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October 2001

J. McEwan

Getting Hurt is a possibility in any recreational endeavor. But there are ways to be safer.

Equine activity sponsors and professionals are not required to eliminate the risks inherent in horse sports, but they must use due care not to increase the risks to participants over and above those that naturally occur in equine sports. Limit liability is just that; it is not immunity from liability. Disqualification from liability is an illusion since states' limited liability statutes contain exceptions and disqualifications based on issues of fact and causual connections that set in motion events that result in injury.

The American Medical Equestrian Association (AMEA) is a not-for-profit organization founded in 1986 whose primary mission is to emphasize safe participation in horse sports and organizations share ideas for mutual benefit. It serves as a resource of information, knowledge and expertise in various aspects of competition and participation with a special emphasis on injury prevention and management. Ongoing research focuses on injury risks and patterns. The AMEA regards factual understanding of injury trends as the only way that appropriate and effective changes can be made.

AMEA representatives participate in the development of standards for safety equipment, research on safety equipment design, and studies on the effectiveness of existing safety equipment. The AMEA has developed protocols for emergency services to handle equine related injuries that occur to lessen injuries from becoming more severe, minimizing fatalities. Education and awareness is achieved through educational programs, informational materials and such appropriately directed position statements that, for example, concern mandatory helmet laws.

According to the AMEA, 30 million Americans ride horses annually. More than 50,000 are treated in emergency rooms, according to the National Electronic Injury Surveillance System (NEISS) compilation of the U.S. Consumer Product Safety Commission. NEISS estimates are calculated from sample of hospitals that are statistically representative of institutions with emergency treatment departments located in the United States and its territories. By pinpointing the time and location of injuries, risk management intervention attempts to reduce and eliminate many of these injuries and fatalities.

Head, neck and spinal injuries in horseback riders constitute the majority of severe injuries and fatalities. Not a surprising fact when you consider riders rarely wear helmets, and the unpredictable animals are capable of moving at speeds over 30 mph and kicking with one ton of force.

Between July 1992 and January 1996, the AMEA studied all patients admitted to the University of Kentucky Medical Center in Lexington, Ky., with horse related neurosurgical trauma.

Of these patients, six underwent craniotomies, in which incisions are made in the skull to relieve pressure; three had spinal operations; and five required ventriculostomies, in which surgical repairs are made to chambers in the brain. Thirty-seven percent of these riders were professionals and 80% of them were not wearing helmets, including all of the patients who died or required skull surgery. Thirty-three percent of those injured were bystanders. AMEA data shows that such horse-related injuries can be severe and fatal because of the significant size, force and unpredictability of horses, as well as the lack of proper headgear. The AMEA recommends that helmets be worn at all times around horses.

Risks of serious injury appears to be a result of cumulative exposure to horses, not any level of experience. Horse stable operations, breeding farms, commercial sales operations, trainers and riding instructors are the main support structures of the equine industry. Professional horsepersons who assist participants to attain their horse-related goals can be perceived as celebrities, or heroes of a sort, especially if they pass along standards that define the safe handling of horses and an educated attitude toward the management of risk.

However, nationwide legal case work shows a lack of any formal horse-related education among professional and amateur participants. The ability to take a horse over high jumps, to succeed at buying and selling livestock, or to train a horse to win a race, does not guarantee an ability to effectively supervise other participants to safely manage a horse. And more importantly, such emergency procedures as basic first-aid, risk education meetings, safety drills, safety incentive programs, procedures and manuals, and severe accident response, are not being addressed adequately.

Inevitably, there are minimal or no efforts to assess a participant's ability to engage in a particular horse activity, so there's no way of knowing if the individual is capable of selecting safe activities, choosing horses that can be managed safely, and determining the ability of the horse to behave safely.

Riders, handlers and other horsepersons in the equine industry are supposed to possess superior knowledge and experience, and yet most have attained insufficient exposure to safety, risk, and hazard issues, and have pursued no formal horse education, membership or continuing education on the subject. These folks represent themselves as expert horsepersons, when in fact they are not. And they apply methodology well below the standards of care necessary to ensure the inherent risks are not increased.

In order to improve safety in the equine industry, these basic educational steps should be taken:

  • Expose individuals to theories, concepts and literature in the horse field.
  • Assist individuals in developing more effective verbal and written skills.
  • Enable individuals to acquire an understanding of current equine industry thought, technology and practices through in-depth study.
  • Assist individuals to develop an ethical framework for their daily decisions-making process.
  • Advance theory and practice in the field.

There are inherent risks involved with being around large animals. No one can guarantee the safety of a rider or handler, and it is impossible to predict exactly how a horse will behave under adverse conditions (a runaway or loose horse situation, for example). NEISS reports that horse activity rank 64th among activities of people hospitalized with injuries.

Racing commissions as independent agents in the Northern hemisphere have created a promising blueprint for all equine activities by enacting rules requiring protective headgear with safety harness; regarding vests, which feature impact-spreading plastic panels that cover the spine or entire body and reduce the impact of a fall or trample; encompassing break-away safety railings on the inside of the track railing to minimize injury to riders and horses in the event of a crisis situation; and concerning the authority and quality of outriders.

The equine industry has a low degree of government regulation. To remain so, the industry must demonstrate that it can and will police itself by implementing high-quality risk management and safety-awareness programs.

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