University of Vermont AAHS

AMEA

November 1993, Vol. III, Number 4

Table of Contents

Save Damaged Helmets
Nevada Trauma Register 1990-1992
Future of Safety Equipment in Equestrian Sports
National Electronic Injury Surveillance System
Women and Horses: What's It All About?
Equestrian Weight Lifting and Strength Training
Equestrian Helmet Program


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Save Damaged Helmets

A physician's daughter died from a fall from her horse when her head was crushed between the shoulder of the horse and the ground. She was wearing a SEI certified protective helmet. When I requested the helmet for study and evaluation, I was told the emergency room to which she went discarded the helmet.

If you are involved as a physician or other medical personnel, or in a managerial position in a horse activity, will you request the persons involved in a horse related accident to save a damaged helmet? Each of the manufacturers of ASTM standard SEI certified helmets ask helmets damaged in a fall be returned to them for checking and possible replacement. In the event the helmet manufacturer cannot be identified, or for any other reason, send the helmet with a description of what occurred, the activity and any resultant injury, the person involved (with address and phone number), to:

Doris Bixby Hammett, MD
Secretary, American Medical Equestrian Association
103 Surrey Road
Waynesville, NC 28786
or to
Dru Malavase
Chairman, ASTM Committee on Equestrian Equipment
2270 County Road #39 RR2
Bloomfield, NY 14469

Thank you for your assistance Doris Bixby Hammett, MD

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Nevada State Health Division

Office of Emergency Medical and Trauma Services
State System Trauma Register
Accidents and Injuries Related to an Animal Being Ridden
January 1, 1990 through December 31, 1992

  


INJURY 1990 1991 1992 TOTAL
FRACTURE
Skull 12 26.7% 7 15.6% 4 11.1% 23 18.3%
Spine 2 4.4% 7 15.6% 8 22.2% 17 13.5%
Ribs 8 17.8% 2 4.4% 4 11.1% 14 11.1%
Pelvis 1 2.2% 0 0.0% 5 13.9% 6 4.8%
Extremities 12 26.7% 7 15.6% 11 30.6% 30 23.8%


DISLOCATION (not shoulder) 3 8.3% 3 2.4%


INTERNAL INJURIES
Intracranial w/o FX 20 44.4% 17 37.8% 10 27.8% 47 37.3%
Cranial Nerves 0 0.0% 1 2.2% 0 0.0% 1 0.8%
Spinal Cord w/o FX 0 0.0% 1 2.2% 1 2.8% 2 1.6%
Thoracic Injury 6 13.3% 2 4.4% 4 11.1% 12 9.5%
Abdominal 7 15.6% 8 17.8% 4 11.1% 19 15.1%


OPEN WOUNDS
Head Neck & Trunk 7 15.6% 7 15.6% 1 2.8% 15 11.9%
Upper Extremity 0 0.0% 1 2.2% 1 2.8% 2 1.6%


SPRAINS % STRAINS
Back 2 4.4% 0 0.0% 2 5.6% 4 3.2%
Superficial 0 0.0% 17 37.8% 1 2.8% 18 14.3%
Contusion w/o wound 11 24.4% 16 35.6% 10 27.8% 37 29.4%
Unspecified Injuries 1 2.2% 1 2.2% 0 0.0% 2 1.6%


Male 23 53.3% 29 64.4% 16 44.4% 69 54.8%
Female 21 46.7% 16 35.6% 20 55.6% 57 45.2%
TOTAL 45 45 36 126
Average Age 30 34 44 36
Under 17 years 11 24.4% 11 24.4% 5 13.9%
Hospital Days 1-45 1-19 1-33 days
Ave Hospital Days 3.56 63.3 94.3
Hospital <1 day 22 48.9% 18 40.0% 21 58.3%
Hospital <3 days 15 33.3% 13 28.9% 14 38.9%
Fatalities 0 0 0 0


INJURED
Pedestrian 6 13.3% 3 6.7% 0 0.0% 9 7.1%
Rider 37 82.2% 41 91.1% 29 80.6% 107 84.9%
Occupant 0 0.0% 1 3.2% 6 16.7% 7 5.6%
Unspecified person 2 4.4% 0 0.0% 1 2.8% 3 2.4%
TOTAL 45 45 36 126

Albert Cirelli, Jr.
Extension Horse Specialist
University of Nevada, School of Veterinary Medicine
202 Fleischmann Agriculture, Room 103
Reno, NV, 89557-0104

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Future of Safety Equipment in Equestrian Sports

Forecasting the future of safety equipment in equestrian sports is not particularly difficult if one looks at the history and development of personal protective equipment in other sports. A look back at the development of personal safety equipment in industrial applications, public safety, and the transportation industries, also gives us a clue about the future of safety equipment in horse sports.

This country’s use of safety equipment in the last century was virtually nonexistent. However, beginning with the construction of the Golden Gate Bridge and the Hoover Dam in the 1930's, use of personal protective equipment began to grow slowly. Small gains in usage continue through the 40's and 50's until the late 1960’s when Federal OSHA began mandating the use of safety equipment in industrial occupations and construction projects. The use of safety equipment showed a surge in usage during this period.

In the 1970's an attorney in Miami, Florida, won a multimillion dollar products liability award against Riddell in a football helmet case. At that point the race was on in government to develop and upgrade performance standards for safety equipment and to mandate equipment from safety belts in automobiles to industrial hard hats, respirators, and motorcycle helmets. In addition, manufacturers began reevaluating their designs for safety products. The best analogy for equestrian sports today is to look at bicycling ten years ago. Millions of Americans rode bicycles, few used safety helmets or reflective materials. Except for organized bicycling clubs, who have mandatory safety equipment requirements, most bicyclists do not have to wear safety helmets, yet millions are now wearing helmets because of public education on the merits of safety.

Although numerous horse sport organizations require at least safety helmets, such as the U.S. Pony Clubs, various 4-H organizations, the Girl Scouts, Horsemanship Safety Association, US Polo Crosse, Camp Horseman Association and other summer camps. The vast majority of riders in this country are not using safety equipment. This sport has been among the slowest to change.

As various groups in this country such as the American Medical Equestrian Association continue to educate the public in the need to use safety equipment, the desire to use safety equipment will grow. The American public at large is becoming better educated on safety. One cannot turn on the television without seeing an advertisement for air bags and use of safety equipment in automobiles. Nor can one ignore the massive campaign for developing healthier life styles from stopping smoking to encouraging mom to cook lower fat meals at home.

I believe all these facets of our lives will directly or indirectly contribute to the education of the public involved in equestrian sports, to think about the use of safety equipment.

I listened to a speech recently by an executive of the Kentucky Educational Television Network who said 85% of the technology we use in 1993 will be obsolete in 7 years at the current rate of development. I believe the strides that will be made in the next 7 years for safety equipment used by equestrian riders will be phenomenal as the demand rises through better education for the public and insurance company advocacy. The safety products themselves will improve dramatically over the next 7 years.

Insurance companies have helped to create a major boost of safety equipment usage in horse sports. Most companies insuring organized events require safety helmets. Stables with horses for hire are required by their insurance companies to make helmets available to all riders.

Today children are using safety products more than ever. These children are tomorrow's parents. The long; term key today is to educate children because they are receptive to safety if taught early. The use of seat belts, drug programs, and fire safety programs are just a few that have been taught very successfully to children nationwide.

Within 10 years the vast majority of equestrians will be using all of the types of safety equipment now available in the market place. Products that we will see in every-day riding include: safety helmets, safety stirrups, and protective vests.

We see safety rails at race tracks and more economical safety fences and safer barriers in cross country events could be on the horizon. Development is underway with injection molded plastic saddles. We will certainly see safety products not yet conceived and current products will be greatly improved as technology becomes available and demands rises.

What is the future of safety equipment in equestrian sports? The future as a manufacturer is very bright, as a concerned citizen I am very optimistic that my children will live in a safer world regardless of their occupation or leisure time sport.

Bruce Blake
President, Lexington Safety Products
400 Fairman Road
Lexington, KY 40503

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Natonal Electronic Injury Surveillance System and Hazard Analysis

Since 1973, the epidemiological research group at the U. S. Consumer Product Safety Commission (CPSC) has operated the National Electronic Injury Surveillance System (NEISS). It collects injury and incident data from a national probability sample of 91 hospitals and emergency rooms (ERs) from across the U.S.

One of CPSC's concerns is the severity of product-related injuries, and head injuries can be among the most severe. The latest CPSC staff analysis of data on head injuries was completed in 1990 using 1988 NEISS data.

There were an estimated total of 2.9 million product-related head injuries treated in US Hospitals ERs in 1988. Of these injuries, an estimated 341,400 (about 12 percent) were related to sports. (This does net include bicycles, skateboards, or all terrain vehicles.)

  
BY AGE OF VICTIM


< 5yrs 16,800 5%
5-14 101,600 30%
Above 15 yrs 222,600 65%


While young and older adults may be aware of much of the risk of injury associated with their participation in sports, this cannot be said about younger age groups. Therefore, sports rule setting groups, safety specialist, and others have a special obligation to find ways to reduce the frequency and severity of these injuries.

Of the 341,400 sports-related head injuries, 67,100 (about 20% were concussions, fractures, and internal head injuries, with 23,000 (35%) of these serious injuries to children ages 5 to 14. Many of these injuries might be prevented or reduced in severity by increased use of helmets or other head and eye protection devices.

  
ACTIVITY HEAD INJURIES
Baseball 95200
Basketball 60900
Swimming 44500
Football 39200
Fishing 13200
Soccer 12000
Skiing, Snow 10000
Golf 9200
Ice Hockey 9100
Horseback Riding 8400
Roller Skating 7800
Hockey/Other/Unk 7400
Paddle Ball 6600
Skiing, Water 6000
Wrestling 5400


PERCENT OF
HEAD INJURIES
ACTIVITY IN CHILDREN 5-14

Roller Skating 61
Ice Skating 51
Baseball 46
Golf 42
Football 36
Hockey, other or unk 35
Horseback Riding 30
Fishing 30
Soccer 28
Wrestling 25
Skiing, Snow 21
Basketball 14
Ice Hockey 13
Skiing, Water 10
Paddle Ball 6
Swimming 5


Most (97%) of the 341,000 cases were treated and released, not hospitalized. Among the more serious hospitalized injuries (involving concussions, fractures, and internal head injuries including some DOAs), it is worth noting that the following were the head injury- estimates for the sports-related activities with the highest frequencies of severe head injuries.

  
ACTIVITY ESTIMATED
HEAD INJURIES


Horseback Riding 2,200
Football 1,500
Baseball 1,400
Skiing, Snow 1,100
Basketball 500


Though these estimates are given in the order of descending frequencies, relatively small differences between estimates may not be statistically significant.

For further information interested persons may call (301)504-0424 or write: National Injury Information Clearinghouse, U. S. Consumer Product Safety Commission, 5401 Westbard Avenue, Room 625, Washington, D.C. 20207

Robert E. Frye
Director, Hazard Analysis Division
Directorate for Epidemiology
U.S. Consumer Product Safety Commission

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Women and Horses

What’s It All About?

The qualities we see at the top of our riding disciplines have evolved through education, training, hard work, long hours, talent and desire. To be a great rider is a worthy and rewarding goal for male or female. Until recently, the thought processes and approach to teaching and training riders and selecting equipment have been generic and male oriented. But the generic approach is not effective with the majority of riders. The majority are females.

Riding is increasingly being defined by the female element -- she is the predominant participant, dollar spender and decision maker in sporting, showing and recreational activities in the horse industry.

Equestrian Resources (EQR) found over 75% of the members of all equine-related non- racing organizations in the United States are female; over 80% in the American Horse Shows Association (AHSA) alone. This percentage, however, does not indicate the higher number of females involved in pleasure riding. EQH estimates at least 500,000 females in the U.S. are enjoying horses as a sport or leisure activity and many say that number is considerably conservative.

EQR Women & Horses (W&H) Conference and National Tour was created to meet this large and growing population of active equestrian participants and is a program designed to he repeated in locations around the county throughout 1994 and 1995. Each conference presents national personalities and experts in a program of practical discussion, advice and product information devoted to improving the "team" performance of women and their horses.

Through the W&H program and our national experts we are developing techniques that increase awareness of the body and mind of rider and horse as well as provide education in what to look for in equipment that will accommodate the female pelvic and muscular structures efficiently and comfortably-.

In the athletic world at large more females are in competition than ever before and they are gaining performance enhancement by maximizing what is unique in their bodies, minds, and personalities. We are seeing more and more women in the top riding and training ranks of horse sports as leaders of equine-related organizations and as instructors. The education and societal messages they are now receiving indicate it is all right for females to pursue and realize competitive goals.

The basis of and the equipment designed for riding have been established by and for males. Horses throughout time have been used mainly for war, battle, and transportation by males. For example, the Western disciplines descending from the Native American, the working cowboy, and the Pony Express; English riding from the traditions of the hunt field and the military; and the Spanish and Arabic influence with their ancient breeds originating from tribal competitions and ceremonial presentations.

Considering the thousands of years the horse has been used by humans, horses have only been used strictly for pleasure and sport by women for a relative short period. Women have only been riding astride in Europe and the Western hemisphere for approximately 60 years.

Has the female equestrian been provided with every benefit and advantage to allow her to become the best rider she can be? The answer is no. The horse community and ancillary interests need to become more aware of the human element--the female equestrian is structured differently and should be instructed and trained with her health, comfort and safety as a priority.

One aspect of the W&H program addresses the female anatomy and its relationship to the movement of the horse. A national expert and W&H national tour speaker on the subject of the female anatomy and riding is Dr. Deb Bennett of Santa Rosa, California. She has done extensive research on the subject and is a hippologist and a paleontologist by trade.

In an article featured in Equus June 1989 ("Who's Built Best to Ride?"), Dr. Bennett explains, "The technique to which I most strongly object is the instruction given the rider to throw his or her belly or waist forward. In either sex, this motion results in compression of the dorsal aspect of the lumbar vertebral column. Sitting the trot or canter this way, with the crotch dropped downward and the lower back hollowed, will over a period of time shorten and harden the dorsal perivertebral muscles and ligaments, compress the intervertebral disks, and eventually lead to spondylolysthesis and the pinching of nerve roots which emerge dorsolaterally between adjacent vertebrae."

"Thanks to the peculiar bony anatomy which permits them to give birth, women often have difficulty learning to sit the trot or canter without bouncing. Women’s lower backs are typically 'curvier’ (more lordotic) than men's. In women the sacrum articulates with the last lumbar vertebra at a much sharper angle than in men. These differences move the tip of the tailbone dorsally in women, effectively getting it out of the birth canal. However, in the context of riding, this structural arrangement also makes it easy for a women to ride with a hollow back and dropped crotch. Conversely, most men have little difficulty coiling their loins (flexing their lumbar span) which is a pelvic motion essential to following the motion of either the trot or canter.

The W&H Conferences are designed to 1) explore the differences, 2) create awareness about the female body and the origin of pain, 3) develop techniques which allow women to become the most efficient and comfortable riders given their particular anatomical and hormonal variations, and 4) identify equipment that will best accommodate the female body.

We encourage research and recognize the many areas of AMEA members' medical expertise. EQR challenges AMEA members to assist in arriving at meaningful information to help female riders. It is important the sports medicine field be particularly aware of the predominant female population involved with horses. Currently most women are not aware of how their bodies work with the movement of the horse and how they can prevent injuries through better understanding.

We see act abundance of chronic low back pain in female riders. Is it any wonder why? They have been trained to hyperextend their backs and cram their heels down while standing on their toes with an unsupportive saddle since they began to ride as a child. Manufacturers of rib, back supports and knee braces are making a lucrative living off women who ride. W&H chooses the principle of a strong support system within their bodies instead of relying on shortcuts and crutches which in the end will only weaken their muscles.

With the correct information, techniques and equipment, women don't have to hurt to ride.

For example, in the W&H Finesse Versus Strength demonstration sessions, we work with participants on becoming more aware and softening their whole approach to sitting on the horse. We reestablish the seat centered on the ischium and teach the student to concentrate on "filling in" her lower back with strength, which ultimately disallows arching or rounding the shoulders. We loosen the leg and allow it to lie flat in line with the pelvis and ground the foot with the stirrup well behind the ball of the foot with the heel parallel to the ground. The elbows remain soft and bent. This allows for an elastic and moving connection at all times resulting in release and relaxation for both horse and rider.

Physicians and physical therapists need to be aware of the types of unique injuries sustained by female riders as well as understand how they relate to movement while mounted or in other activity surrounding the horse.

Whether it be low back pain, a stressed rotator cuff, a stiff neck, or sore knees, female riders can ride pain-free through awareness, education, the proper saddle, and regular stretching and strengthening exercises.

Mary Midkiff
President, Equestrian Resources
PO Box 20060
Alexandria, VA
22320 or call 703/836-6353

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Equestrian Weight Lifting and Strength Training

Muscular strength assists horseback riders in better controlling a horse, both from the ground and in the saddle, letting the horse know who is boss and in riding more safely. A horse can easily decipher if a rider is weak and ineffective. Not only will a horse sometimes simply not respond to a weak rider, but he also can react badly because the weak and ineffective rider is not capable of giving the horse the confidence for which he looks to the rider to provide at uncertain moments.

Some other benefits of strength training include: 1. Decreasing the chances of serious injury, 2. Helping injuries heal quicker, 3. Looking better and more elegant in the saddle, 4. Making riding more enjoyable, 5. Increasing metabolism by increasing muscle mass (which usually decreases every year after the age of 25).

Strength training can be done in as little as 15 minutes, practicing 8 to 12 repetitions of each exercise, 3 to 5 days per week, while watching TV. The investment can be under $50.00 to purchase two or three sets or dumbbells and a book to get started. Dumbbells provide great flexibility, are very portable, train the body to balance as exercises are performed and "the sky is the limit" in creating exercises that fit one' s life-style.

These books can help you begin your strength training program: NOW OR NEVER, THE 12 MINUTES TOTAL BODY WORKOUT and THE FAT BURNING WORKOUT all by Joyce Vedral, Ph.D. and FULL CIRCLE FITNESS by Rebecca Eastman. Magazines to keep you motivated: For women: "SHAPE", "SELF”, “FITNESS"; for men: "MEN'S FITNESS".

The exercises are listed as follows:

HANDS: "Go-ey" horses, unpredictable horses in training or those requiring a high degree of collection as in dressage, can require strength of hands and wrists while leading, lunging, riding and driving. Show horses require strong, deliberate, imperceptible hand, finger and wrist actions to manipulate the reins to get exact and subtle responses. Sometimes squeezing spring handgrips or squeezing a ball can be beneficial. Do wrist curls for -wrist strength while holding a dumbbell.

ARMS: Checking, half-halting, halting, and turning a horse can require arm strength and endurance which can be improved by using dumbbells and doing triceps overhead and cross face extensions, hammer curls, biceps curls and kick backs.

UPPER BACK AND SHOULDERS. A strong back, with good posture and square shoulders, will help hold the rider's position in the saddle and aid in balance and control of the horse. Do external rotations and double upright and bent-over rows with dumbbells. Rhomboid squeezes done in the saddle will strengthen the upper back muscles.

CHEST: The dumbbell flye will strengthen the outer, middle and upper chest. This will assist in improving upper body posture and better control of reins.

LOWER BACK AND BUTTOCKS: To assist in stopping, slowing and controlling a horse, as well as avoiding lower back pain, do lying butt lifts.

ABDOMINAL MUSCLES: Crunches, curl-up and leg raises can help a rider support the upper body and avoid muscle soreness and back pain from spending long periods at the sitting trot, controlled canter or when a horse makes a sudden movement sideways.

LEGS: Practice outer and inner thigh raises, cork-screws, leg extensions and leg curls, standing straight toe-calf raises and use of "Thigh Master". These exercises will assist the rider at performing the inward squeeze and vibration of legs and muscles that are important in imperceptibly keeping a horse moving smoothly and in controlling both the rider's and horse's balance while moving. These should also aid the goal of making horse and rider one unit of movement.

ADVICE: CONSULT A PHYSICIAN PRIOR TO STARTING ANY EXERCISE PROGRAM. Have a strength and fitness trainer provide instruction on how to perform exercises.

Linda Leistman
President, North American Horsemen's Association
PO Box 223
Paynesville, MN 56362,

Reprinted from
NORTH AMERICAN
1991 YEAR BOOK, Vol 3. No 1.

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Equestrian Helmet Program

Harborview Injury Prevention and Research Center

This past year the Harborview Injury Prevention and Research Center's (HIPRC) Equestrian Helmet Program made great strides in the goals set forth. Since the onset of the "equestrian helmet coupon program,” over 130 organization in the United States have ordered coupons totaling more than 200,000.

TARGET STATES
The concept of a "target state" was developed to replicate the initial and highly successful helmet program developed in Washington State.

Vermont
A meeting was held November 1992 attended by the Vermont State Horse Council, Vermont State 4-H Horse leaders and myself- The State of Vermont has a strong group of leaders and has an excellent campaign plan for the year 1993. This campaign includes creating an educational video on helmet fitting that will he broadcast on their public access television station.

After passing the mandatory ASTM/SEI approved helmet ruling the Vermont helmet coalition collectively agreed to use "equestrian safety" as the theme for this year's 4-H State Fair with an emphasis on helmets. This theme is supported by several other activities including a poster contest with the winning: poster displayed on the State Fair Show Program.

California
The state of California has covered a lot of ground since its conception. Linda Morse, the coalition leader, has rallied with her supporters to catch the attention of local stable owners and managers. Two safety seminars have been planned for the near future to address both children and adults including the financial ramifications involving when a rider is injured due to the lack of a helmet.

Linda has also gained the attention of a local law-maker who has shown great interest in the safety program. This in itself has the potential of exploding into a new dimension by means of the participation of the health department, government offices (ie Department of Transportation and the Department of Agriculture), insurance agencies specializing in rural areas, health care practitioners, and the accompanying media attention.

Ohio
Ohio has recently gained a long-awaited coalition leader, Linda Photos, who is affiliated with the Ohio State 4-H. The Horsemen's Corral, a newspaper published in Ohio, has consistently shown its support with articles written by staff writers and reprints on the helmet issue. The Corral is considered to be the official publication for over fifty organizations located in Ohio, West Virginia, Kentucky, Michigan and Pennsylvania with a circulation of 10,000.

Pennsylvania and New Jersey
Pennsylvania and New Jersey both have strong supporters from their local organizations, and have chosen to participate in the program from the "grass roots" approach. The variety of groups participating have given their states a valuable foundation on which to build, similar to the program developed in Washington State. For instance, the Fort Armstrong Horseman's Association of Kittanning, PA, has decided to use the information provided by the HIPRC to develop a safety program for the members of the group.

New Mexico and Oregon
The helmet programs in New Mexico and Oregon have the potential to he very successful with a strong campaign leader. At this stage in their programs both states have the support of their local organizations but need the technical assistance and guidance used in other states (i.e. Vermont and California). I strongly feel that with the information provided by the updated community guide and appropriate contacts available, both of these states will have a viable campaign.

Minnesota
The State of Minnesota was recently added to the list of target states upon the request of the Minnesota State Head Safe Program Director, John Szurek. Mr. Szurek has volunteered as the coalition leader, and is confident with the adoption of this program, he will gain the support of others within his state. A national organization, the North American Horseman's Association, based in Minnesota, and a local 4-H club have already started their own equestrian helmet programs and have pledged their support for their state.

The concept of a "target state" is very important in order for the education to be passed on to others. I have found by attending meetings in both California and Vermont, a wealth of information and ideas were passed on to those who needed a fresh idea or new direction. I also found this very important within Washington State. The Washington State 4-H Clubs were able to use some of the ideas generated by the Vermont State meeting, and the core group in Eastern Washington was able to use some of the information generated by the California seminar including the format. By personally assisting these target states, the invisible barrier is broken and a new network is created.

Updated Community Guide
The issue of the updated community guide has been placed an hold temporarily to provide the most recent data available. This booklet of information is one of the most important tools for this program. Nearly eight hundred copies will be distributed across the United States, including members of the national coalition and the organizations affiliated with this program. The "new" version will include:

Listing of all ASTM/SEI approved manufacturers and styles with description, contact names and numbers.

Suggestions on how to create a club discount program.

Use of media trials, including press releases and announcements.

"Hard copies" of educational brochures for club use.

Marketing ideas for club programs on local and state-wide basis.

Listing of national coalition members for referencing.

Format outlines for safety seminars used in different target states.

The Future Outlook for the Equestrian Helmet Program

The efforts put forth for this last year have made a strong impact in the targeted riding communities and their supporters. Now that the initial foundation has been created and contacts with highly respected organizations have been made, the time has come for the expansion of the project.

The expansion ad target states, based on the interest shown this past year. The "target state" idea has proven itself in respect to the motivation of organizers and supporters in the designated target states. With the increased interest shown by supporters in other states, the program is sure to grow.

Expand the number of active coalition members through the use of the media and seminars throughout the country. The track record of this program has shown the importance of hands-on training in a seminar atmosphere. Those who participated in past seminars have developed a grass roots approach in their own communities, which is in itself the very strength of this program. Also, this approach gives the opportunity for educational and marketing techniques to be shared among the participants. The recognition received by the equestrian helmet program is largely due to the media exposure. Over eight hundred publications related to the helmet program receive the press releases sent by the HIPRC. The majority of these publications are directly related to the equestrian world by riding disciplines, horse breeds, and sport. In addition, the members of the National Equestrian Helmet Coalition publish press releases in their own newsletters to generate the participation of the individuals in the program.

Distribution of the updated community guide. The program will continue to support the horse-related groups. However, for the 1994 year it will expand to include: State Health Departments, Child Health Care Focus Groups, applicable PTA's and PTSA's, Injury Prevention Centers, Child Advocacy Groups, parenting Publications, etc. These potentially new supporters will also receive the updated community guide, which will diversify the types of interest groups involved. This tactic will also raise the awareness in the general public. Hence, local media attention and supporters will be gained.

Evaluation

The process in which the program will be evaluated is by tracking the ASTM/SEI approved helmet sales in the fall of 1994 from all helmet manufacturers. The reported increase of sales will show just how effective the equestrian helmet program is and clarify the market’s interest in the products.

Nichole Water
Harborview Injury Prevention and Research Center
Coordinator, Equestrian Helmet Program
325 Ninth Ave, ZX-10
Seattle, WA 98104

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