the last 30 days of a training preparation was best modelled with linear and quadratic terms. Results indicated that increasing cumulative racing distances were associated with an initial reduction in the odds of MSI that then levelled out and finally appeared to increase again as the explanatory variable continued to increase. The risk of MSI varied significantly between trainers.

CONCLUSION

This study identified intrinsic (age) and extrinsic risk factors for MSI in training and racing Thoroughbreds in New Zealand. The risk of MSI initially decreased, then increased, as cumulative racing distance increased. Significant variation between trainers indicated management and training methods influence the risk of MSI.

Horse-level risk factors for fatal distal limb fracture in racing Thoroughbreds in the UK

REASONS FOR PERFORMING STUDY

Fractures below the level of the radius or tibia (distal limb fractures) are the most common cause of equine fatality on UK racecourses; however, little is known about their epidemiology or aetiology. Identification of risk factors could enable intervention strategies to be designed to reduce the number of fatalities.

OBJECTIVES

To identify horse-level risk factors for fatal distal limb fracture in Thoroughbreds on UK racecourses.

METHODS

A case-control study design was used. Fractures in case horses were confirmed by post mortem examination and 3 matched uninjured controls were selected from the race in which the case horse was running. One hundred and nine cases were included and information was collected about previous racing history, horse characteristics and training schedules. Conditional logistic regression was used to identify the relationship between a number of independent variables and the likelihood of fracture.

RESULTS

Horses doing no gallop work during training and those in their first year of racing were at significantly increased risk of fracture on the racecourse. Case horses were also more likely to have trained on a sand gallop, i.e. a gallop described by trainers as being primarily composed of sand.

CONCLUSIONS

Modifications to training schedules, specifically within the first year of racing, may have a large impact on the risk of fatal distal limb fracture on the racecourse. Horses should do some gallop work in training and our results suggest that the minimum distance galloped should be between 805-2012 m (4-10 furlongs)/week.

POTENTIAL RELEVANCE

The information from this study can be used to alter training schedules in an attempt to reduce the incidence of fatal distal limb fracture in Thoroughbred racehorses. Training should include some gallop work, and further studies, recording the exact level of work, will help to identify an optimum range of training speeds and distances which will reduce the liklihood of catastrophic fracture on the racecourse.

Risk factors for Thoroughbred racehorse fatality in jump starts in Victoria, Australia (1989-2004)

REASONS FOR PERFORMING STUDY

The risk of fatality is greater in jump than in flat racing in Victoria, Australia. This is the first study to identify risk factors specific to jump starts in Victoria.

OBJECTIVE

To identify risk factors for fatality of Thoroughbred racehorses in jump starts on all racecourses in Victoria, Australia between 1989 and 2004.

METHODS

Fatalities comprised all horses that died during or immediately after a jump (hurdle or steeplechase) race or official jump trial and all horses that were subjected to euthanasia within 24 h of an event in which an injury was sustained. The retrospective study involved 191 case starts and 2324 control starts. Univariable and multivariable backward stepwise logistic regression was used to identify risk factors for fatality at any one start. A multiple level model was used with racecourse included as a random effect.

RESULTS

In the final multivariable model, the duration of the racing career of the horse, the number of flat, hurdle and steeple starts accumulated in the 60 days prior to the case or control start, the number of flat and jump starts accumulated over the racing career, if the horse had had a start between 1 and 14 days prior to the case or control start, the type of jump race (hurdle or steeple), the calendar year of the start and the location of the racecourse were associated with fatality.

CONCLUSIONS

The findings highlight the need to investigate further the differences between hurdle and steeplechase events and the adverse effect of prolonged prior flat racing careers on the risk of fatality in jump starts.

POTENTIAL RELEVANCE

This is the first study to examine risk factors for fatality in jump starts in Victoria. The results should shape the development of interventions to reduce the risk in jump starts in the future.

The risk of a horse-and-rider partnership falling on the crosscountry phase of eventing competitions

REASONS FOR PERFORMING STUDY

Fatalities resulting from horse falls occurring during the cross-country phase of eventing competitions initiated epidemiological investigation of the risk factors associated with horse falls.

OBJECTIVES

To identify variables that increased or decreased the risk of a horse fall during the cross-country phase of an eventing competition.

METHODS

Data were collected from randomly selected British Eventing competitions held in Great Britain during 2001 and 2002. Data were obtained for 173 cases (jumping efforts resulting in a fall of the horse-and-rider partnership) and 503 matched controls (jumping efforts not resulting in a fall). The risk of falling was modelled using conditional logistic regression.

RESULTS

An increased risk of a horse fall was associated with jumping into or out of water; taking off from good-to-soft, soft or heavy ground; fences with a drop landing; nonangled fences with a spread > or =2 m; and angled fences. Other risk factors included riders who knew that they were in the lead within the competition before the cross-country phase; an inappropriate speed of approach to the fence (too fast or too slow); horse-and-rider partnerships that had not incurred refusals at earlier fences; and riders who received cross-country tuition.

CONCLUSIONS

This study has identified modifiable course- and fence-level risk factors for horse falls during the cross-country phase of eventing competitions. The risk of horse and rider injury at eventing competitions should be reduced by 3 simple measures; maintaining good to firm take-off surfaces at fences, reducing the base spread of fences to <2 m and reducing the use of fences at which horses are required to jump into or out of water. Risk reduction arising from course and fence modification needs to be confirmed by intervention studies.

POTENTIAL RELEVANCE

Knowledge of factors that increase or decrease the risk of a horse fall can be used by UK governing bodies of the sport to reduce the risk of horse falls on the cross-country phase of eventing competitions, and reduce the risk of horse and rider injuries and fatalities. As one in 3 horses that fall injure themselves and one in 100 horse falls results in fatality to the horse, we suggest that immediate consideration is given to these recommendations.

Risk factors for fatal lateral condylar fracture of the third metacarpus/metatarsus in UK racing

REASONS FOR PERFORMING STUDY

Lateral condylar fractures of the third metacarpus/metatarsus are the most common cause of equine fatality on UK racecourses. Identification of risk factors for such injuries and the subsequent implementation of intervention strategies could significantly reduce the total number of racecourse fatalities.

OBJECTIVES

To identify horse-, race- and course-level risk factors for fatal lateral condylar fracture in Thoroughbreds on UK racecourses.

METHODS

Case-control study designs were used. Case horses were defined as those that were subjected to euthanasia having sustained an irreparable lateral condylar fracture while racing at any of the 59 UK racecourses. Case races were defined as those in which one or more horses sustained a fatal lateral condylar fracture. Three controls for each case horse were selected at random from the race in which the case was running. Three controls for each case race were selected at random from all races of the same type held in the same year. Ninety-eight cases were included in the study. Conditional logistic regression was used to identify the relationship between a number of independent variables and the likelihood of fracture.

RESULTS

Horses doing no gallop work during training and those in their first year of racing were at significantly increased risk of fracture on the racecourse. Case horses were also more likely to have started racing as 3- or 4-year-olds. Fractures were found to be more likely in longer races with a larger number of runners, races in which professional jockeys were not permitted to ride and races in which the going was described as firm or hard.

CONCLUSIONS AND POTENTIAL RELEVANCE

Modifications to training schedules, specifically within the first year of racing, may have a large impact on the risk of fatal lateral condylar fracture on the racecourse. Horses should do some gallop work in training and our results suggest that the minimum distance galloped should be between 201 m (1 furlong) and 1609 m (8 furlongs) per week. The association with age at first race requires further investigation for flat and National Hunt racing separately. A reduction in the number of races taking place on very firm going could have an impact on the number of lateral condylar fractures.

Risk of fatality and causes of death of Thoroughbred horses associated with racing in Victoria, Australia: 1989-2004

REASONS FOR PERFORMING STUDY

Determining the risk of fatality of Thoroughbred horses while racing is essential to assess the impact of intervention measures designed to minimise such fatalities.

OBJECTIVES

To measure the risk of racehorse fatality in jump and flat starts on racecourses in Victoria, Australia, over a 15 year period and to determine proportional mortality rates for specific causes of death.

METHODS

All fatalities of Thoroughbred horses that occurred during or within 24 h of a race were identified from a database. The risk of a start resulting in a racehorse fatality in all races and within flat and jump races, proportional mortality rates, population attributable risk, population attributable fraction and risk ratios were calculated along with 95% confidence intervals. Poisson regression was also performed to estimate risk ratios.

RESULTS

There were 514 fatalities over the 15 year period; 316 in flat races and 198 in jump races. The risk of fatality was 0.44 per 1000 flat starts and 8.3 per 1000 jump starts (18.9 x greater). The risk of fatality on city tracks was 1.1 per 1000 starts whereas on country tracks it was 0.57 per 1000 starts. Of the 316 fatalities in flat races, 73.4% were due to limb injury, 2.5% to cranial or vertebral injury and 19.0% were sudden deaths. Of the 198 fatalities in jump races, 68.7% were due to limb injury, 16.2% to cranial or vertebral injury and 3.5% were sudden deaths. The risk of fatality in flat starts increased between 1989 and 2004 but the risk in jump starts remained unchanged over the 15 year period.

CONCLUSIONS

The risk of fatality in flat starts was lower in Victoria than North America and the UK but the risk in jump starts was greater. Catastrophic limb injury was the major reason for racehorse fatality in Victoria but there was a larger percentage of sudden deaths than has been reported overseas. The risk of fatality in jump starts remained constant over the study period despite jump racing reviews that recommended changes to hurdle and steeple races to improve safety.

POTENTIAL RELEVANCE

This study provides important benchmarks for the racing industry to monitor racetrack fatalities and evaluate intervention strategies.

Whip use and race progress are associated with horse falls in hurdle and steeplechase racing in the UK

REASONS FOR PERFORMING STUDY

Falls during racing present a risk of injury to both horse and jockey and a risk of fatality to horses.

OBJECTIVES

To use video recordings of races to describe the circumstances surrounding horse falls at hurdle and steeplechase fences and to identify and quantify within-race risk factors for horse falls in National Hunt racing in the UK.

METHODS

A retrospective, matched, nested case-control study using video recordings of races was conducted on 6 UK racecourses. Cases and controls were matched on both race type and jump number at which the fall occurred. Conditional logistic regression analysis was used to examine the univariable and multivariable relationship between predictor variables and the risk of falling.

RESULTS

The risk of falling was significantly associated with whip use and race progress. Horses which were being whipped and progressing through the race were at greater than 7 times the risk of falling compared to horses which were not being whipped and which had no change in position or lost position through the field.

CONCLUSIONS

This study has identified whip use and the position of the horse with respect to others in the field as potential risk factors for horse falls.

POTENTIAL RELEVANCE

If these findings are confirmed by the use of intervention trials (e.g. with whip-free or restricted whip use races), modifications could be introduced which would reduce the frequency of horse falls, leading to improved equine welfare.

Risk factors for Thoroughbred racehorse fatality in flat starts in Victoria, Australia (1989-2004)

REASONS FOR PERFORMING STUDY

Research into risk factors specific for fatality in flat racing should be focused at a regional level as the risk factors may differ among countries and even regions within countries.

OBJECTIVE

To identify risk factors for fatality of Thoroughbred racehorses in flat starts on all racecourses in Victoria, Australia between 1989 and 2004.

METHODS

Fatalities comprised all horses that died during or immediately after a flat race or official flat trial, and all horses that were subjected to euthanasia within 24 h of an event in which an injury was sustained. The retrospective study involved 283 case starts and 3307 control starts. Univariable and multivariable backward stepwise logistic regression was used to identify risk factors for fatality at any one start.

RESULTS

In the final multivariable model, horse gender, prior racing history, race length, racing year, racecourse location and track rating were associated with fatality.

CONCLUSIONS

This study identified specific risk factors for fatality. The findings are consistent with the hypothesis that horses accumulating high speed exercise are predisposed to catastrophic injury. The study has also highlighted the need to investigate further the adverse effects of different track ratings on the incidence of injury and subsequent fatality.

RELEVANCE

The results will facilitate the development of effective strategies to improve overall safety of horses and jockeys in flat racing in Victoria, Australia.

Association of type of sport and performance level with anatomical site of orthopaedic injury diagnosis

REASON FOR PERFORMING STUDY

Although anecdotal reports of increased orthopaedic injury risk in equine sports exist, there is little scientific evidence to support this.

OBJECTIVES

To test whether horses undertaking a single competitive sport have increased risk of specific injuries compared to those used for general purpose riding (GP); and whether injury type varies with sport category and performance level.

METHODS

Data from 1069 records of horses undergoing orthopaedic evaluation (1998-2003) and meeting inclusion criteria were reviewed. Sport category (GP, showjumping, dressage, eventing, racing), level (nonelite or elite) and diagnosis were recorded. Effects of sport category and level on probability of a specific diagnosis were assessed using chi-squared tests. Logistic regression was used to determine which competitive sports and levels increased risk of injury compared with GP.

RESULTS

Overall there was a significant effect of sport category and level on diagnosis (P<0.0001). There was significant difference between anatomical site injured and sport category (P<0.0001); a high risk of forelimb superficial digital flexor tendon injury in elite eventing (P<0.0001) and elite showjumping (P = 0.02); distal deep digital flexor tendon (DDFT) injury in elite showjumping (P = 0.002); and hindlimb suspensory ligament injury in elite (P<0.0001) and nonelite (P = 0.001) dressage. There was a low risk of tarsal injury in elite eventing (P = 0.01) and proximal DDFT injury in dressage (P = 0.01).

CONCLUSIONS

Horses competing in different sports are predisposed to specific injuries; particular sports may increase the risk of injury at certain anatomical sites; and the type and site of injury may reflect the type and level of performance.

POTENTIAL RELEVANCE

These findings could guide clinicians in the diagnosis of sport related injuries.

Fracture rate in Thoroughbred racehorses is affected by dam age and parity

This study's aim was to determine the effects of dam age and parity on the rate of fracture in offspring in Thoroughbred racehorses in training for flat racing. It was hypothesised that first foals and those from older mares would have a higher fracture rate than subsequent foals and those from younger mares. A two-year observational cohort study collected data from eight trainers on 335 horses that were monitored since the start of their training as yearlings. Multivariable Poisson regression analyses showed that first foals had a significantly lower fracture rate than subsequent ones (RR=0.33; 95% CI=0.12, 0.89; P=0.02) and rate of fracture decreased with increasing dam age (RR=0.91 per year increase in dam age; 95% CI=0.83, 0.99; P=0.03). This study shows for the first time that the rate of equine injury may be influenced by factors that affect skeletal development. Further research on intra-uterine and peri-natal determinants of injury risk in later life in horses is needed.

Risk factors for musculoskeletal injuries in 2-year-old Thoroughbred racehorses

Musculoskeletal injuries (MSI) in racehorses have been identified as the most common cause of lost training days and weeks spent resting at pasture. Several training-, track- and horse-related risk factors have been identified. However, there is no clear understanding of the inter-relationship between these factors. The aim of this longitudinal cohort study was to investigate risk factors for MSI in 2-year-old Thoroughbred racehorses. Australian Thoroughbred trainers were convenience sampled and enrolled in a 27-month longitudinal cohort study. The study population consisted of all 2-year-old Thoroughbred racehorses trained by a participating trainer. Horses were followed from the time of enrollment until the completion of the study or until they were lost to follow-up. Trainers were visited at approximately 14-day intervals to collect training and injury data. Training days were categorised as fast days if the maximum speed during training exceeded 800 m/min. For each horse, the first training period that included one or more fast days was analysed. A multiple logistic regression model was used to determine those horse- and training-related variables that were associated with MSI. Data from 274 horses trained by 14 trainers at five racetracks were analysed. Forty percent of the horses sustained a MSI during their first fast preparation. The average distance trained at speeds >or=800 m/min and the percentages of fast days from the first fast day until the end of the preparation were the only variables associated with MSI. After accounting for these variables there were still significant differences between trainers. This suggests that there are other training-related variables such as the rate of increase in distance trained at speeds >or=800 m/min that may be risk factors for MSI. In addition, other factors such as the level of veterinary involvement and the training centre/racetrack may be risk factors for MSI. More analysis using multi-level modelling is required to determine the relationship between trainer- and track-related risk factors.

A comparison of survival models for assessing risk of racehorse fatality

Survival analysis was used to assess risk factors for fatal injuries on UK race courses. This allowed assessment of variation due to temporal horse-level effects, including previous racing intensity and historical distribution of race types, as well as race-level factors. Comparisons were made between measuring survival time as number of days and as number of races to injury from the first race. Two related models were presented for time as number of races to injury: a Cox regression model fitted using partial likelihood, with the Efron approximation to handling ties, and a discrete-time logit model fitted using maximum likelihood. The latter approach had the advantages of being computationally more efficient and enabling the testing of different functional forms for the dependence of hazard on time. Retrospective data were available from all race starts on the 59 courses in Britain from 1990 to the end of 1999, as analysed by . The analysis was conducted on the data for the 47,424 horses that had started racing in the UK: 538,895 starts with 1,228 fatal injuries. Horses starting racing abroad were excluded, but some included horses would have raced abroad at some stage during their racing career. The results for the selected models were broadly consistent with each other and with previously published studies. Steeplechase and hurdle races had a higher risk of fatal injury than flat races (relative hazards 1.5 and 1.7, respectively). Risk increased with the firmness of surface, age and race distance (reaching a plateau at 20 furlongs) and decreased with previous racing intensity (reaching a plateau after seven races run in the last 12 months). Horses running their first race of a new type were also found to be at higher risk (relative hazard 1.5). The main difference between the models for time as number of days and number of races concerned the role of age: age at race was identified as the more important factor in the latter model, whereas, age at first race was more significant in the former model.

Analysis of horse race videos to identify intra-race risk factors for fatal distal limb fracture

The objective of this study was to identify risk factors, during racing, associated with imminent fatal distal limb fracture in Thoroughbreds. One hundred and nine cases of fatal distal limb fracture were identified from all 59 UK racecourses over a 2-year period (February 1999-January 2001). Three uninjured control horses were randomly selected from the same race as the case horse. Videos of races in which fractures occurred were viewed using a defined protocol. Fractures in flat races occurred at any time during the race, whereas 74% (45/61) of cases in national hunt type races occurred in the second half of races. More than 75% (79/103) of cases were spontaneous, i.e. there was no obvious external influence such as a fall at a fence or collision with another horse. Sixty-six percent (44/67) of horses, sustaining a forelimb fracture, fractured the forelimb they were using as lead leg at the time of fracture. When case and control horses were compared, horses that were: (a) making good progress through the race, (b) reluctant to start and (c) received encouragement in the final 10s before the time of fracture, were more likely to sustain a fracture.

A case-control study of factors associated with pelvic and tibial stress fractures in Thoroughbred racehorses in training in the UK

Few epidemiological studies have investigated risk factors for musculoskeletal injury occurring in Thoroughbred racehorses during training, although it is the major cause of wastage in the racing industry. We recently conducted a large-scale epidemiological study to estimate the incidence of fracture in racehorses in training in the UK and to identify associated risk factors. Thirteen racehorse trainers provided data on horses in their care, with daily recording of training information and provision of details on any fractures incurred. Data were collected for 2 years, including two consecutive flat racing seasons (1999 and 2000). This paper describes findings from a nested case-control study investigating factors associated with the occurrence of pelvic and tibial stress fractures in our study population. Cases were identified from the main study and defined as horses with a pelvic or tibial stress fracture, confirmed through routine diagnostic imaging. Randomly selected controls were matched on date of fracture in the case. Age and gender of the horse, its exercise history and training surfaces were examined as explanatory variables. Exercise was quantified as cumulative distances cantered and worked at high speed in 30- and 60-day periods prior to date of fracture in the case. Conditional logistic regression was used to construct multivariable models for the 30- and 60-day periods, respectively. We hypothesised that larger cumulative exercise distances would be associated with an increased risk of pelvic or tibial stress fracture and that different training surfaces would be associated with differences in fracture risk. In the 30-day period, when adjusting for trainer, the risk of pelvic or tibial stress fracture increased with increasing distance cantered, reaching a peak at around 50 km, after which the risk reduced. This trend was not obvious in the 60-day period, with no significant association between exercise distances and risk of stress fracture. Predominant use of one particular sand-based all-weather surface was related to an increased risk of pelvic or tibial stress injury, although this finding should be interpreted with caution. Surface maintenance and construction may play a role; variables that were not considered in the current analyses, which were based on a relatively small number of cases. Trainer was associated with differences in stress fracture risk after adjusting for exercise distances and surface but age and gender were not.

Catastrophic fracture of the lateral condyle of the third metacarpus/metatarsus in UK racehorses – fracture descriptions and pre-existing pathology

The characteristics of, and pre-existing pathology associated with 75 cases of fatal lateral condylar fracture sustained by Thoroughbreds while racing in the UK were described. Cases were identified from 220 cases of fatal distal limb fracture submitted as part of studies designed to identify risk factors for all fatal distal limb fractures. Fractures were most common in hurdle races and affected the right forelimb twice as often as the left forelimb. Fracture dimensions were similar to previous reports, however there was a much greater prevalence of articular and diaphyseal comminution and of concurrent fractures in the current report. Pre-existing pathology was particularly common in the medial and lateral parasagittal grooves of the distal articular surfaces of the third metacarpus/metatarsus. The degree of this pathology was not associated with horse age, length of career or number of career starts.

Rehabilitation and Conditioning of Sporting Dogs

Owners and trainers exercise sporting dogs to increase their fitness and optimize their conditioning and performance. Training is designed to in-crease strength, endurance, and agility and is sport-specific. Sporting dogs are susceptible to specific musculoskeletal injuries. The rehabilitation of sporting dogs after these injuries follows specific principles during the acute, subacute, and reconditioning periods.

Risk factors for cross-country horse falls at one-day events and at two-/three-day events

The cross-country phase of eventing competitions has been associated with injuries and fatalities to horses and riders. A case-control study was carried out to identify variables that were associated with increased or decreased risk of a horse fall on the cross-country phase at event competitions. After initial analysis, the dataset was split according to the categories of one-day events as compared to two- or three-day events to establish whether significant risk factors varied between the different types of eventing competitions. Data were collected for 121 cases (horse falls) at one-day events, 59 cases at two- or three-day events and for their 540 matched controls. The data were analysed using conditional logistic regression. The variables of no previous refusals on the course, fences with a landing in water and the combined variable of the angle and the spread of the fence were significantly associated with the risk of a horse fall in both datasets. Additional risk factors for one-day event falls were: fences requiring a take-off from water, a drop landing, the rider's knowledge of their position before the cross-country phase and if the rider received cross-country tuition. Three-day event risk factors in the multivariable model included: the camber of the fence and participation in non-equestrian sports by the rider. This study identified variables that were significantly associated with an increase or a decrease in the risk of a horse fall during the cross-country phase of different types of eventing competitions. Some of these variables are modifiable and the results of this study have been reported to the governing body of the sport of eventing in the UK so that possible interventions might be considered.

Fractures sustained by racehorses in Japan during flat racing with special reference to track condition and racing time

The purpose of this report is to describe the results of epidemiological surveys of racing-related fractures in Thoroughbred horses in Japan. In the period 1987-2000, a total of 10,203 fractures were diagnosed in 556,705 runners, resulting in an overall incidence of 1.83%. The annual incidence of fractures in flat racing during the 14-year period fluctuated between 1.44% and 2.19%. The majority of fractures affected the forelimbs. We found significant effects of track condition on injury incidence. The incidence of fractures decreased as track conditions on turf became softer and increased as track conditions on dirt became muddier. Because of the general trend for the incidence of fractures to vary with track condition, we examined the relationship between track conditions and racing times for winning horses in 4117 races and for 50,564 overall runners for the period 1990-1994 on two tracks. For turf courses, racing times became longer as track conditions became softer. In contrast, for dirt courses, racing time tended to become shorter in muddier conditions. The variation in the incidence of fracture with track condition might be due to the corresponding difference in racing time.

Risk factors for injury to the superficial digital flexor tendon and suspensory apparatus in Thoroughbred racehorses in New Zealand

AIM

To investigate risk factors for injury to the superficial digital flexor tendon (SDFT) and suspensory apparatus (SA) of the forelimbs in Thoroughbred racehorses in New Zealand.

METHODS

Poisson and negative binomial regression, with exposure time represented by cumulative training days for each horse, were used to relate explanatory variables to the incidence rate (IR) of cases of inflammation of the SDFT (n=51), and injuries involving the SA (n=48) in a population of 1,571 commercially- trained racehorses over 554,745 study days. Only the first occurrence of an injury for any one horse was eligible for inclusion. Separate analyses were run for data from horses in training regardless of whether they had started in a trial or race, and using a subset of these data restricted to those preparations associated with at least one start in a trial or race. Results were reported as incidence rate ratios (IRR) and 95% confidence intervals (CI).

RESULTS

Male horses had a higher risk of injury to the SA (IRR 2.57; p=0.005) and tended to have a higher risk of injury to the SDFT (IRR 1.74; p=0.09) than female horses. Increasing age was associated with increased risk of injury. Horses aged 4 and > or =5 years were 6.76 (p<0.001) and 15.26 (p<0.001) times more likely to incur injury to the SDFT, and 2.91 (p=0.02) and 3.54 (p=0.005) times more likely to incur injury to the SA, respectively, than 2-year-olds. Horses were more likely to suffer an injury to the SDFT or SA in a training preparation that was not associated with any starts in official trials or races compared with those preparations that were associated with more than one start (p<0.001), and more likely to injure the SA compared with preparations containing one start (p=0.03). The IR of injury to the SDFT tended to be lower between November-January (IRR 0.78; p=0.08) and February-April (IRR 0.75; p=0.08) compared with August-October. Incidence of injury to the SDFT or SA was not associated with the cumulative distance raced in the last 30 days of a training preparation.

CONCLUSION

This study identified risk factors for injury to the SDFT and SA in Thoroughbred racehorses in New Zealand. Injuries were more likely in males, older horses and in horses in training preparations without any starts. There was no evidence of association between injury and cumulative high-speed exercise.

A prospective cohort study to investigate risk factors for horse falls in UK hurdle and steeplechase racing

REASONS FOR PERFORMING STUDY

Equine fatalities during racing continue to be a major welfare concern and falls at fences are responsible for a proportion of all equine fatalities recorded on racecourses.

OBJECTIVES

To identify and quantify risk factors for horse falls in National Hunt (NH) racing and to report the frequency of falling and falling-associated fatalities.

METHODS

A prospective cohort study was conducted on 2879 horse starts in hurdle and steeplechase races on 6 UK racecourses. Any horse that suffered a fall at a steeplechase or hurdle fence during the race was defined as a case. Data were obtained by interview and observations in the parade ring and from commercial databases. Multivariable logistic regression models, allowing for clustering at the level of the track, were used to identify the relationship between variables and the risk of falling.

RESULTS

There were 124 falling cases (32 in hurdling and 92 in steeplechasing) identified. The injury risk of fallers was 8.9% and fatality risk 6.5%. Duration of journey to the racecourse, behaviour in the parade ring and weather at the time of the race were associated with falling in both hurdle and steeplechase racing. Age, amount of rainfall and going were also associated with falling in steeplechase racing.

CONCLUSIONS

Falls at fences are significant contributors to equine fatalities during NH racing. Potentially modifiable risk factors identified were the condition of track surfaces and journey time to the racecourse.

POTENTIAL RELEVANCE

It is hoped that information from this study may be used in future interventions to improve horse and jockey safety in racing. The study has also identified areas requiring further research, such as equine behaviour and its effect on racing performance, and the effect of light conditions on jumping ability.

[Animal welfare legal aspects of rodeo events]

Rodeo events have been criticised by animal welfare organisations as being adverse to animal protection, for years. This was the motive for TVT to put several of these criticised disciplines to evaluation in terms of animal protection aspects. For that purpose, various rodeo events were visited, and videotaped material of almost all events, which had taken place in Germany in 2003 and 2004, was evaluated. Rodeo events are subject to and 11, sec.1, No. 3d, German Animal Protection Act, which implies compulsory accreditation. In the scope of such events, causing any sort of pain and suffering (and 3 No. 6 German Animal Protection Act) is prohibited. A proof of the severity of the pain caused, is therefore no necessity. For the "critical" disciplines "Bare Back Riding" and "Saddle Bronc Riding" a so called "flank" is used. A flank is a leather strap, fastened to the sensitive parts of the horse skin, (around the flanks,) which is tightened to a maximum as soon as the horse is released from the starting box. Analysis show, that the strap has to be seen as the trigger for the wanted kow-tow. The different coping strategies shown by the animals prove that the leather strap is an apt instrument to cause pain and/or suffering (anxiety/fear/stress) in horses. Bull riding, instead, showed that the rider has to be seen primarily as the trigger for defence behaviour, here. In consideration of the current legal position and taking ethic principles into account, it seems appropriate to only authorise rodeo events under the condition of a flank strap ban. Bull riding should be banned in general.

Effects of athletic taping of the fetlock on distal limb mechanics

REASONS FOR PERFORMING STUDY

Athletic taping is used frequently by human athletes to stabilise, maintain or strengthen soft tissue structures, but empirical evidence supporting any changes in equine kinematics is lacking.

OBJECTIVES

To assess the effects of athletic taping of the fetlock applied by an experienced athletic trainer on forelimb mechanics in healthy horses.

HYPOTHESES

That athletic taping of the distal forelimb reduces 1) hyperextension of the fetlock joint during stance, 2) flexion of the fetlock joint during swing and 3) ground reaction forces during stance.

METHODS

Ground reaction force and kinematic data were obtained for 6 healthy horses trotting at 3 m/sec for 4 sequential conditions (baseline, untaped; pre-exercise, taped; post exercise, taped post 30 mins trotting exercise; transfer, 4 h after tape removal). Data were analysed using 2-way mixed ANOVAs (condition; joint).

RESULTS

A statistically significant interaction was identified for the fetlock during the swing phase (mean +/- s.d. peak flexion at baseline 157 +/- 4 degrees, reduced with taping to 172 +/- 4 degrees; P<0.05) compared with no differences across conditions for the other joints. Peak vertical force reduced significantly (P<0.05) with taping.

CONCLUSIONS

Athletic taping of the fetlock does not alter the kinematics of the forelimb during stance, but does limit flexion of the fetlock during the swing phase. The decreased peak vertical force may be due to an increased proprioceptive effect.

POTENTIAL RELEVANCE

Reduced peak vertical forces may be of benefit in preventing or reducing injury. Further investigation remains necessary before it can be concluded that taping should be applied for tendinous or ligamentous rehabilitation in equine patients.

Race- and course-level risk factors for fatal distal limb fracture in racing Thoroughbreds

REASONS FOR PERFORMING STUDY

Considerable variation in the rates of equine fatality at different racecourses draws attention to probable risk factors at the level of course or race that might be partly responsible. Distal limb fractures are the most common cause of equine fatality on UK racecourses and identification of risk factors for such injuries and subsequent implementation of intervention strategies could significantly reduce the total number of racecourse fatalities.

OBJECTIVES

To identify race- and course-level risk factors for fatal distal limb fracture in Thoroughbreds on UK racecourses.

METHODS

A case-control study design was used. Case races were defined as those in which one or more horses sustained fatal fracture of the distal limb. Controls were selected in 2 different ways. Firstly, 3 races in which no fracture occurred were selected from all races of the same type held within 5 days of the case race (Analysis 1). Secondly, 3 control races were selected for each case race from all races of the same type held in the same year (Analysis 2). One hundred and nine cases were included in the study. Information about the race and the racecourses was collected from Computer Raceform. Conditional logistic regression was used to identify the relationship between a number of independent variables and the likelihood of fracture in a race.

RESULTS

Longer races with a larger number of runners were more likely to contain a fracture. Firmer going and fewer days since the last race on the same course were associated with an increased risk of fracture. The going at the course at the previous race meeting was also associated with the likelihood of fracture.

CONCLUSIONS

Modifications to the going on the day of a race and greater emphasis on ground maintenance between race meetings may have an impact on the risk of fatal distal limb fracture during racing.

POTENTIAL RELEVANCE

Modification of risk factors such as the going and number of days since the last race meeting could reduce the number of equine fatalities on UK racecourses. The condition of the racecourse may be an important risk factor and future research should focus on the identification of course maintenance techniques that produce the safest possible racing surfaces.

Case-control investigation of the factors affecting the risk of horses falling during steeplechase racing in the UK

A concurrent case-control study of 12 UK racecourses was made between March 1, 2000, and August 31, 2001, to identify and quantify the factors associated with the risk of horses falling in steeplechase races. Cases were defined as a jumping effort at a steeplechase fence that resulted in a fall and controls were defined as a successful jumping effort over any steeplechase fence at any of the 12 racecourses within 14 days before or after the case fall. Information on the horse, the jockey and the race were collected and all the fences on all the courses were surveyed. Conditional logistic regression was used to examine the relationships between the predictor variables and the risk of falling. There was one fall per 254 jumping efforts. The risk of a horse falling decreased the more times it had raced on a particular racecourse. The number of fences, the distance from the previous fence and the nature of the previous fence also affected the risk of falling. If the previous fence was a water jump the risk of falling increased; fences that were sited on flat or slight uphill gradients (up to approximately 1 in 25) were associated with a lower risk of horses falling than downhill fences, and higher takeoff boards were associated with a higher risk of falling.

Memory decay and performance-related information bias in the reporting of scores by event riders

We used data from a case-control study investigating risk factors for horse falls in the cross-country phase of eventing in Great Britain (GB) to examine evidence for memory decay and information bias. Responses to two questions obtained by telephone for 173 cases and 521 controls were examined for evidence of differential reporting according to the respondent's case-control status and performance in the dressage and cross-country phases of competitions. Information bias was found in the accuracy of reporting dressage penalty scores when analysed as a function of performance level (good/poor). Poor dressage performers were less likely to report accurate dressage scores than good performers. The accuracy of reporting dressage scores decreased as the time between the event and questionnaire completion increased, with no case-control interaction. Competitors who incurred cross-country jumping penalties at the event preceding the selected event reported their cross-country scores with less accuracy when compared with competitors who incurred no penalties. No information bias was found when the reporting of dressage and cross-country scores were analysed as a function of respondent category (case/control).

Risk of fatal distal limb fractures among thoroughbreds involved in the five tpes of racing in the United Kingdom

The risk of fatal distal limb fractures in thoroughbreds racing in the UK was calculated and shown to vary considerably between the different types of race. Flat turf racing was associated with the lowest risk (0.4 per 1000 starts) and national hunt flat racing was associated with the highest risk (2.2 per 1000 starts). The types of fracture were classified by detailed radiographic and postmortem examinations of all the cases recorded over two years, and the distribution of the different types of fracture in the five main types of racing was examined. Overall, lateral condylar fractures of the third metacarpus were the most common, and they were also the most common in national hunt-type races (hurdle, steeplechase and national hunt flat races). In all-weather flat racing biaxial proximal sesamoid fractures were most common, and in turf flat racing fractures of the first phalanx were most common. The risk of fractures of more than one bone was greater in national hunt-type races.

Descriptive epidemiology of fractures occurring in British Thoroughbred racehorses in training

REASONS FOR PERFORMING STUDY

Musculoskeletal injury is the major cause of days lost from training and wastage in Thoroughbred racehorses. Little scientific information is available on the majority of injuries occurring in training.

OBJECTIVES

To estimate the incidence of fractures in British racehorses in training and describe the occurrence of different fracture types and bones involved.

METHODS

Thirteen UK racehorse trainers participated in a prospective study, providing data on horses in their care for 2 years. Details on horses, their daily exercise and fracture occurrence were recorded.

RESULTS

A total of 1178 horses provided 12,893 months at risk. Nontraumatic fracture incidence was 1.15/100 horse months (95% CI = 0.98, 1.35) and 78% of fractures occurred during training. A wide variety of fracture types and bones were involved, although at least 57% were stress fractures. Pelvic and tibial stress injuries accounted for 28% of fractures diagnosed.

CONCLUSIONS

It is important to study injuries in training as well as in racing. The number of stress fractures suggests that training regimes for young Thoroughbreds could often be improved to create a more robust skeleton, able to withstand injury.

POTENTIAL RELEVANCE

Studying injuries in racehorses in training can provide a scientific basis for the design of safer training regimes.

Horse injuries and racing practices in National Hunt racehorses in the UK: the results of a prospective cohort study

A prospective cohort study was conducted on horses starting in hurdle and steeplechase races on six UK racecourses in 2000 and 2001. Trainers or carers were questioned on the horses' pre-race routine and observational data were collected in the stables and parade ring. Some practices were common to many starters, such as withholding food and water before racing whereas other practices, such as schooling frequency, were more variable. There was a total of 2879 starts and a total of 83 injuries or medical events (28.8/1000 starts). The commonest types of injury were tendon/suspensory injuries and lacerations/wounds. Multivariable logistic regression models were used to identify the relationship between predictor variables and the risk of injury. Risk of injury or medical event was associated with distance of the race and weight carried. The risk of injury, excluding medical events, was associated with the speed of the race and foot conformation.

Risk factors and prevalence of injuries in horses during various types of steeplechase races

OBJECTIVE

To identify the types of injuries sustained by horses that competed in steeplechase races and determine the prevalence of and risk factors for those injuries.

DESIGN

Prospective study.

ANIMALS

2,680 horses that competed in various types of steeplechase races from 1996 through 2000.

PROCEDURE

Data regarding races; environment; equipment problems; the number of horses that entered, started, and finished races; the number of riders that fell; and the number of horses that were slowed or stopped by the rider, ran off the course, fell, and sustained injuries or physical abnormalities during races were collected on a standard form by the official veterinarian who attended each meet. Data from all meets were not recorded; however, in recorded meets, data from every race were reported.

RESULTS

Data for 197 hurdle, 65 timber, 76 flat, and 8 mixed races were recorded. Nine (3.4/1,000 horses that started in races) horses died or were euthanatized, and 7 of those were associated with catastrophic musculoskeletal injury. Seven fractures were recorded. Four fractures involved forelimbs, 1 involved a hind limb, and 2 involved the cervical portion of the vertebral column. All horses with fractures were euthanatized. Deep or hard course conditions were associated with an increased risk of breakdown injuries.

CONCLUSIONS AND CLINICAL RELEVANCE

Successful development and implementation of strategies to prevent injuries and death in horses in steeplechase races depend on a clear understanding of the types and prevalence of injuries involved and risk factors associated with those injuries.

Case-control study to investigate risk factors for horse falls in hurdle racing in England and Wales

Between March 1, 2000 and August 31, 2001, a case-control study was conducted on 12 racecourses in England and Wales to identify and quantify the risk factors associated with horse falls in hurdle races. The cases and controls were defined so that variables relating to the horse, the jockey, the race and racecourse, and the jump could be considered. The cases were defined as a jumping effort at a hurdle flight that resulted in a fall, and the controls were defined as a successful jump over a hurdle at any of the 12 racecourses within 14 days before or after the case fall. Conditional logistic regression was used to examine the univariable and multivariable relationships between the predictor variables and the risk of falling. The risk of falling was significantly associated with the position of the jump in the race, and with the distance and speed of the race. A horse's previous racing experience and history were also significantly associated with the risk of falling and horses participating in their first hurdle race were at almost five times greater risk of falling than horses that had hurdled before.

Evaluation of a stochastic Markov-chain model for the development of forelimb injuries in Thoroughbred racehorses

OBJECTIVE

To evaluate a Markov-chain model for the development of forelimb injuries in Thoroughbreds and to use the model to determine effects of reducing sprint distance on incidence of metacarpal condylar fracture (CDY) and severe suspensory apparatus injury (SSAI).

SAMPLE POPULATION

Weekly exercise and injury data for 122 Thoroughbreds during racing or training.

PROCEDURE

Weekly data were used to construct a Markov-chain model with 5 states (uninjured [UNINJ], palpable suspensory apparatus injury [PSAII, SSAI, CDY, and lost to follow-up [LOST]). Transition probabilities between UNINJ and PSAI were estimated as a function of weekly sprint distance by use of linear regression analysis. The model was used to predict distributions of annual CDY and SSAI incidences in southern California racehorses and was validated by using CDY incidence reported by racetrack practitioners. The model was modified by reducing the number of sprint distances that were > 6 furlongs (> 1.20 km) by 20%, and CDY and SSAI incidences were compared with those generated by the baseline model.

RESULTS

The model accurately fit development of injuries in the sample population but overestimated development of injuries in the southern California racehorse population. Development of and recovery from PSAI were correlated with distance run at high speeds. Reducing by 20% the number of sprints run at distances > 6 furlongs significantly reduced modeled annual CDY and SSAI incidence by 9%.

CONCLUSIONS AND CLINICAL RELEVANCE

Reducing the number of sprints at distances > 6 furlongs, particularly among horses with PSAI, reduces risk of CDY and SSAI.

A retrospective case-control study of horse falls in the sport of horse trials and three-day eventing

REASONS FOR PERFORMING STUDY

Serious injuries to horses and riders in horse trials (HT) and three-day events (3DE) are usually associated with falls of horses, which invariably involve falls of the riders. Many potential causes for these falls have been discussed.

OBJECTIVES

The aim of this case-control study was to investigate the risk factors for horse falls on the cross-country phase of horse trials and three-day events.

METHODS

Using retrospective data, significant risk factors identified with unvariable analysis (P value <0.2) were entered into a multivariable logistic regression model. Significant risk factors (P value <0.05) were included in the final model.

RESULTS

It was revealed that a number of course, obstacle and rider variables were significantly and independently associated with the risk of falling. Falling was associated with obstacles sited downhill (Odds ratio [OR] 8.41) and with obstacles with ditches in front (OR = 5.77).

CONCLUSIONS

The relationship between course variables and the risk of falling was characterised and showed a significantly increased risk with increasing numbers of jumps on the course and for jumping efforts later in the course. In contrast, after allowing for the total number of obstacles on the course, an increase in the total number of jumping efforts appeared to have a protective effect. A later cross-country start time was associated with a decreased risk of a horse fall. Amateur event riders were approximately 20 times more likely to fall than professional riders.

POTENTIAL CLINICAL RELEVANCE

This study has identified a number of risk factors associated with horse falls and highlights areas that can be altered to improve safety in cross-country competitions.