Horse-related accidents an integral part of human-equine relationships

Our centuries-long interactions with horses include their use as agricultural and commercial aides, and companions for sport, leisure and – as Riding for the Disabled Association Ireland will confirm – therapy.

Thus, a report in the American Journal of Physical Medicine & Rehabilitation (October 2017), finds therapeutic riding " . . . a viable intervention option for patients with balance, gait, and psychomotor disorders".

Nevertheless, human-equine relationships can be risky, with one study noting: “Horses weigh an average of 1,500lb, [can] travel up to speeds of 40mph and can deliver 1,000 Newtons of force in a single kick.”

In a major review published in the Internet Journal of Allied Health Sciences and Practice (December 2018), Dr Lauren Meredith considered 71 peer-reviewed studies (five of which investigated injuries to jockeys in horse racing). Sixty of 71 studies "suggested that those most frequently involved in horse-related accidents are young females and 97 per cent of papers investigating injury mechanisms found the most commonly involved was a fall from horseback".

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Dr Ali Abdulkarim recently led a study of Irish equestrian injuries. The results were published in 2018, both in the Irish Journal of Medical Science (IJMS), and in Emergency Medicine International (EMI). Of 30,700 patients admitted to Tullamore's Midland Regional Hospital (MRH) Emergency Department in 2013, 149 (0.49 per cent, mean age 27 years) had equestrian-related injuries. Of these, 104 had soft-tissue injuries and 52 had fractures; 82 per cent were recreational riders; and more females (58 per cent) were injured than males (42 per cent).

Recreational riders

Most injuries were to recreational riders, but how many recreational riders might there be in Ireland? Data from Horse Sport Ireland, equestrian sport's governing body, which includes eventing, hunting, show-jumping and recreation – but not horse racing – show that in 2016 there were more than 6,000 pony/riding club members; 33,169 sport horses for leisure riding; and 10,152 sport horses for competition.

For comparison, Irish Horseracing Regulatory Board data show that 543 licences/permits were issued to riders in 2017. As for horseracing injuries, Dublin City University's Dr Siobhan O'Connor led a team that investigated the "Epidemiology of Injury Due to Race-Day Jockey Falls in Professional Flat and Jump Horse Racing in Ireland 2011-2015" in the Journal of Athletic Training (2017).

From 2011 through 2015, 114 jump-racing jockeys and 100 flat-racing jockeys held professional racing licences in Ireland. For each year, on average, jump-racing saw 849 falls in 17,110 rides with 173 injuries; in flat-racing there were 44 falls in 11,472 rides with 16 injuries. Echoing Dr Abdulkarim’s study, soft-tissue injuries predominated, with fractures the second commonest injury.

How do horse-related injuries compare with other sports?

Hurling

In 2010 a study of 127 Irish elite male hurling players, reported training and match-play injury rates of 5.3/1,000 hours of play and 102.5/1,000 hours, respectively, whereas in 2000 a Canadian study found an equestrian injury rate of 0.49/1000 hours of riding following a five-year review of hospital admissions. Further, an Australian study of sport-related hospitalisations in 2011/12 noted that soccer accounted for 8.2 per cent of hospitalisations; cycling 8 per cent; rugby (unspecified) 4.6 per cent; and equestrian activities 4.3 per cent.

How can equestrian safety be enhanced?

The IJMS article advises: "Specific training should be provided on how to manage a fall, including releasing one's feet from the stirrups, positioning to limit injury when hitting the ground and how to roll away to avoid being potentially kicked or trampled by the horse after a fall."

And Horse Sport Ireland's website, provides detailed safety information on several topics including concussion, safety and personal protection equipment and riding while pregnant.

Dr Abdulkarim and colleagues present injury data in their IJMS and EMI papers, but both underestimate the extent to which horses impact Irish society in economic terms. Their EMI paper states: "The Irish Equestrian industry . . . [contributes] in excess of €454 million to the Irish economy annually", citing a HIS Report from University College Dublin (UCD) published in 2012. However, the 2012 report actually states: "The contribution of the Irish sport horse industry to the Irish economy is in excess of €708 million per annum."

Full-time jobs

On October 20th, 2017, HIS published a further report. This states that, in 2016, the Irish sport horse industry contributed more than €816 million to the Irish economy, a 15.25 per cent increase over the contribution of €708 million estimated by the UCD 2012 report. Further, the number of full-time jobs had increased from 12,500 in 2012 to over 14,000 in 2017. The 2017 report was available, not only before the IJMS paper was accepted, but also before the EMI received the paper on December 7th, 2017 – yet both papers cite only – and apparently incorrectly – the 2012 report.

Neither paper mentions the contribution of the equine breeding and racing industry to Ireland's economy. A Horse Racing Ireland 2017 report notes that the core Irish breeding and racing industry employs about 9,500 full-time workers and that the "total direct and stimulated expenditure of the Irish breeding and racing industry is estimated as €1.84 billion in 2016."