University of Vermont AAHS
AMEA

November 1995, Vol. V, Number 4

Table of Contents

Every Time... Every Ride...
Horse Safety While on the Ground
NEISS Summary 1995
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Every Time...Every Ride...

In July of 1995, after a year and a half of work, the equestrian helmet video Every Time...Every Ride... was completed and sent for duplication. As the volunteer who saw the need for this tape and followed it through to completion, I have been asked, "How did you get into this?" Trust me, I have asked myself that a hundred times over. What began as a six month project for our county 4-H evolved into a nationwide, professionally- produced injury prevention video. Starting this effort was like popping the tap on a well- shaken can of soda. (It splattered my life.)

Experience taught me there were intelligent, caring adults willing to sacrifice their time, money and energy for the good of kids and horses but woefully unaware of the need for ASTM/SEI protective headgear. "We need a video," I told my neighbor, the mother of a child saved by my backyard helmet rule. By that I meant surely there was one out there somewhere we could get to use.

Nicole Walters at Harborview quickly informed me I was right. We needed a video. Everyone wanted one -- but someone would need to create it. She put me in touch with dozens of organizations and individuals. That was January of 1994. Since then I have learned about fund raising, grant writing, professional video production, script writing, marketing, the Screen Actors Guild, the press, etc. But the two most important things I have learned are these:

First, there are an incredible number of people in this country who care about others enough to sacrifice their time, their money and even their heartache.

Second, it only takes one. One unlucky slip from a horse. One person to tell. One person to listen. A best friend from elementary school had her dependable trail horse of six years slip and fall over backwards on a paved road. I had told, she had listened. She returned to work as a lawyer the next day and sent her ASTM/SEI helmet back for replacement.

Why did I start? I love horses and riding and want others to enjoy them as well. Micki Petras said it best in a letter about the death of her eleven year old daughter.

"As a novice 'show mom' it never occurred to me to question this practice (not allowing protective helmets) nor did I ever think of challenging the dress code. This mistake of mine will haunt me the rest of my life. I hope we will be able to prevent another incident where a child's love of horses and riding; could turn into a never ending pain in the hearts of her/his family"
I believe we can. Most people are intelligent and will make a good decision if presented with the facts rather than argued with myths. Wearing a helmet is a simple precaution that can reduce the risk of putting yourself six feet below the ground, so education often equals usage. Indeed, after viewing "Every Time...Every Ride..." many have changed their minds. "Every Time ... Every Ride..." is intended for horseback riders, parents and instructors. Professionally produced, with voice over narration by William Shatner, this twenty-two minute video was made possible by Washington State Cooperative Extension and Washington State 4-H Foundation with the support of numerous other safety conscious organizations.

Its purpose is to educate riders about the need for protective headgear and the possible consequences of riding without it.

Real people are combined with footage of horses in action - Western, English, saddle seat, driving, gaming, dressage, trail riding, back yard play etc. It has proven to be riveting to children and adults alike. Interviews with families touched by brain injuries, doctors, and just plain kids, clearly show the very real risk of riding, the trauma of brain injury and the margin of safety which an ASTM/SEI certified equestrian helmet may provide. Mast viewers choose to increase their helmet usage. It is a wonderful tool to use with riding clubs, school groups, families, boarders and riding students. If you are not convinced about the need for protective headgear, keep an open mind, watch the video so you call understand the true risk and ask yourself, is it worth it? If you are convinced, tell others. And please, wear an SEI certified equestrian helmet, Every Time...Every Ride....

Some Preliminary Results

We are encouraging the use of a survey when the video is shown. This both provides feedback and requires the viewer to personalize the information. The survey asks about the viewer's use of AS'l`M/SEI headgear prior to viewing and intended use after viewing "Every Time...Every Ride..." A few preliminary numbers are interesting. From a 4-H camp, clinic, fair and random mail-in responses, we have 135 surveys. Respondents chose between Always (4 pts.), Most of the Time (3 pts), Some times (2 pts.), Rarely (1 pt.), and Never (0 pts.). By corn paring the pre-viewing usage points to the goal (4 pts.), it was possible to determine a maximum possible point increase in expected use for the group. Out of a possible 173.5 point increase, a 116,5 point increase was reported. That is 67% of nineteen "Never" before, two remained hard-core "Nevers", eight moved up to "Sometimes", Or "Most of the Time" and nine moved up to "Always". These were all Western or Western and English riders, most over 18 years of age. -This is a very small survey but tremendously encouraging nonetheless.

It is hard to be modest and share any of the comments we have received! Some examples:

What were the video's and weaknesses?

Emotional impact, jello simulation, ages, variety of riding disciplines, not just women, showed people having fun, length..." "Testimonials especially Rusty Nail's." "Having an expert and doctor tell you that an injury can happen even while standing still." "...showing that accidents can happen to responsible, qualified riders the same as to careless beginning..." "They used kids our age to speak to show that it really can happen to us." William Shatner" "...the horses. The love and care shows - we need to all care enough to wear helmets." "'The deaths." "The physician living with brain injury." "'That the helmets were safe and tested!" "Much variety in age of riders -- many experiences." "Sensitivity of the material." " Everything!"

Jean Gulden
10226 East 44th Avenue
Spokane, WA 99206

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Horse Safety While on the Ground

1994 Survey by American Farrier's Association
by Jim Woods

Medical articles have reported as many as 34% of horse related deaths are not from riding injuries, but from injuries in the proximity of the horse. The American Farrier's Association members are most knowledgeable of the horse from the ground. In an effort to relate their experience to information being gathered with the goal to reduce horse related injuries, a survey was taken of AFA members.

This survey form was published in the Journal of the American Farriers Association on a heavy paper distinguishing it from the regular pages with a date and address for return. It was later taken personally to two meeting of the AFA for distribution. A total of 80 replies were received. These are tabulated below.

National representation was obtained as persons from 29 states and Canada replied. Wisconsin had 9, Ohio and Florida 8, Indiana 6, and Texas 5, with fewer replies from the other states.

Twenty-three of those replying did not have certification, two were working toward certification and one in a internship, with all others being certified by some organization. Males were 85% of the respondents with females making up 15%

Discussion

I am not sure that this survey is useful in reducing horse related accidents in any population except horseshoers. What 1 am sure of is that horseshoers have more experience working with horses on the ground than any other group involved in the horse industry. As such, they have much of value to teach the rest of the population what is involved with horses. By nature, the horse is a herd animal with its natural pecking order. Hopefully as a horse handler you are at the top of the pecking order. If you are below the horse, your chance of injury is greater. Horses are dangerous. There will always he accidents. When you pit a one thousand pound, not very bright creature against a one hundred and fifty pound person, the result will be an occasional problem. Our purpose is to limit their incidence and severity.

There is a cartoon that has made its way throughout the horse industry titled: "The OSHA Horse." It reveals many of the problems of equine safety, In the last few years a number of states have passed laws that limit liability in the horse business by establishing by law the fact that horses are inherently dangerous.

Horses are not very bright.

Horses are creatures whose primary means of defense is flight.

Horses are animals who have evolved with eyes on the side of their heads to see predators at great distance. As such they have blind spots immediately in front and behind them. There is a cone of blindness for the horse of about six feet in front and behind.

Horses have no conscience. I have heard a lot of dissent about this. In spite of what you would like to believe, your pet may run over you and it will not feel a bit bad unless it hurts itself in the process.

Horses respond to all sorts of stimuli. Avoid dangerous horses and dangerous activities on windy days if possible. Windy days are as vitalizing to horses as they are to humans. I am not sure whether it is the barometric change, or the noise and activity that accompanies a strong wind.

Macho or macho activity is one of the biggest causes of injury. Get some help. Be sure that someone is close around who knows where you are if help is needed. The cell phone will probably reduce the number of fatal horse accidents.

Getting the Horse

The first chance of injury is when you come in contact with the horse. This is when you get him from the stall or pasture.

Plan ahead. Go to the stable early in the day while the herd is still spread and happy. This will lessen some of the problems at the gate. Or go latter, after the horses have been brought in or have come in. Take help with you; one to chase the herd and one to lead the horse to be brought out. Find a place where there are smaller groups of horses turned out together Train your horse to come to you at the gate. If your horse is stalled part of the time, arrange to have him left in when you want to ride. All or some of these may be possible.

If the horse is in the pasture, talk to him, get his attention. Usually he will turn his head toward you or even walk to you. Approach him from the side, usually the front left side. Talk to him and pat him an the shoulder and put on his halter, Then attach the lead to the halter. If he already has the halter on, approach him the same way and attach the lead. Staying on the front left side next to his shoulder lead him to the cross tie or grooming area.

In the stall make sure the horse is aware of your intentions. As you open the stall door, the approach is the same. Talk and pat him as you put on the halter and the lead line.

The most frequent injuries involving the horse occur:

From bites, frequently when putting on the halter;

Striking with the front feet, possibly when you are approaching him from the front or working on the front end;

A kick, when approaching him from the hind or working on the hind end;

Stepping on you while leading or working with him;

The most serious injuries occur when he spooks, either when being lead or while working with him.

So back to the stall or pasture. When you first approach the horse to attach the halter or when leading, he can bite you, strike you or kick at you. This is why you let him know your intentions and let him know at all times where you are. Then while leading stay at the front left shoulder, not in front where he can walk over you, or in back of the shoulder when he can kick you. While leading, pay attention. Do not let him move his head around where he could butt you in the head or bite you. Most important of all, do not wrap the lead around your hand or wrist. That is really an accident waiting to happen. If the horse would spook or shy and run, you could be dragged and severely injured.

Suppose while you are leading him or holding him, he tries to rear. Be aware of the front legs trying to strike at you; you could be struck on the head, face or body. The best thing to do if there is a clear area behind him is make him back. This will quickly tire him and you can regain control.

Working with the Horse

Now that we have the horse in the cross ties, lets look at what can happen. He can bite you while grooming. He can strike at you. He can kick at you. And worst of all, he can blow up and you will really have a wreck.

If you let him know your intentions and keep his focus on you, your chance for an accident will be reduced. Pat him and let him know you are there. If you intend to pick up his feet, pat him on the shoulder and work your way down the leg so when you pick up his foot he knows it is you and not a fly. You won't spook him. Watch his feet and your feet. Make sure they don't find each other.

On the hind end, pat him on the butt, work your way down his leg as you reach to pick up his foot. Do not startle him. Make sure he knows it is your hand. Keep a hand on his flank so that if he moves toward you, he will push you away. Some people when they go from one side to the other stay close to the horses hind end. I prefer to take the time to walk far enough behind so that I can't be kicked; or take the time to move around his front end. Pat and talk to him. Let him know where you are and you know where he is.

While you are working on him, pay attention, watch him and watch your surroundings. Do not let him or you become distracted.

Watch his feet. You are working on a front foot, and you notice his hind feet starting to creep forward. You know he is up to something: like getting ready to rear or pull his foot away. Be attentive to the horse. If he starts to swish his tail, shake his head or tense up, there is usually a reason and an action is about to occur.

Horse Holder

One way to help eliminate some of these chances for injuries is to have someone hold the horse instead of cross tying him. This is preferred and the best way when possible. 'The handler must pay attention to you and the horse: not day dreaming, looking out the barn door or somewhere else. The handler must watch the attitude and attention of the horse.

The first duty of a good horse holder is to keep the person working on the horse from getting injured. The secondary duty is to allow completion of the task attempted. Make sure the handler is on the same side of the horse as you are. If there is a problem he can turn the horse to the handler and away from you thus avoiding an injury.

If we have a horse holder he/she can help if we have to restrain the horse, while we work on him. If we need a twitch the handler controls the horse and the twitch so we can not worry about being hit in the head with a flying twitch. 'The horse holder can also pick up a foot if we need to work on a hind leg. This gives us a lesser chance of being kicked. He can talk to the horse and reassure the horse while we are working on him. The horse holder and the person doing the work have to work as a team and have a common understanding of the horse and what is to be done. That way there is less chance of injury.

Returning the Horse

Now that you are finished you have to put the horse back in the stall or pasture. This is the same as when you caught him. However, most important of all, when you release the horse, turn him to you to unhook the lead line. That Tha way he will not run past you and give you a playful kick

In summary you can reduce the bites, strikes, and kicks by paying attention to the horse and the job to be dune. Use a helper when possible, and let the horse know your intentions. Do not surprise or startle him.

Trailer Loading

A personal observation is that loading a horse into a trailer is the must dangerous situation that arises in the entire list of horse related tasks. This provides the opportunity for injuries from all of the above while your judgment may be hampered by anger and frustration. The most important thing in avoiding injuries in loading is to start early. If you need two hours to get loaded and get to the show, start three hours before show time. The purpose of this article is not to tell you how to train a horse, but training and practice will go a long way toward preventing loading problems. Be sure you have someone to help and to respond to emergencies if they occur.

I think the reasons for more horse injuries today is the fact that we have people unfamiliar with horses and how horses think and act. We have veterinarians and farriers who have never owned horses giving advice and working on them. We have people who buy five acres of land with a house and barn on it and figure they are supposed to have horses. These are both real opportunities for accidents to happen. We need real horsemen and horsewomen with the basic understanding of horses in general and how the horse thinks and reacts. This basic and simple understanding will lead to fewer accidents. But sometimes the familiarity can lead to an accident or injury as we all too well know. We need common horse sense on how the horse thinks and acts. We can get this from books, videos, horsemen and horsewomen, and from past experience.

Be careful. Train the people around the stable to realize the potential problems. Anticipate the problems. You are your brothers keeper or at least you should be. Avoid potential problems before they happen. Most important of all is to become a knowledgeable horseman or horsewoman.

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NEISS Summary 1995

The figures used are from a compilation of information derived from horse associated injuries treated in hospital emergency rooms participating in the National Electronic Injury Surveillance System (NEISS) of the U.S. Consumer Product Safety Commission. TheNEISS estimates are calculated from a sample of hospitals which are statistically representative of institutions with emergency treatment departments located within the United States and its territories. NEISS warns small figures in their statistic have a high margin of error and may not have significance. This article will report the NEISS figures for 1993-1994.

AGE   1979-82  Percent  1987-92  Percent  1993-94  Percent
0-4 3,318 2.0 7,008 1.9 2,785 2.0
5-14 45,504 27.1 75,930 21.1 28,720 20.5
15-24 56,185 23.5 87,633 24.4 27,599 19.7
25-44 49,570 29.6 145,139 40.4 57,119 40.9
45-64 11,422 6.8 37,202 10.3 21,364 15.3
65+ 1,685 1.0 6,513 1.8 2,188 l.6
TOTAL l67,683 359,543 139,765

The figures substantiate the observation that persons under the ages of 25 years are having decreased injuries in the horse activities, with the continued predominance of the ages of 25-44 years. The greatest percentage increase over these two years is in the ages over 64 years,

BODY PART    1979-82    %  1987-92    %   1993-94   %
Lower Trunk 19,842 11.9 44,554 12.4 20,210 14.5
Head 18,957 11.3 37,896 10.6 15,844 11.3
Upper Trunk 13,938 8.3 36,192 10.1 13,733 9.8
Wrist 12,248 7.3 27,639 7.7 10,668 7.6
Ankle 10,438 6.2 20,415 5.7 7,848 5.6
Lower Arm 10,349 6.2 19,187 5.3 6,742 4.8
Shoulder l0,315 6.2 25,681 7.2 10,228 7.3
Face 9,845 5.9 22,028 6.1 7,070 5.1
Finger 8,405 5.0 13,952 3.9 7,113 5.1
Knee 8,312 5.0 16,300 4.5 4,893 3.5
Foot 8,206 4.9 14,883 4.1 5,901 4.2
Lower Leg 7,808 4.7 17,412 4.9 6,412 4.6
Elbow 6,227 3.7 10,629 3.0 3,569 2.6
Hand 5,337 3.2 8,727 2.4 3,781 2.7
Upper Leg 4,824 2.9 8,472 2.4 3,247 2.3
Upper Arm 3,562 2.1 8,615 2.4 2,495 l.8
Neck 3,230 1.9 5,461 1.5 3,484 2.5
Toe 2,363 1.4 2,877 0.8 1,369 1.0
Mouth 1,131 0.7 2,291 0.6 923 0.7
Eyeball 765 0.5 1,258 0.4 327 0.2
Pubic Region 674 0.4 2,205 0.6 904 0.6
25-50% Body 454 0.3 9,627 2.7 1,803 1.3
Ear 332 0.2 872 0.2 219 0.2
All Parts Body 74 0.0 1,446 0.4% 733 0.5
Not Stated/Unk 276 0.1 248 0.2
TOTAL 167,686 358,895 139,765



HEAD 34,260 20.4 69,806 19.5 27,867 20.0
Head, Face, Mouth
Neck, Ear, Eyeball


UPPER 56,443 33.6 114,430 32.0 44,516 32.1
EXTREMITY
Upper, Lower Arm, Elbow
Finger, Hand, Wrist, Shoulder


LOWER 41,951 25.0 80,359 22.4 29,670 21.3
EXTREMITY
Lower, Upper, Leg, Knee
Ankle, Foot, Toe


TRUNK 34,504 20.5 82,951 23.2 34,847 25.1
Upper, Lower Trunk
Pubic Region


MULTIPLE PARTS 786 0.5 10,499 2.9 2,022 1.5


TOTAL 167,944 358,045 139,002

The percentage of all injuries that occur to the head and upper extremities have changed very little. Injuries to the trunk appear to be increasing.. Injuries to the lower extremity appear to be decreasing.

   TYPE OF INJURY


1979-82 % 1987-92 % 1993-94 %


CONTUSION/ 69,441 37.9 115,546 32.2 42,382 30.3
ABRASION


FRACTURE 47,382 25.9 102,568 28.6 40,131 28.7
SPRAIN/STRAIN 29,338 16.0 60,381 16.8 23,207 16.6
LACERATION 16,998 9.3 32,433 9.0 11,636 8.3
CONCUSSION 6,775 3.7 12,740 3.1 4,908 3.5
INTERNAL INJURY 1,852 1.0 10,841 3.0 2,824 2.0
DISLOCATION 3,102 1.7 7,349 2.0 1,634 1.2
OTHER 2,592 1.4 6,708 1.9 4,983 3.6
HEMATOMA 2,246 1.2 4,075 1.1 4,838 3.5
PUNCTURE 635 0.3 1,578 0.4 356 0.3
UNKNOWN 1,125 0.6 666 0.2 694 0.5
AVULSION 592 0.3 1,102 0.3 313 0.2
CRUSHING 81 0.0 1,246 0.3 149 0.1
FOREIGN BODY 421 0.2 236 0.1 914 0.7
DERMA/CONJUNCT 125 0.1 339 0.1 115 0.1
AMPUTATION 107 0.1 350 0.1 379 0.3
BURN 30 0.0 324 0.1 59 0.0
NERVE DAMAGE 182 0.1 0 0.0 224 0.2
HEMORRHAGE 118 0.1 40 0.0 0 0.0
SUBMERSION 0 0.0 112 0.0 0 0.0
RADIATION 0 0.0 102 0.0 0 0.0
POISONING 0 0.0 81 0.0 0 0.0
DENTAL 0 0.0 0 0.0 224 0.2
TOTAL 183,142 358,817 139,762

Concussion has remained the same in percent figures. If we use the age figures above, it would appear that the older age groups are having the concussions. The figures over these several years do not show significant changes in the type of horse related injuries.

GENDER    1979-82    %   1989-92    %   1993-94     %
MALES 64,964 38.8 150,963 42.1 57,556 41.2
FEMALES 102,614 61.2 207,806 57.9 82,209 58.8
TOTAL 167,578 358,769 139,765

Gender percent figures are not changing significantly. Females have the greatest percent of accidents but the male percent appears to have a slight increase.

SEVERITY


YEARS
1979-82 % 1987-92 % 1993-94 %

ZERO 1,920 1.1 6,127 1.7 4,358 3.1
ONE 28,278 16.9 53,723 15.0 18,394 13.2
TWO 45,089 26.9 83,484 23.3 33,262 23.8
THREE 52,225 31.1 104,805 29.2 41,829 29.9
FOUR 19,933 11.9 41,539 11.6 15,316 11.0
FIVE 11,449 6.8 39,921 11.1 16,548 11.8
SIX 8,244 4.0 27,621 7.7% 9,519 11.8
SEVEN 126 0.1 1,476 0.4% 232 0.2
EIGHT 418 0.2 121 0.0 307 0.2%
TOTAL 167,682 358,817 139,765

Zero is no injury increasing in severity to eight death. As in the previous study, there is no identifiable trend.


LOCATION 1979-82 % 1987-92 % 1993-94 %
Known Known

HOME 40,557 30.2 91,596 42.7 29,752 41.6
SPORTS 47,129 35.0 53,664 25.0 21,339 29.9
FARM 28,240 21.0 40,016 18.7 9,320 13.0
PUBLIC 8,478 6.3 23,101 10.8 9,310 13.0
STREET 5,222 3.9 2,824 1.3 1,416 2.0
SCHOOL 1,764 1.3 900 0.4 323 0.5
INDUST 3,096 2.3 2,409 1.1 0 0.0
UNKNOWN 33,183 144,506 68,305
TOTAL 167,669 359,016 139,766
KNOWN
TOTAL 134,486 214,510 71,461

Injuries in sports have continued with marked decreases. This may be because those who are in these activities are aware and are wearing certified protective headgear as well as following other safety measures, whereas those at home have not changed their riding habits to the same degree. The decrease in injuries on the farm may be a result of the loss of farm land over the nation. There has been an increase of the percent of injuries in "public", roads, trails and parks, where riders are now riding with the loss of farm land.

TREATMENT


1979-82 % 1987-92 % 1993-94 %
Known Known

TR/REL 144,009 85.9 318,533 88.8 125,259 89.8
TN/REL 6,331 3.8 8,327 2.3 2,478 1.8
TN/HOSP 2,586 1.5 4,470 1.2 * *
HOSP 14,234 8.5 27,322 7.6 11,480 8.2
DOA 418 0.2 121 0.0% 307 0.2
UNK 102 43 240
KNOWN 167,578 358,773 139,524
TOTAL 167,680 358,816 139,765

*In 1993-1994, all transfers were listed together.

These figures do not give significant changes over the years covered.

CONCLUSION

The greatest change in the horse related injures appears to be the increasing age of those injured and the location of the injury increasing at "Home" and "Public" where recreation riding occurs.

NEISS, US CONSUMER PRODUCT SAFETY COMMISSION
National Injury Information Clearing House
Washington, DC 20207
Reported by Doris Bixby Hammett, MD
103 Surrey Road, Waynesville, NC 28786

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