University of Vermont AAHS

April, 1993, Vol. III, Number 2

Table of Contents

USCTA Accident Statistics for 1990 and 1991
Arizona Equestrian Injuries: Sources of Considerable Trauma
Editorial Comments: Equestrian Injuries
Horseback Riding in the United States
Rider Survey Results
Yosemite National Park Curry Company 4-Year Record Review
Head and Neck Injuries in Equestrian Sports
Jockey Injuries Study Released

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USCTA Accident Statistics for 1990 and 1991

Statistics gathered by the United States Combined Training Association from AHSA Technical Delegate (TD) reports from 1990 and 1991 USCTA-sanctioned events are included in this issue of the AMEA Newsletter. Reports from the TDs include incidents that may or may not have resulted in injury. These statistics were compiled by Lois Cozzi, Competitions Manager in the USCTA Office.

The most frequent injury to the Event Rider is a shoulder injury. Of the total number of injuries reported, 42 (21%) were shoulder injuries, the most common being fractured clavicles and shoulder separations. I personally do not feel a protective riding vest would have prevented most of these shoulder injuries. First of all, since in my experience most event riders wear the vest, the injuries were not prevented. Secondly, the newer vests can now be fitted with shoulder "pads." While some riders feel these restrict their arm and shoulder motion and do not use them, I feel the amount of force generated by a fall probably will not be absorbed by these pads. Many riders, when falling off, land directly on their shoulder. This amount of force localized to this one area is quite difficult to absorb. I am not aware of any studies on whether these shoulder pads protect the shoulder and believe further studies are warranted.

The second most common injury was "Other". Of these, most were mounted and the TD simply reported a fall without apparent injury. If you combine the "Kicked", and Spectator/Groom" and part of the "Other" categories, you find a surprisingly large percentage of the total injuries reported by TDs at the events were unmounted. Nine of these incidents involved being kicked by a horse while: in its stall, applying or removing bandages, leading a horse, walking past a tied horse being next to a horse that was rolling, and while trying to catch a loose horse. The site of the injury was usually not specified, but 9 were kicked in the head (one was unconscious) and one was kicked in the chest. Other injuries in the unmounted category included being run over by a horse (spectator), stepped on my a horse, bitten by a horse, falling on the show grounds (usually by tripping in a hole), and hyperventilation.

Twenty percent of injuries involved the head and face. Of these about half (15) involved a concussion or possible concussion and another ten involved a "blow to the head" but further comments indicated the rider was "okay" and without concussion. Many times the rider was able to complete the event. The type of headgear usually was not specified, but in 2 incidents it was noted SEI headgear might have prevented a more serious injury. The USCTA did not mandate ASTM/SEI headgear until 1991 and then rescinded this mandate later in the season. The number of head injuries was slightly higher in 1991. Five riders were kicked in the head. Three were unmounted. Of those mounted and falling off, both were noted to be kicked below the helmet but on the head. Facial injuries included fractured jaws (3), lip injuries (5), fractured nose (4), bloody nose (3), chipped or lost tooth (2), facial lacerations (4) fractured cheekbone (1), and lacerations inside the mouth (1). Some of these injuries were sustained by the same rider and given in detail here whereas in the chart are listed only once (e.g., all facial injuries combined for that rider as "one" injury.)

The percent of back and neck injuries was the fifth most common type after shoulder, head, other, and bruising. Reviewing the reports indicates the majority of these are neck injuries sustained in association with head injuries. There was one fracture of C6 reported. These did not appear to be significant back injuries. One rider was reported to have sustained a back injury and was noted not to be wearing a body protector vest. Perhaps the small number of back injuries indicates body protector vests are helping reduce these type of injuries.

The place where most accidents occurred was on cross country. Cross country involves jumping fixed obstacles at speed. If a hors hits one of these obstacles, either the rider or horse and rider will fall. The second most common area was either stadium or other unspecified. Warmup areas for the jumping phases were the next most likely place for an injury. It comes as no surprise the jumping phases accounted for 86% of the injuries. Dressage accounted for only 1% and the stable area and other accounted for 12%, again indicating the surprisingly large number of unmounted injuries.

The total percentage of injuries for all riders was 0.36% or about 4 per 1000 riders. Since the average rider shows at more than 4 events per year the number above 1 per 1000 rides. Assuming 6 rides per year, there are about 2 injuries per 100 rides per year.

The number of injuries at the Advanced or Olympic level is small, only 8 in two years. This, however, amounted to 1.3% of the competitors at this level or about 5 times that of the lowest or novice level. The denominators of the two divisions are quite different with 39 times more starters at novice than at advanced! A small difference in the number of injuries in the advanced group would make a huge difference in the percentage. Riders at the upper level have more spectators watching them, perhaps adding to a higher level of incident reports and medical attention than at the lower levels. Also, at Advanced there maybe up to 45 jumping efforts on cross country and steeplechase and 25 on stadium for a maximum of 60 jumping efforts on cross country and steeplechase. In novice there are only 12 to 20 jumping efforts allowed on cross country and 8 to 12 on stadium. At Advanced, the maximum number of jumping efforts is often used, whereas, at Novice it is not. Therefore, an advanced competitor may jump three times the number of fences at greater height and faster speed than a novice would jump. Obviously, the risk of injury increases with the number of jumping efforts not to mention the height and speed at which they are jumped. It should also be noted that one rider accounted for 25% of the incident reports at Advanced. Of the Advanced injuries, all were from falls on cross country. One involved bruises only, three fell without serious injury, one fell with a slight concussion and three sustained fractures. One rider fractured a jaw and cheekbone, one fractured ribs, his pelvis, and sustained a concussion and one fractured a clavicle. Of these 8 injuries, 6 were at CCI Three Day Events, when the horse may be more fatigued, and 3 were at horse trials. There were no non-jumping accidents in the advanced group, indicating perhaps a smaller risk by this group to sustain unmounted stable injuries.

The total number of accidents increased slightly in 1991, but the number of riders also increased by 4%. Overall, the per cent of riders sustaining injuries was low.

David A. McLain, MD, FACP, FACR
Board of Governors
Chairman, Safety Committee
7325 Cahaba Valley Road
Birmingham, AL 35242

USCTA Figures

Injury          1990      1991      Total    Percent
Head           10 10.8%  15 13.6%    25       12.3
Facial          5  5.4%  10  9.1%    15        7.4
Shoulder       25 26.9%  17 15.5%    42       20.7
Arm/Elbow       5  5.4%   9  8.2%    14        6.9
Wrist/Hand      5  5.4%   3  2.7%     8        3.9
Ribs            4  4.3%   3  2.7%     7        3.4
Neck/Back       5  5.4%  12 10.9%    17        8.4
Leg/Ankle       3  3.2%   4  3.6%     7        3.4
Bruising       15 16.1%   3  2.7%    18        8.9
Other          11 11.8%  30 27.3%    41       20.2
Being Kicked    5  5.4%   4  3.6%     9        4.4
INJURED        93       110         203

NON- COMPETITORS Spectator/ Groom 3 3.1% 4 3.5% 7 6.1 TOTAL 96 114 21O

WHERE ACCIDENT JUMPING INCIDENTS OCCURRED BY LEVEL OF DIFFICULTY Cross-country 72% LEVEL Competitors Injuries Percent Stadium 9% Advanced 622 8 1.29 Other 9% Int'med 2218 21 0.95% C/C Warm-up 4% Prelim 8925 45 0.50% Stabling 3% Training 15639 55 0.35% Stadium Warm-up 2% Novice 24409 60 0.25% Dressage 1% Total 51813 189 0.36%

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Arizona Equestrian Injuries: Source of Considerable Trauma

Injuries from pleasure horseback riding have not been well documented in the United States. Currently the Centers far Disease Control (CDC) estimates 9.9% of patients seen in emergency rooms because of injury while horseback riding require hospitalization. In Arizona, although a large number of pleasure riding accidents occur, the specific number has never been tabulated. To assess the scope of injuries in Arizona consequent to pleasure riding as well as the results of their medical care, Arizona State Discharge Data Tapes were reviewed. E-Codes (E 906.8 and E 828.2) for mechanisms of injury related to riding animals were searched for the years 1990 and 1991. Five hundred and one individuals were documented as being hospitalized from such injuries. Our hospital system has seen 229 adults and 121 children in emergency rooms with these E codes (E906.8 and E828.2). Of these, 56 adults and 13 children were admitted for inpatient care. The admission rate of 24.5% for adult patients was extremely high as compared to previous tabulated national data. ER admission rate of 10.7% for children is consistent with CDC estimates.

Patterns of injury were reviewed for admissions to our trauma center (one of four system hospitals) in 1991. Types and distribution of injuries for patients injured while horseback riding were reviewed. Of the 43 adults seen in the emergency center, 17 (39.5%) were admitted. Of these 20% were diagnosed with a head injury. This admission rate is exceptionally high, even though the distribution of injuries is similar to other reported surveys. There were 4 reported deaths in patients as a result of horseback riding in Arizona during the years 1990 and 1991.

Pleasure horseback riding in Arizona is clearly a significant mechanism of injury in trauma.

Charles F. Allen, MD, FACS
Medical Director, Trauma Service
Good Samaritan Regional Medical Center
1130 East McDowell Road, Suite B-10
Phoenix, AZ, 85006

Arizona Injuries Figures

1990-1991 Regional Hospital Good Samaritan Emergency Room System Trauma Center Out-patient Num % Num % ADULTS 229 65.4 105 78.9% CHILDREN 121 34.6 28 21.1% TOTAL 350 133

INPATIENT HOSP ADULTS 56 81.2% 37 86.0% CHILDREN(<15) 13 18.8% 6 14.0% Total 69 43 DEATHS 2* *Both under 15 years. Total in Arizona=4.


GOOD SAMARITAN TRAUMA GOOD SAMARITAN HOSPITAL MEDICAL CENTER ADMISSIONS ER Adult Pediatric % Seen % Hosp Male 50 48% 14 50% Riding 34 32% 79% Female 55 52% 14 50% Nonriding 9 22% 21% TOTAL 105 28 RIDERS ADMITTED AREA INJURED ER %ER Hosp %Riders/ Head 7 16.3% Nonriders FX Extremity 12 27.9% Riders 106 32% 34 79% FX Jaw 2 4.7% Nonriders 27 34% 9 21% FX Pelvis 4 9.3% TOTAL 133 43 FX Spine 2 4.7% FX Rib 1 2.3% Total % Head Lung 3 7.0% ER of Abdominal 5 11.6% Emergency Room Total Lac/Abrs/Spr 2 4.7% Adult head 14 103 14% Total 38 Child head 6 28 21% NON RIDERS TOTAL Head 20 133 15% Head 1 FX Ext 1 Hosp %of Fx Rib 1 HEAD INJURY Adm Adm Lac/Abr/Spr 5 Adults 5 37 14% Total 8 Children 3 6 50% TOTAL INJURIES 43

Person may have more than one injury.

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Editorial Comments: Equestrian Injuries

The study of horse related injuries in Arizona using the E-Codes 906.8 and 828.2 (fall from animal and stepped on or kicked by animal) by C. F. Allen, MD, is a significant study. He uses three sets of data for 1990-1991: State Hospitals discharges, Regional EM room and hospital admissions, and detailed data from one large Level 1 Trauma Regional Medical Center hospital.

Dr. Allen points out in Arizona, horseback riding is a major tourist, social and recreational activity. Because of the diverse and open terrain, activities are primarily recreational with organized equestrian events and shows comprising a smaller percentage than in other parts of the United States and Europe.

Several significant figures are apparent: For horse related injuries, children under 15 years of age make up 34.6% of the regional and 21% of Good Samaritan Regional Medical Center outpatient admissions. This can be compared with NEISS 1991 outpatient admissions of 23% for the same aged children. NEISS hospital admissions for all ages through 1991 was 8.1%. We do not have the male/female numbers of outpatient admissions, but those admitted to the hospital are equally male/female. We expect from other studies females to out-number the males in out patient admissions, but females to have more severe injuries requiring hospitalization. This may not he true in this study.

Of those seen in the Emergency Room, 35% were admitted to the hospital. The only other figures we have are from Nevada in which in 1990 82% and in 1991 69% of the injured were admitted to the hospital. We cannot be sure the E-Codes were used in the same way for these figures.

In the Good Samaritan Regional Medical Center horse related injuries for children under the age of 15 years, one third of the admissions resulted in death, and 50% of the admissions were head injuries.

In adults, non riding accidents made up 39% of the outpatient admissions, and 19% of the hospital admissions. In children under 15 years of age, non-riders made up 54% of the outpatient admissions and 79% of the hospital admissions.

More riders were admitted for their injuries than non-riders (79% vs 21%). However from the emergency room, rider injuries required admissions 32% of the time, while non-rider injuries required admission 34% of the time. In riders, fracture of the extremity was the most likely reason for admission (28%) with head injury (16%) second and abdominal injury third (12%) in frequency. In non-riders, a laceration, abrasion or sprain was the most likely cause for admission.

It is hoped other researchers will use the availability of E-code figures for their state to study the horse related injuries resulting in outpatient emergency rooms visits, and hospital admissions.

Doris Bixby Hammett, MD
103 Surrey Road
Waynesville, NC 28786

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Horseback riding in the United States

To determine the extent of horseback riding injuries, we conducted a national mail survey of horseback riders. A total of 2,195 riders randomly selected from the mailing list of a national mail order company that sells horseback-riding equipment completed the questionnaires. A total of 299 respondents (13.6%) had been hospitalized at least once in their lifetime because of a horseback riding injury, and 589 (26.9%) had seen a physician in the last two years because of such an injury. Almost 43% of injured persons were treated at hospital emergency departments, and the upper extremity (44.1%) was the most common site of injury. The most common types of injuries were sprains or strains (37.7%) followed by fractures or dislocations (37.2%). The injury rate was O.5 per 1,000 riding hours- Only 36.7% of persons with concussions wore a helmet at the time of injury. Physicians should counsel their patients who ride horses about the hazards of the sport. the need for appropriate training and the importance of helmets.

David E. Nelson, MD, MPH
Centers for Disease Control and Prevention
Mailstop F36
4770 Buford Highway
NE Atlanta, GA 3034
(with Fredrick P. Rivara, MD, MPH,
Connie Condie, Suznnne M Sntith, MD, MPH)

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Rider Survey Results

In 1990 the AMEA conducted a Rider Survey through a questionnaire in 30 of the magazines the horse community reads. This selected list of magazines was developed looking for geographic location, the type of riding of the majority of readers, past evidence of interest in safety information, and the number of subscribers.

RESPONDENTS WITH PREVIOUS INJURY TOTAL 2404 %TOTAL YES Injury 68.55% NO injury 31.20% 1 Injury 17.47% 2-4 Injuries 37.69% 5-7 Injuries 7.15% 8+ Injuries 4.99% Concussion 24.96% Hospitalized 22.92%

The respondents had to be sufficiently interested to complete the survey and return it. This may have altered the replies in that those who had previous injuries were more likely to respond than those who did not. The number of riders who had been hospitalized was 22.9% compared to the above study in which 13.6% had been hospitalized. One fourth of the riders had a concussion. In this study, we do not know who was wearing a helmet at the time of the injury but it must be assumed that most were not.

These figures reinforce the recommendations made by the above authors relative to the hazards of horseback riding and the importance of protective headgear.

Doris Bixby Hammett, MD

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Yosemite National Park Curry Company 4-Year Record Review

Yosemite National Park Curry Company conducts supervised recreational horseback rides for visitors. The records of incidences involving visitors and horses were reviewed for the last four years. All incidences were reported whether or not an injury occurred. During the last two of these years, the horseback riders 12 years and under were required to wear ASTM SEI protective helmets when riding and adults were offered the helmets and signed a release form before the ride.

There were 225 incidences reported in the four years from 1989-1992 from 214,736 riders who rode a horse 428,330 hours for 1 incidence for every 1048 riders, and one incidence for every for every 1904 hours of riding. Of the 225 incidences, the treatment was known in 217. Of the known treatment, 46.1% were treated at the Clinic at the Park; 45.6% required no treatment.

There were 279 areas of injury; 11 areas were unknown, 20 had no injuries. The head was the third most frequent injured area at 17.5% (34) of the total accidents with known injuries (194), face sixth with 10.3% (20), neck eleventh with 7 (3.6%) and Mouth/dental much lower with 1 (0.5%). The head, face, neck, mouth/dental make up almost one third of the total injuries.

                           TABLE I

Rank Area of Injury Number Percent 3 Head 34 17.5% 6 Face 20 10.3% 11 Neck 7 3.6% 17 Mouth/Dental 1 0.5% TOTAL 62 31.9% TOTAL KNOWN 194

Beginning in 1993 Yosemite Park and Curry Company Horse Concession is making SEI Safety helmets mandatory for all of the guest riders, without exception. 'The company strongly believes this action, along with adherence to height, weight, and age standards, will improve their operations by reducing the potential for serious guest incidences.

Doris Bixby Hammett, MD
103 Surrey Road
Waynesville, NC 28786


NEISS AGE DIVISION AGE 92 91 90 89 TOTAL TOTAL % 0-4 2 2 4 3 11 5.1 5-14 11 20 22 21 74 34.4 15-24 1 4 4 9 18 8.4 25-44 22 18 23 17 80 37.2 45-64 8 7 7 6 28 13.0 65+ 1 0 2 1 4 1.9

Unknown 1 2 0 3 6 2.8

TOTAL 46 53 62 60 221 TOTAL KNOWN 45 51 62 57 215

AREA INJURY 92 91 90 89 TOTAL % of Known

Head 4 9 10 8 31 14.4% Back 6 6 13 7 32 14.9% Lower Leg 9 6 6 10 31 14.4% Knee 6 5 5 5 21 9.8% Face 3 5 6 4 18 8.4% L Trunk 2 2 4 1 9 4.2% Lower Arm 3 1 2 8 14 6.5% Shoulder 2 3 1 6 12 5.6% Finger 0 2 1 1 4 1.9% Neck 1 0 2 4 7 3.3% Upper Trunk 3 0 1 3 7 3.3% Ankle 2 0 0 3 5 2.3% Wrist 0 1 1 0 2 0.9% Foot 0 0 2 0 2 0.9% Elbow 3 2 0 3 8 3.7% Upper Leg 1 1 0 0 2 0.9% Pubic Reg 0 1 0 0 1 0.5% Toe 0 0 0 0 1 0.5% Hand 2 0 0 2 4 1.9% Mouth/Dental 1 0 0 0 1 0.5% Upper Arm 1 0 0 0 1 0.5% Multiple 1 0 0 0 1 0.5% Unknown 3 2 4 4 13 6.0% MEDICAL 0 0 1 0 1 0.5% NONE 6 7 3 3 19 8.8% Total 59 53 62 73 247 Known Injury 50 44 55 66 215 More than one area can be injured.

YEAR TOTAL RIDERS % INCIDEN Change fr Hours Incident Incidences OF RIDERS Prev Year RIDING per Hr 1992 47 51076 0.092% 94.2% 104000 2213 1991 54 54230 0.100% 98.6% 97000 1796 1990 62 55000 0.113% 101.0% 114330 1844 1989 62 54430 0.114% 113000 1823

Tot 225 214736 0.105% 428330 1904

DIAGNOSIS 92 91 90 89 TOTAL % of Known

Contusion 12 8 19 18 57 28.9% Abrasion 11 11 8 16 46 23.4% Strain 5 9 8 11 33 16.8% Concussion 1 5 8 4 18 9.1% FX 0 2 7 6 15 7.6% Laceration 2 6 4 2 14 7.1% Sprain 2 1 0 2 5 2.5% Dental 1 0 0 1 2 1.0% Shook up 0 2 0 0 2 1.0% NEURO INJ 0 0 0 1 1 0.5% Multiple 1 0 0 0 1 0.5% Bee Sting 1 0 0 0 1 0.5% MEDICAL 0 0 1 0 1 0.5% ShortOfBreath 0 0 1 0 1 0.5% # INJURY 11 10 5 8 34 Unknown 6 6 6 5 23 TOTAL 53 60 67 74 254 INJURED 36 44 56 61 197

More than one type of injury reported

CAUSE OF ACCIDENT 92 91 90 89 TOTAL % of Known Fell 33 39 41 40 153 70.8% Kicked 4 5 8 6 23 10.6% Scraped 3 5 3 3 14 6.5% Bitten 0 2 2 5 9 4.2% Animal Fell 1 2 0 2 5 2.3% Stepped On 0 0 1 1 2 0.9% Hit Object 1 1 0 3 5 2.3% Other 1 0 3 1 5 2.3% Unknown 3 1 3 3 10 Total 43 55 61 64 226 Total Known 40 54 58 61 216

Bill Johnson
Vice President
Yosemite Park and Curry Company
Yosemite National Park, CA 95389

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Head and Neck Injuries in Equestrian Sports

Many people participate in horse activities in the United States. Most accidents occur in leisure riding, making record keeping difficult. Horse activities are safe, ranking 67 in the number of admissions to hospital emergency rooms in the USA. Injuries, when they occur, tend to be severe.

Statistics from Medical Examiners in the United States and morbidity studies from Australia and New Zealand are given, as well as statistics from four sources: The National Electronic Surveillance System (NEISS) hospital emergency room admissions, the Justin Sportsmedicine Program of pro rodeo, the National Park System visitor and employee injuries, and the United States Pony Clubs, a national organization of youth and young adults.

MORBIDITY studies show from 78% (Australia) to 60% (USA) of deaths are caused by head injuries. From the medical examiner figures, females have 25% of the deaths, but 50% of the deaths from head injuries.

NEISS figures in comparison of 1979-1982 to 1987-1991 suggests a decrease in the total head and neck injuries. Concussion decreased 11%. By comparing the number of accidents into age groups, the ages 5-15 years had 29.2% less head/neck injuries. In contrast, head/neck injuries increased 38.1% in ages 24-44 years, 41.1% in ages 45-64 years and 69.3% if over 64 years of age.

JUSTIN SPORTSMEDICINE PROGRAM records examinations for possible injuries at pro rodeo events. Head/face injuries make-up 4.4% and cervical spine 5.8% of the total injuries. By comparing the years 1981-1985 with 1986-1990, head/face injuries have increased 125% and neck injuries increased 13%. In major injuries, concussion increased 115.4%, facial fractures 130.4%. Cervical spine fracture/possible fracture decreased 68.6%.

NATIONAL PARK SERVICE horse related figures show that employees have 4.2% head, 5% face, and 1.7% neck injuries while visitors have 8% head, 4.4% face, and no neck injuries.

UNITED STATES PONY CLUBS involve youth under the age of 22 years, and record all accidents whether or not an injury occurs. A concussion is defined as any momentary confusion, seeing stars, etc. During the last two years, ASTM SEI protective hats replaced the previous USPC standard helmet.

If a head/face injury occurred, the injured was more than twice as likely to require hospitalization. If a head injury occurred 68% had a concussion. During the last two years using SEI approved protective helmets, head/face/neck injuries decreased 38.1%; head injury 27.2%, face 63.1%, and neck 15.4% from the previous 8 years of the study. The severity decreased: the need of inpatient hospital treatment decreased by 41.3% and those requiring physician office or emergency room treatment by 44.4%.

CONCLUSIONS: The figures in these studies cannot be conclusive. They suggest that head/neck/face injuries in horseback riding are frequent and severe, and can be prevented or reduced by wearing ASTM SEI protective helmets. The horse and academic community by communication can provide studies which will show the causes and how these accidents can he prevented.

Doris Bixby Hammett, MD
103 Surrey Road
Waynesville, NC 28786
Presentation given at ASTM Symposium
Head/Neck Injuries
May 1993

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Jockey Injuries Study Released

The risk of injury to Thoroughbred racing jockeys was profiled in the most comprehensive study ever conducted among active jockeys. The study, conducted by the Rehabilitation Institute of Chicago through a grant from Mr. and Mrs. Leonard H. Lavin, was presented at the University of Arizona Racing Program's 19th Annual Symposium on Racing.

The 706 active jockeys participating in the self-conducted study reported more than 1,700 injuries during their careers with more than 60 percent of the jockeys reporting one or more fractures. On average, jockeys report injuries requiring medical attention three times a year. During the course of their careers, jockeys miss one out of every seven racing days because of injury.

There also appears to be correlation between jockey weight control methods and injury. More than 60 percent of the jockeys report skipping meals or using a sweat box to control weight; 38 percent or more use diuretics or induced vomiting. Jockeys who reported more weight control measures were more likely to report a greater number of injuries in the past year.

Dr. Joel Press, of the Rehabilitation Institute of Chicago, presented the findings of the study designed by Dr. Robert Addison, director of the institute's office of medical planning.

Dr. Press emphasized the goal of the study was to provide data for future industry projects, including the design of improved safety equipment, clinical rehabilitation techniques, education and prevention procedures.

"The upper extremities and chest accounted for 53% of the fractures," Dr. Press noted. "This may suggest a possible role for flak jackets such as those mandated for jockeys in the U.K. The high number of concussions may suggest a need for protective head gear."

Dr. Addison suggested a logical next step would he the creation of a national jockey injury database. "By collecting data on injuries that occur, in a standard format from every track, along with information such as weather and track condition, we would be in a better position to make specific recommendations on improving safety for this great sport."

John Giovanni, national manager of the Jockeys' Guild, pointed out the high level of participation by jockeys emphasizing their interest in safety issues. "Surveys were distributed to tracks throughout the country, printed in both English and in Spanish," Giovanni said, "and 64 percent of those surveys were completed."

Dr. Robert Addison
Rehabilitation Institute of Chicago
345 East Superior Street # 376
Chicago IL 60611-9593

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