University of Vermont AAHS

September 2000, Vol. XI, Number 3

 Table of Contents

Equestrian Headgear Standards
Official Approval for BHS Coaching Degree
Trauma and the Veterinarian
11th Annual Meeting
Ohio Department of Transportation Study
Q & A
4-H Equestrian Helmet Use - Editorial Comment
Equestrian Helmet Use in the National 4-H Programs
News Items

Return to AMEA Page

Equestrian Headgear Standards

Reviewed by
Biokinetics and Associates, Ltd

The Canadian Equestrian Federation (CEF) requested Biokinetics and Associates Ltd. to review equestrian headgear standards In order to specify certification levels for the headgear used in sanctioned events.

To this end, three headgear standards were identified including the European EN 1384:1997, the North American ASTM F1163-1999, and the Australian/New Zealand 3838-1988. Additionally, a British product assessment specification PAS 015.998 for equestrian helmets was reviewed. The British product assessment specification is not considered to be a standard in the regulatory sense. It is based on the European standard, while having tougher criteria for most tests, and some additional requirements. While the motives for such an additional document remain unclear, it likely has to do with the complexities of the recent European common market. However, for the remainder of this document, the PAS 015:1998 shall be referred to as a standard, even though it is unlikely that compliant helmets would be available outside the United Kingdom.

In general, all of the standards assess a helmet's ability to provide adequate protection to the wearer through a series of performance tests. Tests are designed to replicate the stresses that each helmet system may undergo in the event of a head impact. A helmet is designed to absorb impact energy through deformation or destruction of itself, rather than the head within. The nature of a helmet’s use will determine both the style of tests, as well as their severity. For example, a football helmet will typically undergo regular pounding of low severity impacts, while an equestrian helmet is intended to withstand only a single high severity impact. Therefore, football and equestrian helmet standards will define different tests and impact level, although the style of testing will be similar for both. All of the standards reviewed for equestrian headgear cover the two major components of a helmet standard: impact and retention. Impact tests measure the ability of a helmet to reduce the amount of acceleration experienced by the brain to a non-threatening level. The severity of the test that delivers this impact in a laboratory is based on energy levels that would reasonably be experienced during use of the helmet. A helmet is secured on a humanoid shaped headform, which is typically made form metal or plastic that has shock sensing instrumentation imbedded at its center. This shock sensor, or accelerometer, measures the acceleration imparted to the headform through the helmet, expressed in multiples of gravitational acceleration (G’s). The helmeted headform is oriented to target a specific test site, and then raised to a predetermined height and released onto a solid steel anvil. The anvil selected is designed to reflect the different shapes that a helmet might contact. The better the helmet, the less acceleration that the headform experiences. In this manner, a test standard will define an acceptable level of acceleration, based on predicted human tolerance. Retention tests measure the ability of a helmet to stay on the wearer’s head, and remain in the proper position to provide protection. Obviously, If a helmet does not stay positioned properly during normal use, and during the violence of an incident, it cannot protect the head during primary and maybe secondary hits.

Typically, the helmet is secured in the usual manner onto a humanoid headform, and an apparatus Is to stress the retention system. The fasteners are stressed, as well as the buckle, stitching and webbing. Typically, the retention system is required to remain intact, and limits are put on the amount of stretch allowed in the system during the test. Additional test requirements are specified for penetration resistance, peak (visor) deflection and lateral deformation. However, these are secondary In importance to the impact and retention tests.

Summary and Recommendations

The preceding information provides a comparison between the standards on a topic by topic basis. However, a comparison of topics does not in itself provide an overall comparison of the standards To do this, a more qualitative and subjective impression Is made, looking at the overall scope of each standard In general, all standards cover the major bases of impact and retention system strength, and no standard is glaringly Inappropriate.

The ASTM standard overall is felt to be the toughest. It requires overall the highest impact and retention test severity and is tied with the ASNZ standard for the most head coverage.

The BSI standard is probably the most thorough, covering more topics than any other. However, some of the BSI requirements seem to be too specific, bordering on design restrictive. As mentioned earlier, there may be underlying European trade motives for this as evidenced by Its basis being the EN standard. The EN and AS/NZ standards were relative equal In most respects, but each had notable shortcomings. The AS/NZ cold temperature test conditioning is too warm to be appropriate for the Canadian winter climate and its retention strength test is relatively weak. The EN standard lacks a hazard anvil Impact test, relying on a lesser penetration test to assess focused impact protection. It is not the expressed purpose of this report to recommend one standard over another However; there is no hesitation in recommending the ASTM and BSI standards, and the noted caution in recommending the EN and AS/NZ standards.

OTTAWA, ONTARIO — Following the results of the above study commissioned by the Canadian Equestrian Federation (CEF) to review equestrian head gear testing standards, the CEF Executive Committee have endorsed the use of protective headgear that meet the ASTM or BSI standards and it recommends that all riders wear this headgear.

With the long-term goal of implementing standards for protective headgear, the CEF commissioned Biokinetics and Associates Ltd., an Ottawa-based firm, to review equestrian headgear testing standards following the CEF Annual General Meeting in October 1999.

Biokinetics reviewed four headgear-testing standards of equestrian helmets. The standards included the European standard EN 1384:1997, British standard PAS 015:1998, North American standard ASTM Fl 163-1999, and the Australian/New Zealand standard 3838:1998, commonly referred to as EN, BSI, ASTM and AS/NZ respectively.

In reviewing the series of testing protocols used by each of the above standards, Biokinetics determined that all of the standards assess the helmet's ability to provide adequate protection to the wearer. The standards testing examined a multitude of criteria Including climate factors, the amount of coverage given to the back of the head, the ability to withstand impact, the ability to stay on when subjected to forced removal the geometry of the helmet and chinstrap, the retention system of straps or fasteners to hold the helmet in place, the human head's injury tolerance, the ability to withstand a puncturing impact and the stiffness of the helmet's peak. It is worthy to note that equestrian helmets are designed to withstand only one high-severity Impact, in its assessment, presented to the CEF Executive Committee on May 8, Biokinetics determined that the ASTM standard was the toughest and that the BSI standard was the most thorough. Although the EN and AS/NZ standards were comparable in most tests, the EN standard relies on a less reliable test (penetration) to assess the helmet's focused impact protection, while the AS/NZ standard's temperature conditioning test is not cold enough to account for Canadian winter temperatures.

After reviewing Biokinetics' report, the CEF Executive Committee has endorsed the use of protective headgear that meet the ASTM or BSI and it recommends that all riders wear this headgear.

The CEF Executive Committee is studying possible amendments to the CEF General Rules that would reflect a more contemporary view of safety In the sport and recognizes that further consultation with the various sanctioned disciplines and with the Industry, Including the commercial industry, must occur to assess the Impact of these changes. At present, some disciplines cannot adopt these recommendations within their discipline rules without seriously Impacting the nature of their sport. However, the CEF has a responsibility to recognize risk factors in riding, promote safety and to stay abreast of any developments on this Issue. With a global trend towards making approved protective headgear mandatory In most sports, the CEF will be reviewing how the horse community can benefit from approved mandatory headgear in all disciplines.

Members are invited and encouraged to debate the issue provide feedback to the CEF Executive Committee and the CEF Risk Management and Safety Committee. Please send your comments In writing to Don Adams, Executive Director, Canadian Equestrian Federation, 2460 Lancaster Road, Suite 200, Ottawa, ON, KIB 4S5, Fax: (613) 248-3484, e-mail:


Horse Council BC
2669 Deacon Street
Abbottsford BC V2T M3
Phone: (604) 856-4304
or 1 (BM) 345-W55


Official Approval for BHS Coaching Degree

from The Equestrian News

The British Horse Society, in conjunction with University College Worcester, has developed an exciting new venture for a BHS Coaching Degree. This is the first ever Coaching Degree aimed specifically at equestrian sports and the first sports-specific coaching degree in the United Kingdom. The course breaks new ground in coaching qualifications.

Initially the course will be offered as a part-time "top-up" for existing coaches who already hold the BHS instructor certificate. Plans for the future include development of a full-time option allowing Integration of the practical vocational training currently offered by BHS exams with an academic qualification at higher equestrian coaches who can use their knowledge of Coaching and Sport Science to improve British performance In equestrian sports.

For further information, contact the Course Leader, Mia Huws, 01926 707821 ( for details.


Trauma and the Veterinarian

Landercasper J, Cogbill TH, Stutt PJ, Landercasper BO J
Department of Surgery,
Gundersen Clinic/Lutheran Hospital,
La Crosse, Wl 54601

A survey of all American Veterinary Medical Association members in Minnesota and Wisconsin was conducted by questionnaire to document injuries resulting from animal treatment.

Of 995 respondents, 64.6% had sustained a major animal-related Injury. Seventeen percent were hospitalized within the last year. Of those hospitalized, 25.3% required a surgical procedure. Hand injuries were most common in a veterinarian's career (62.6% of respondents), followed by trauma to the arms (27.6%), and the head (20.8%). The thorax (8.5%), genitalia (3.9%), and intra abdominal viscera (2.8%) were Injured less often. Operative procedures were frequently required to treat veterinarian injury from animal patients. Thirty-five percent of veterinarians required treatment for suture, of lacerations, 10% for reduction of fracture/dislocation, and 5% for dental work in their career. One craniotomy and one carotid artery repair were necessary. Mechanism of injury was animal kick (55.5%), bite (3.4%), crush (11.7%), scratch (3.8%), and other Interesting causes (14.9%). These Included the patient pushing, goring, head butting, running over. and falling on the veterinarian.

Additional work-related hazards Included zoonotic disease, autoinoculatlon of live brucella vaccine, and self-inflicted scalpel injuries from sudden patient movement. The most common animals involved were bovine (46.5%), canine (24.2%), and equine (16.2%).

Lost days from work secondary to animal Injury averaged 1.5 days (range, 0-180 days) in 1986 and 8.5 days (range, 0-365 days) during –the veterinarian's career. Job related automobile accidents also occurred. Veterinarians, averaged more than 300 miles driven per week, and only 56% reported following the speed limit. Fifteen percent did not wear seat belts. Self-treatment of Injuries was common.

Editorial comments

It is interesting to learn from a large number of veterinarians that the largest mechanism of injury was a kick by an animal. Of these, only 15.2% were horse-related. Equestrians can profit from advice given to veterinarians, eg. slow down, wear your seat belt and wear your helmet when riding or working near horses.

Doris Bixby Hammett, MO

I have always given the veterinary profession the utmost of respect for their expertise; but, they deserve even more credit for their courage.

John F Stremple MD


AMEA Annual Meeting slated for October 20-21 in Ohio


The AMEA Annual Meeting Is scheduled for October 20-21, 2000. Join us for the annual members meeting and conference held at Lake Erie College, 391 W Washington Street, Painesville Ohio. Registration will begin at 8:00 am, October 20.


Please make your reservations immediately, as space is limited. For reservations contact Quail Hollow Hotel and Conference Center 11080 Concord Hambden Road Painesville Ohio 44077-9557 Phone 440-350-5511 Fax 440-352-0125


$200.00 Physicians; $175.00, Non-Physicians; $100.00, Students. Please complete the registration form and return to the AMEA Office. For questions please call La Juan at 903-509-2475.








Physician …………….$200


Student ……………… $100

School/study _________________________


Please complete and return with registration fee to:

AMEA Annual Meeting, 5318 Old Bullard Road, Tyler, Texas 75703. Check or money order only.

Notice of AMEA Board Meeting & AMEA Members Meeting

The AMEA Board meeting will take place Thursday, October 19. Meeting commences at 6:00 p.m. at Quail Hollow Hotel & Conference Center, Painesville Ohio.

The AMEA Annual Meeting of Members will be held Saturday, October 21 in conjunction with the AMEA conference at Lake Erie College Equestrian Center, 391 W Washington Street, Painesville Ohio.


American Medical Equestrian Association
11th Annual Members Meeting and Medical Symposium 2000
Lake Erie College Equestrian Center, Painesville, Ohio

Thursday, October 19

4:00 – 6:00 p.m. Registration         Quail Hollow Hotel

6:00 p.m. Board of Directors Meeting Quail Hollow Hotel (Room # TBA)

Friday, October 20

7:30-8:00 a.m. Registration/Coffee         Lake Erie College Equestrian

8:30 a.m. Welcome                          La Juan Skiver
                                                   Executive Director, AMEA

John F. Stremple, MS MD MS                 AMEA Program Chairman
                                                   & Moderator
                                                   Medical Editor, AMEA News
                                                Professor Emeritus of Surgery,
                                                   University of Pittsburgh


Sue Coen                                 Associate Dean of Equine Studies,
                                                   Lake Erie College


9:00 a.m. Safety Techniques in Teaching Groups to Train Young Horses

                Sue Coen Associate Dean of Equine Studies,
                                                   Lake Erie College

9:45 a.m. Safety Considerations in Teaching Students Breed Techniques

                Elizabeth Giedt, DVM        Asst. Prof. of Equine Studies,
                                                   Lake Erie College

10:30 a.m. Coffee

11:00 a.m. A Unique Pattern of Horse-Related Deaths in Ohio

                George Koepke, MD        Former Chairman & Prof. of                                                      Physical Medicine & Rehab.
                                                   Univ. of Michigan


11:45 a.m. Lunch

1:30 p.m. It is Not if You Get Hurt, It is When and How Badly

                Bill McCain                 President, Mideastern Farriers

2:15 p.m. Polo the Game: Polo Assn Safety Studies of Helmet and Face Mask


                Tim Nice, MD FACS        Chairman, U.S. Polo Assn. Safety


3:15 p.m. Coffee

3:45 p.m. Shoulder Injuries & Knee Problems in the Rider

                John Bergfeld, MD        Executive Dir., Cleveland Clinic
                                                  of Sports Medicine


6:00 p.m. Cocktail Reception Quail Hollow Hotel


Saturday, October 21

8:30 a.m. Coffee Lake Erie Equestrian Center

9:00 a.m. Common Atraumatic Rider Injuries

                Janet Sorli, MD                 Vice President, AMEA

9:45 a.m. Horse-Related Deaths in North Carolina 1990-1999
                Maureane Hoffmann, MD PhD Assoc. Prof. of Pathology, Duke

10:30 a.m. Membership Meeting

Presentation of the Ayer-Hammett Award

12:00 Lunch

1:00 p.m. Emergency Room Horse Related Injuries in the U.S. over the last                      20 years

                The National Electronic Surveillance System (NEISS) Report

                   Doris Bixby Hammett, MD USPC Safety Committee Member
                                                   AMEA Board of Directors
                                                   Associate Editor, AMEA News

1:45 p.m. Panel Discussion: A Reality Check, Resistance to Horse-Related                      Safety

    Programs: Where are WE? Where do We Need to Go?

                Drusilla Malavase    Chairman ASTM Subcommittee on
                                               Equetrian Headgear


                Loree Probert, MS    Safety & Environmental
                                               Univ. of W. Va.


                La Juan Skiver               Executive Dir., AMEA
                                               Executive Dir., CHA

4:00 p.m. Board of Directors Meeting Quail Hollow Hotel

Note: Participants may use attendance at this symposium for category 2 continuing education credits (CME).


Ohio Department of Transportation Study

Editor’s Note:

The following is response to the study conducted by Dr. George Koepke, MD of Findaly, Ohio of horse-related fatalities in Ohio from 1990-1998.

Dr. Koepke’s report was published in the AMEA News, Vol. XI, Number 2, June 2000, Ref. P. 4, Horse-related Fatalities in Ohio, 1990-1998.

To contact Dr. Koepke:

George Koepke, MD
2222 E. Main Street
Findlay, OH 45840
(419) 424-3834 or


June 28,2000

Dr. George H. Koepke, M.D.
2222 South Main Street
Findlay, Ohio 45840

Dear Dr. Koepke:

Thank you for your letter concerning horse related fatalities in Ohio. We share your concerns over any loss of lives, especially along Ohio roadways.

Our staff recently completed a two-year study analyzing safety issues when Amish Buggies share Ohio's roadways with motor vehicles. Our analysis and final recommendations were developed from accident data and information gathered at meetings with approximately 700 members from Ohio's Amish Community that took place over a one-year period. ODOT staff worked in conjunction with employees from the Ohio Department of Public Safety (ODPS) on the analysis and the community meetings.

Each Department is issuing recommendations on how to make our roadways safer for shared usage by horse drawn vehicles and motorists. ODPS has released its final report. A copy is available through Laurie Lang, Office of Governor's Highway Safety Representative, ODPS, 1970 W Broad Street, Columbus, Ohio 43225,614-466-3250. The ODOT report is still in draft form. We will send you a copy upon its completion.

The ODOT study analyzed the same time period your study covered. Our data identified that five of the buggy related fatalities, which you reported occurred during this period on State-owned roadways. We found that the primary reason all of the buggy/motor vehicle accidents occurred was because motor vehicle drivers underestimated both the horse drawn vehicle (5-8 mph) /motor vehicle (35-55 mph) speed differential, and the time needed to slow down the motor vehicles.

Our study identified the state roadways where all horse drawn buggy accidents occurred. Through our research and discussions with members of the nearly 50,000 Old Order Amish in Ohio, our recommended approach is to, where feasible, widen the shoulders of each roadway frequented by Amish travelers, whenever one of the identified routes is resurfaced. This will provide a safe parallel roadway on which to travel.

Should you have any further questions concerning this issue, please contact Suzann Gad, MCP, Administrator, Office of Urban and Corridor Planning, 614 644-7093 or SGAD@DOT.STATE.OH.US.


Gordon Proctor
Ohio Department of Transportation


George H. Koephe, MD
2222 South Main Street
Findley, Ohio 45840

luly 3.2000

Gordon Proctor, Director
Ohio Department of Transportation
P.O. Box 899
Columbus, Ohio 43216-0899

Dear Mr. Proctor,

I respond promptly to your kind response to my study of horse-related deaths in Ohio from 1990-1998. I enclose statistics of buggy-MVA-related accidents that I compiled again from copies of death certificates and coroners' reports. You will note that seven (not five) deaths occurred, from accidents on state routes and an additional five on county or township roads.

As a member of the board of directors of the AMEA, I am trying to promote safety for all concerned with horses. We appreciate the efforts of those representing the ODOT, the county and township roads to make all roads safer for everyone.


George H. Koepke, M.D.


Q & A

A previously healthy, female rider in her for ties recently presented to my office with a history of a fall from her horse in 1997. She landed on her lower back. No x-rays were taken at the time as she was diagnosed with soft tissue injury and contusions of the lower back.

She had a slight tingling in her lower right leg, which progressed over the past 3 months. She received physiotherapy on several occasions with some benefit but encountered opposing recommendations from the therapists on her treatment.

An x-ray was performed this year, which revealed lumbarizatlon of the SI segment. No x-rays prior to the accident were available. She had recently been told by a physiotherapist that she had a hemiated disc and should not ride.

Examination revealed slight soft tissue swelling of the right sacral area with normal curvature of the spine and no scollosis. Range of movement of the back was normal. She was tender in the R sacral and buttock areas along the piriformis. Straight leg raise was essentially negative and deep tendon reflexes were normal. Sensation was unimpaired. Anterior pelvic pressure was normal. Abduction and external rotation of the R hip was decreased, and caused the tingling sensation in the R foot and calf. Pelvic exam was normal. She also had some spasm In the R psoas muscle.

in British Columbia a non-emergency CT scan can take 12 weeks wait, which would have meant missing the summer, show circuit. She elected to pay privately for a MRI, which revealed no instability of the sacral segment and only minor disc bulges at L3-4. There was no stenosis and no cord or nerve impingement.

I felt safe in telling her she had a R piriformis syndrome and show her some stretches for that particular muscle. I also recommended psoas stretches and deep muscle massage.

The piriformis and psoas muscles are obviously essential to a winning performance by a rider The differential diagnosis of sciatica includes piriformis syndrome, hamstring injury, chronic hamstring origin tendinitis and ischeal bursitis. The sciatic nerve runs between the piriformis and superior orgemellus muscles into the this. This makes the symptoms of disc hemiation at L5-SI and piriformis syndrome difficult to differentiate clinically. Acute disc protrusion Is a contraindication to riding as a permanent foot drop or bowel and bladder Incontinence may occur. It is essential to differentiate Piriformis syndrome from disc protrusion and CT scan or MRI Is critical to send a rider back to their chosen sport safely.

Dr. Janet M. Sorli
British Columbia

An Instructor/OT at a handicapped riding facility states he has client, a girl with athetoid Cerebral Palsy, who does not trot due to neck instability. Her parents are not keen to have Flexion/extension x-rays as she is going through some other treatments at this time. He asks does the cervical instability only starts in adulthood or do we insist on a dynamic x-ray now?

The answer Is located in an article from the May 1994 newsletter, Volume IV No. 2. The author clearly Indicates that examination by a physician of the cervical region of riders with Athetoid CP Is required. As well, the author seems to suggest that damage to the cervical structures occurs after a prolonged period of time of vigorous head nodding. Therefore, do not trot with this rider because head nodding is definitely a concern. Discuss with the parents and the rider that you do other fun activities instead of trotting, Also If you know that she has an unstable cervical spine, there Is no need to risk Injury with flexion-extension views. Cervical instability has been seen among newborns and among preschool athetoids. Ordinarily, athetoids are not good candidates for fusion. A well fitting soft collar might be better tolerated. Cervical Instability can definitely start at an early age (the classic being a Down's child).

Dr. Janet M. SorIi


4-H Equestrian Helmet Use

Editorial note

4-H Is the youth development education program of the Cooperative Extension Service. This non-formal, educational program Is conducted by the US Department of Agriculture, state land-grant universities, and county governments. The program combines the resources of federal, state and county extension staff and volunteer leaders. This unique partnership provides a youth development program that is research based with a close tie to the research Information of the land grant university. Participation In the 4-H educational program Is open to all interested youth. participants are primarily between the ages of 6 and 18 years of age, and reside in every demographic area.

Although the national office provides recommendations as it has with the use of ASTM SEI headgear, the local program is controlled by an advisory committee which makes the decisions, including that of mandatory protective headgear.

The AMEA conducted a survey of state helmet policies in 1992 (AMEA NEWS May 1992). Great strides have been made since this early survey. Although there Is yet much work to be done In education and mandating ASTM/SEI fitted secured helmets for all youth In the 4-H program, the leaders are to be commended for their leadership and the progress the program has made.

Doris Bixby Hammett, MD


Equestrian Helmet Use in the National 4-H Programs


A review of helmet policies directly related to the 4-H Horsemanship project in all SO states and current methods of implementing a safety program to include equestrian helmets.

Nationally the 4-H program has been credited with providing Innovative and fun activities for youth that provide meaningful experiences for Individuals interested in agriculture as well as a large variety of other subject areas. Each land-grant university Is seen as a leader in its responsibility to provide for the health, safely and well being of program participants, whether youth or adults. All 4-H youth participating in activities involving risk need to have the best protection available to ensure an optimal learning environment.

While there are no exact numbers of youth reported to be involved in the United States in equine activities, the National 4-H Headquarters at United States Department of Agriculture reports that 238,407 youth were enrolled In the 4-H Horse project in FY-1999. In addition, the National Agricultural Statistics Service reported In their last 1997 census that the horse population in the United States exceeds 2.4 million head. This data reflects an increase from 1995 of over 400 thousand horses and ponies. The popularity of equestrian-related activities in youth and adults is without question and continues to grow. The American Horse Council (AHC), reports the horse industry as a $12.3 billion business, excluding pari-mutuel betting. The AHC further estimates there are greater than 27 million riders over the age of 12 In the United States.

A consequence of this heightened interest is an increase In equestrian-related Injury. The most common group to receive treatment for these Injuries is young female riders'. Typically, the common cause of death and serious injury in all riders is head injury; with the percentage of these injuries causing death and serious injury being higher in young riders'. In 1975, Dr Leslie Williams, DVM, Dr. pH, et al then at Colorado State University, wrote the earliest scientific paper related to horse accidents in the United States. "The Blue 'I~11 Fly Syndrome: Horse-Associated Accidents" was presented at the annual American Public Health Conference''. The first attempts at designing protective headgear was marketed in 1974 (Snell). The resulting product was bulky, heavy and at times poorly balanced. Consequently the helmet was not readily accepted by the equestrian enthusiast, in 1979 the United States Pony Clubs (USPC) appointed a committee to develop standards for testing equestrian helmets. The goal was to design a helmet that was smaller, lighter and more comfortable, yet provide the rider with protection to the head In the event of a fall. This new design led the USPC to mandate the use of equestrian

helmets in 1985. A year later the American Standard for Testing Materials (ASTM) developed its equestrian helmet standard replacing the USPC standard In 1988*. Currently, new helmets that meet the ASTM standard must also be certified by the Safety Equipment Institutes (SEI), a compliance organization responsible for certifying industrial products'. The SEI seal, containing the date and manufacturer's lot number is permanently applied to the Inside of the helmet, providing assurance to the buyer that the helmet Is an approved equestrian helmet. As the helmet is made protective for a single impact, the helmet should be replaced after a crash but if no accident has occurred, every five years.

The incidence of emergency room horse related admissions in the United States under the age of 25 for 1997 is estimated at 25,710 individuals. In a national study Investigating sports and recreational injuries; the highest proportion of injury events resulting In multiple Injuries occurred as a result of riding animals—a higher proportion than bicycling, in-line skating, or sports-related falls', in 90% of the cases, injuries to equestrians that require hospitalization are caused from the rider being separated from the horse while riding or the rider falling with the horse*. The most common types of injuries include contusions, fractures and sprains. Physical distribution of these injuries are 22% to the head and neck, 54% to the upper body, 21% lower body, and unspecified 3%'. Horse-related injuries represent greater than $88 million in medical costs, with the average cost per Injury estimated at $7,410*. Thompson and Von Hollen (1996), reported that the most common cause of equestrian injury was attributed to horse behavior (primarily "spooking") and human behavior and practices'.

Without question, the consistent use of fitted, secured ASTM/SEI harnessed helmets will decrease equestrian deaths and serious head injuries"(8, 6, 10, 11, 12, 13).

Even though horseback riding has been reported to have one of the lowest overall rates of hospitalized injury for all sports calculated on a general population basis(14, 15); equestrians have been estimated to be at higher risk of serious injury than participants of most other sports. including motorcycle and automobile racing(16, 17). Since the majority of reported injuries has been In the youth sector of equestrian participants, It would seem logical that youth programs related to equestrian sports and activities strongly encourage If not mandate the use of protective headgear (ASTM/SEI) while mounted. The American Academy of Pediatrics (AAP), recommend the following steps for preventing and/or lessening the severity of horseback riding-related injuries:

1. Present education programs, such as those offered by the United States Pony Club and 4-H, to parents, riding Instructors, horse show management and organizers.

2. Parents should be urged to verify that the horses their children ride are matched with their riding abilities.

3. Riding activities should be supervised commensurate with the skill level of the rider.

4. Young riders, when mounted, should wear helmets that meet the ASTM F 1165 equestrian standard and certified by the SEI. In addition, the helmet should be properly fitted and secured by appropriate chin strap. All organizations and activities (riding schools, horse shows, rodeos etc.) that promote or sanction horseback-riding events should require entrants to use approved (ASTM/SEI) headgear. Herein lies the challenge facing the horse industry and youth development organizations like 4-H. Extension educators must motivate the public to take the risk involved with horseback riding seriously. The evidence points overwhelmingly toward protective headgear as a way to minimize the risk of this highly popular youth activity. For many adults Involved with organized youth development programming, implementation

of state policy has been a method to bring this critical safety Issue to light. A national survey of the 4-H Horse Project helmet policy was conducted to determine the extent of mandatory helmet regulations in the 4-H program in each state. The results of that survey were surprising in many aspects. Of the 50 states surveyed 41 had some type of helmet rule. Most of which covered all Hunter events over fences. Twenty-two states had a complete rule that covered all events English or Western in the 4-H Horsemanship program. Of these 22 states, one required that all adults participating in the activities be helmeted as well. Nevada's rule covers all equestrian events and activities whether mounted or not. Arizona and Idaho have no state rule, however, Individual counties have taken the initiative to draft a helmet policy within their counties.

One state has a helmet policy that is only in effect while at state or county functions, individual clubs or counties may opt out of the helmet policy at their own meetings and club shows. While it can be said that a positive step has been made by the 4-H program on a national level to promote safety education In the Horse Project, there Is still a reluctance in some areas to embrace protective headgear as a method to reduce risk in this highly popular project, in the early design of a harnessed equestrian helmet, comfort, visual appeal, size and price were not of paramount consideration. Strong efforts were made by research and development teams In the equestrian helmet industry to address these issues and develop a helmet that was most acceptable to the riding public. Currently helmets come in a variety of styles, colors and dimensions. Certainly the success of implementing a helmet policy In a particular riding community lies in a helmet that Is viewed as comfortable and appealing to the individual rider. Since the survey pointedly indicates that the states with little to no helmet policy In effect within the 4-H program are generally considered to be quite "Western" In attitude, the lack of an acceptable Western harnessed helmet could possibly be sited as one of the barriers. The Western helmet that has been marketed for the past 6 years Is outdated in style and has a very poor silhouette when viewed from the side and front. Whether admitted or not, many equestrians in competitive circles are very fashion conscience. If they feel that a piece of equipment does not enhance the overall look of horse and rider as one unit, then very likely it will not become part of their riding outfit. Many of the states that have adopted a complete helmet policy within their 4-H Horsemanship program view It as a pro-active stance in the name of safety for all youth that are Involved In this high-risk activity. Organizations like SAFE KIDS have supported the helmet policy In 4-H by sponsoring 4-H youth In the purchase of new equestrian helmets. Grant funding from these types of groups greatly enhance the transition from a non-helmeted program to a helmeted one. While discussion on a mandatory helmet policy for organized events was sometimes heated, there was a feeling that with improvements in rider education and rising Insurance costs, its outcome was inevitable". One of the greatest challenges to educators Implementing future safety programs is to overcome the existing negative perceptions of Individuals directly Involved. To significantly increase helmet use, equestrians must realize that there are products available which are both comfortable and inviting to wear". Another Important Implication for future programs is that although most equestrians are aware of the need for protective headgear, many perceive that they are not at risk. Thus, an Important criteria for any program must be to alter a rider's risk awareness through education and human Interest stories".

Carmelita Lamb, M.S.
314 West 5th
County Courthouse
NDSU Extension Service
Bottineau, ND 58318


1. Leader Guide-Keeping Oregon Covered

2. Chitnavis JP; Gibbons CLMH, Hirigoyen M, Lloyd Parry J, Simpson AHRW Accidents with horses: What has changed In 20 years? injury 1996; 27(2): 105-105.

3. Barone GW Rodgers BM. Pediatric equestrian injuries: A 14-year review. The Journal of Trauma 1989; 29(2): 245-247.

4. Hammett DB. American Medical Equestrian Association News 1998; Editorial

5. Seal Marks Approved Headgear Am Horse Council Newslett. April 1983; 10(1)

6. U.S. Consumer Product Safety Commission. Preliminary data horseback riding ages 0-24 1997, Washington, (DC): National Electronic Injury Surveillance System; 1998.

7. Bijur PE, Tremble A, Hare Y, Overpeck MD, Jones D, Scheldt PC. Sports and recreation injuries in U.S. children and adolescents. Archives of Adolescent Medicine 1995; 149:1009-1016

8. Nelson DE, Bixby-Hammett D. Equestrian injuries in children and young adults. American Journal of Diseases of Children 1992; 146:611-614.

9. Thompson JM, Von Hollen B. Causes of horse-related injuries in a rural western community. Canadian Family Physician 1996; 42:1103-1109.

10. Aronson H, Tough SC. Horse-related fatalities In the Province of Alberta, 1975-1990. The American Journal of Forensic Medicine and Pathology 1993; 14(l):28-30.

11. Centers for Disease Control and Prevention, injuries associated with horseback riding: United States, 1987 and 1988. MMWR 1990; 39(20)329-332.

12. Bond GR, Christoph RA, Rodgers BM. Pediatric equestrian injuries: Assessing the impact of helmet use. Pediatrics 1995; 95(4);487-489.

13. Berhang AM, Wlnslett G. Equestrian injuries. Physician Sports Medicine 1983; ll(l):90-97.

14. Watt GM. Hospitalised injuries Victoria, July 1987-June 1993. Monash university Accident Research Centre. Melbourne: Monash University Accident Research Centre; 1995. Report No. 67.

15. Firth JL. Equestrian injuries. in: Schneider RD, Kennedy JC, Plant ML, editors. Sports injuries: mechanism, prevention, and treatment. Baltimore (MD); Williams & Wilkins; 1985:431-449.

16. Silver JR, Loyd Parry JM. Hazards of horse-riding as a popular sport. British journal of Sports Medicine 1991; 25(2)105-110.

17. American Academy of Pediatrics Committee on Sports Medicine and Fitness. Horsebackriding and head Injuries. Pediatrics, 1992:89-512.

18. Condie C, Rivara PP, Bergman AB. Strategies of a successful campaign to promote the use of equestrian helmets. Public Health Report 1993 Jan-Feb; 108(l):212-126.





Alabama X   X X    
Alaska X          
Arizona X* X X X   X
Arkansas   X        
California X   X X X  
Colorado   X   X    
Conn. (t) X   X X X  
Delaware X   X X    
Florida X       X  
Georgia X     X    
Hawaii X   X X X  
Idaho (tt)   X        
Illinois X     X    
Indiana X   X X   X
Iowa X   X X   X
Kansas X     X    
Kentucky X   X X X X
Louisiana X   X X X X
Maine X   X X X  
Maryland X   X X X  
Mass. X   X X X X
Michigan X   X X    
Minnesota X K-3 only          
Mississippi X     X    
Missouri X   X      
Montana X state show     X**    
Nebraska   X        
N.H. X***   X X X  
N.J. X   X X   X
N.M.   X        
N.Y. X   X X X  
Nev.**** X   X X X  
N.C. X   X X    
N.D. X   X X X  
Ohio   X        
Oklahoma   X        
Oregon X   X X X X
Penn. X   X X X X
R.I. X   X X X  
S.C. X   X X    
S.D. X     X    
Tenn. X   X X   X
Texas   X        
Utah   X        
Vermont X   X X X X
Virginia X   X X X X
Wash. X   X X X X
W.Va. X   X X X X
Wisconsin X   X X X X
Wyoming X   X X X  

t Must have helmets for state show and county fairs, but individual clubs may opt out at their club shows or activities.

tt No state rule, however individual counties have adopted a mandatory rule.

* AZ has no state polity. Each county drafts its own, which includes age specific HUS, Saddleseat; Gymkhana must be helmeted as well as Team Sorting.

** Only in classes over fences

*** Adults must wear a helmet at 4-H sanctioned events as well.

**** At all times mounted or not.


News Items

AMEA Annual Meeting

Call for Papers

October 20-21, Cleveland, Ohio, will be the date and place for the eleventh annual meeting of the American Medical Equestrian Association.

Mark your calendars and plan to attend. John F. Stremple, MD, F.A.C.S., Professor Emeritus of Surgery, University of Pittsburgh, will be the coordinator of the program.

The AMEA welcomes medical papers relating to the equestrian sports. If you have a presentation or wish additional Information contact Dr. John F. Stremple, 160 Monks Road, Saxonburg, PA, 16056; Telephone 724-352-4691, FAX 724/552-7693; e-mail:

Call for Nominations

Nominees for the position of AMEA Board of Directors are now being accepted.

Please forward your nominations to the AMEA Office:

American Medical Equestrian Association
5318 Old Bullard Rd.
Tyler, Texas 75703

If preferred, you may email your nomination to

Nominations will close Monday, October 16, 2000.

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