November 1998 Newsletter
November 1998, Vol. IX, Number 4
Injury in the Wilderness
Comparing Headgear
Drugs in Horse Activities
AAHS Brings Safety to Navajo Reservation
Equitation 1960
Jockey Injuries in 1997
USPC 1997 Accident Study
Rodeo Standard for Protective Helmets
Ten Legal Commandments
World Equestrian Games, 1998
Executive Secretary's Report
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INJURY IN THE WILDERNESS
FROM THE RlDING PHYSICIAN VIEWPOINT
If you are a physician who foxhunts or trail rides, then inevitably you are going to be called to evaluate
an injured or ill rider. The location is often remote and for example, in the Midland Fox Hound country
where I ride, sometimes difficult to access even with a 4 wheel drive vehicle.
Some critical decisions often need to be made and they can be stressful for everyone involved,
especially if you are a riding dermatologist. What if your 52 year old riding buddy starts having chest
pain? What do YOU do if you are trail riding in a remote area and someone falls off her horse and is
knocked unconscious? How should you evacuate the person? When should you leave to call for help?
When can you leave an injured person alone to go for help? What do you do with the horses?
The first step in answering any of these questions is to be prepared. Keep in mind and mentally rehearse
what you would do in any of these scenarios. Tell someone where you are going and when to expect
your return. Know the country in which you are riding as best you can and if unfamiliar to you should get
a map well in advance. If you are a physician you will save yourself a lot of trouble by carrying a cell
phone on your belt in case of an emergency. If it in on the horse, the phone may leave with your horse.
Most hunt staff have radios and giving one to the physician of the day greatly facilitates communication.
We frequently have at least one or two physicians in our hunt field and usually one of us volunteers to
stay with an ill or injured rider. A rotation keeps the burden lighter on everyone. Know what hospitals
are in your area, their capabilities and which one is the closest. Fortunately we have a familiar
relationship with our nearest community hospital, the EM nurses recognize an injured rider is coming
when muddy people with boots on and lots of scratches on their faces appear at the door.
Take common sense safety precautions. Urge everyone in your field to wear an ASTM-SEI helmet with
chinstrap fastened. Encourage riders that have potentially serious medical problems like diabetes,
seizures or heart conditions to wear a med alert bracelet. You may not feel you are responsible for the
medical care decisions of everyone with whom you trail ride or foxhunt but you will be when they have
a fall from a horse and you are the only medical person available. Anyone who rides or is around
horses should have an up to date tetanus immunization. Hunt staff should have preexposure rabies
inoculation.
Know what medical skills are available, who is trained in first aid or CPR. Does the local EMS service have
a 4 wheel drive ambulance (most don't)? What areas do you go into that might require a person being
hand carried out on a backboard? Which is the closest hospital with capabilities to handle major trauma
or head injuries? Do they have a CT scan or a neurosurgeon on call?
Carry or have available some basic medical supplies. For a days foxhunting or a local trail ride I carry in
my sandwich case an ampoule of 1/100 epinephrine, a TB syringe, a vial of injectable Benadryl, a 5cc
syringe, a 14 g angiocath, a cotton triangular sling (never a lack of clavicle fractures in riders), Advil,
Tylenol and hydrocodone tablets. If you are going on an extended ride of more than a day then you will
need a more comprehensive pack as well as to obtain a medical screening sheet on each rider before
you go. Put a backboard, hard cervical collar, sheet rolls, and duct tape in the horse trailer and leave it
there. (Your local EMS service will usually give this stuff to you when it becomes worn or outdated). One
day you may be very thankful.
Review emergency procedures with the other medical personnel on your ride, as well as with the MFH
and hunt staff. Follow basic precautions in courtesy and etiquette. One of the cardinal rules of
foxhunting or trail riding is do not leave the field of riders without notifying the fieldmaster or trail boss.
This is basic common sense and helps avoid situations in which you may be left alone and injured. When
someone is injured in OUR hunt we usually ask that the fie1d of riders go on leaving one person to hold
the injured rider's horse, another to attend to the victim (calling for any riding medical personnel if not
present) and a third or fourth person to stay to hold the other horses and help the physician or person
who is assuming care of the patient.
When an injury does occur you must assess the urgency and make a decision. Can the person walk out
to the nearest vehicle? Can they ride out or do the need experienced EMS evacuation? In general
helicopter evacuation from the scene is not a good idea when you have multiple people in the area on
horseback. Before you know it YOU are going to have a lot more problems on hand. Evacuating a patient
by ground is often faster and less risky.
Initiate a call for immediate evacuation if the patient has the following: persistent altered mental status
after a fall with loss of consciousness, orthostatic syncope, chest pain that is clearly not chest wall in
origin, the return of loss of consciousness following head injury, debilitating pain, or evidence of a spinal
cord injury such as intense neck or back pain, arid numbness or weakness in the extremities. (1)
What if you are riding with just one other person? If you have no communication device then you are
going to be forced to try to stabilize the person to the best of your abilities and get help as soon as
possible. This may range from staying with the patient and hoping someone comes along that can go for
help (obviously not an option in a remote area) to leaving an injured person alone and going for help.
Follow the ABC's of resuscitation and keep in mind that you should not leave a confused patient who
might inflict further harm on himself or others, someone who is bleeding copiously without controlling
the bleeding or an unconscious person who is vomiting or has an obstructed airway. Of course make
sure you know where you are going and how to get back.
References:
1) Wilderness Medical Society Practice Guidelines for Wilderness Emergency Care. Edited William W,
Forgey, MD. IGS Books, Inc., 1995
2) Medicine For The Outdoors, Paul Sauerbach, MD. Little, Brown and Co. 1986.
Julie Ballard, MD
Haralson Farm
5067 Smokey Road
Newnan, GA 30263
Dr. Julie Ballard is an emergency physician at Piedmont Hospital in Atlanta, GA, a life long equestrian,
who spent the first part of the summer in bed recovering from her own horse-related accident.
Injury in the Wilderness: Editorial Comment
Julie Ballard has a great article on wilderness riding and first response. If you are reading this article, I
assume you are "cursed" with the prospective that things do go wrong, how can I help prevent it, and
what can I do when it happens.
The American Medical Equestrian Association mission is to educate the oblivious riders who see no
consequences of their poor decisions. Follow the Boy Scout motto of "Be Prepared." The AMEA's goal is
to educate and be a source of information to anyone who seeks help.
Unfortunately bad things happen. I was involved this past weekend with a barn fire with eleven horse
deaths and burns to one of the rescuers. I do not think we can save the world but I feel we need to be
the voice of safety in the horse community.
William Lee, MD
Desert Foothills Medical Center
PO Box 2150
Carefree, AZ 85377
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HOW DOES EQUESTRIAN HEADGEAR COMPARE
AND WHAT SHOULD I WEAR?
Drusilla Malavase replies:
Two in-depth studies compare ASTM/SEI helmets to British, EuroStandard, and Australian helmets.
These studies show that the ASTM equestrian standard is more protective that the other standards.
One Australian helmet does pass ASTM testing and is available in the United States. I will provide copies
of these studies as they are multiple pages with drawings, tracings, tables, etc. for the research scientist
who is interested. Mail me your address and what study you wish.
If you are more interested in the comparison of ASTM/SEI with what I call Vanity Helmets ( labelled
"item of apparel only" ), I would suggest that you have a look at the video "Every Time, Every Ride",
available from the Washington 4H Foundation, the American Association for Horsemanship Safety
(www.law.utexas.edu/dawson/), and the USPC bookstore (bookstore@ponyclub.org ). There are huge
differences in energy management and the retention systems of vanity helmets and protective ones. It
is all very well to praise the small size and familiar fit of the former, but why strap on something which
protects you from little more than the sun and the rain ?
If you want to know what particular ASTM/SEI helmets are most effective, all of them with the SEI seal
surpass the ASTM equestrian standard, and your decision should really be made by your type of riding
(competition? pleasure? hot weather? racing?) and the model within that category which fits you best.
This presupposes that you are willing to go to a dealer who carries more than one manufacturer's
products ( good service!) and that you are smart enough to read the manufacturer's fitting instructions
carefully (and you would be horrified to know how many riders and tack store owners don't!) I have
found that there is a model which fits each of us best, with the greatest degree of comfort possible;
however, some of us lucky "average head" people can be happy in any correctly fitting model if we will
give it a chance for a couple of rides.
Drusilla Malavase
Chairman, ASTM Subcommittee Equestrian Headgear
2270 County Road #39, RR #2
Bloomfield, NY 14469
e-mail address: drumalavase@hotmail.com.
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DRUGS IN HORSE ACTIVITIES
Let's pretend. It's something we all do as kids but tend to grow out of as we mature and become adults.
But take a moment now and pretend that you own, run or are an investor in a stable of horses worth
hundreds of thousands of dollars...maybe even millions. If you were in a conventional business you
might consider these horses as inventory or equipment. Certainly all the tack and other support
equipment counts as an asset. As such, you would probably have alarm systems, security guards and a
comprehensive drug and alcohol testing program for the employees.
Let's pretend that you do all of these things. Which program do you think is doing the most to protect
your assets? Well there's no doubt that alarms and guards are valuable but they are basically like locks;
they keep honest people honest. A determined thief will get in despite your security measures. But what
about drugs? Not just cocaine and marijuana...but also alcohol, amphetamines/methamphetamines,
heroin and others are all readily available. If you don't have a drug testing program in place you don't
know if you have a problem or not. Suffice it to say, the odds are heavily weighted that drugs are being
used/abused on your grounds and the potential for losses is tremendous!
If your employees live and/or work in an area where most employers perform drug testing and you
don't can you guess what type person you are most likely to attract as an applicant? If the applicant
can't pass the test they tend to look for the jobs that don't test. If you hire this person what are you
getting for your money other than a warm body? How about a 300 % increase in their use of medical
benefits, increased absenteeism, a 3x increase workers' compensation injury claims and decreased
productivity (as compared to the non-abuser).
So how do you start a drug testing program and what does it cost? First and foremost you develop a
comprehensive drug testing policy. Don't skimp and try to copy someone else's policy. You train your
horses using your own methods and style so why do you want to copy someone else's style of employee
management? A good, comprehensive policy can usually be prepared for you for under $500.00 in most
cases by a knowledgeable attorney familiar with your states drug testing laws and benefits. In some
states, compliance with the state regulations allows a discount on your workers compensation
insurance. Once you have a policy you need to notify all of your employees of the date the policy will go
into effect. This waiting period varies from state to state and can be as short as immediate to as long as
60 days before you can test current employees. New hires are subject to testing immediately. Look for a
good Medical Review Officer (M.R.O.) to interpret all test results for you. If you are not a doctor, and
you don't even play one on TV, leave this to the professionals. In fact, many are Certified Medical
Review Officers from organizations like the American Association of Medical Review Officers
(A.A.M.R.O.), American College of Occupational and Environmental Medicine (A.C.O.E.M.), or American
Society of Addictionology Medicine (A.S.A.M.). The M.R.O. is an M.D. or D.O. that will interpret the test
results obtained from the laboratory and will determine if an abuse of drugs is evident. Many M.R.O.'s
can offer turnkey programs for multiple sites in multiple states. This offers the large employer the
greatest control over their programs and is often the most cost effective method of running a drug
testing program.
So you decide to set up a program and it's up and running. What should you expect? Expect the
unexpected! You will catch people you never suspected of having a drug problem and will probably find
that some of the people that you have a hunch are using drugs actually are not! One of the greatest
benefits, however, is the overall improvement in your workforce and your workplace safety. You will see
an improvement in both attitude as well as morale and, in the long run, for every dollar you spend on
your drug testing program you can expect a return (a savings) of $3.00 or more. So what do you say, let's
stop pretending and get real. After all, you live and work in the real world.
Other sites/Resources:
American Association of Medical Review Officers: www.aamro.com
Alcohol and Drug Testing Procedures: Office of Drug and Alcohol Policy Compliance:
www.dot.gov/ost/dapc
Drug testing and Legal Issues Web Site: www.ol2.com
C. B. Thuss, Jr., M.D.
President and Certified M.R.O.
Absolute Drug Detection Services, Inc.
Certified by A.A.M.R.O.
Email: cthuss@absolutedrug.com
Web Page: www.absolutedrug.com
1400 Urban Center Drive
Suite 115
Birmingham, Al. 35242
800-878-7786, 205-969-1387 Fax
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AAHS Brings Safety to the Navajo Reservation
The American Association for Horsemanship Safety, Inc. (AAHS) has made major strides in bringing
horsemanship safety to the Navajo Reservation. Over the last two years, AAHS has been working with
(one current and one former) nationally recognized PRCA bull riders to decrease horse related injuries
on the Reservation through education. J. P. Paddock and Harry Begay originally became involved with
AAHS when they participated in an AAHS Instructor Clinic in Arizona. Both earned Instructor status at
that clinic, and were identified as potential AAHS Clinicians. Harry and J.P. were very concerned with the
number of horse related injuries on the Reservation, especially those that involved children. They were
drawn to the AAHS system since it was originally developed through the observation of rodeo horse and
bull riders. In addition, the fact that it is a systemic approach to teach people to teach riding quickly and
efficiently was very appealing.
Harry and J. P. traveled down to Golondrina Farm in Fentress, TX, to earn their pre-clinician status and to
discuss potential methods for raising funds to increase safety awareness on the Navajo Reservation. In
December of 1997, Jan Dawson and Dr. Betsy Greene wrote a grant to Indian Health Services (IHS) for
funding that would allow for completion of Harry and J. P.'s Clinician requirements and the production
of four "Keep it Natural" clinics to be presented in four locations on the Navajo Reservation. The grant
was awarded, which allowed Harry and J. P. to assist with the largest clinic that AAHS puts on each year
at Camp Stewart for Boys in Hunt, TX. At the clinic they became more adept in instruction of the system
of teaching riders to develop Secure Seat(sm), evaluating potential instructors, and providing
constructive feedback and solutions for instructors that were struggling in their efforts.
This past June, Harry, J.P., Dr. Greene and Jan Dawson gathered in Window Rock, AZ, to conduct the first
of four clinics on preventative health care and natural, safe training and riding methods. The clinic,
attended by many people including Ralph Fulgham (IHS grant administrator), his wife and child was well
received by all. During the clinic, J.P. gave personal testimony of the value of Secure Seat(SM) . He
described how his young daughter had quite an adventure on her first efforts at riding his big horse
"Brownie" instead of her own pony. She and Brownie were riding when Brownie decided to run up a
draw. She lost her reins and Brownie kept running, but his daughter maintained her seat until the horse
stopped. J.P. was noticeably touched as he passed on the story, and you could tell that he had, at that
point in time, totally bought into the value of the Secure Seat(SM) riding system.
Although the clinics were not advertised as "Safety Clinics," it became very clear to the attendees that
safety was a number one priority since all clinicians were using certified safety helmets. Harry and J.P.
gave riding demonstrations while Jan Dawson narrated the Secure Seat(sm) and "Keep it Natural"
concepts throughout the clinics. As the clinics progressed, Harry and J.P. both became more active in
the presentations, and often switched between English and Navajo languages when explaining concepts
for the audience.
Throughout the clinics in Window Rock, Chinle, Kayenta and Tuba City, it became obvious that riding on
the Reservation was not comparable to the "typical" lesson program. One of the unique aspects of
"riding around home" on the Reservation is that "home" may include a five-mile radius of desert land.
There seems to be considerably less arena riding and a great deal of open land, on which the youth
often ride alone. This understanding of differences in riding habits and cultures made it clear that the
most important thing to teach the young Navajos was to simply stay on the horse. The Clinicians came
to the conclusion that the standard operating procedure would not be the most effective method of
reaching this particular audience. This observation helped AAHS to establish a considerably different,
but effective effort in horse safety education for this particular audience. Harry and J. P. have worked
with AAHS to develop a mirror organization entitled Native American Association for Horsemanship
Safety, Inc. (NAAHS).
Since rodeo is the third major industry on the Navajo Reservation, J. P. and Harry are heroes to many
young Navajos, and this provides an excellent avenue for promoting helmet use and horse safety. Both
endorse the use of approved helmets and their strong endorsement helped the audience to begin to
accept helmet use. AAHS and NAAHS have plans to continue their joint efforts of increasing safety
awareness and practices through the development of educational materials. Another method of
delivery will include presentations by Harry and J.P. at schools and Chapter Houses on the Reservation.
Overall, this has been a very positive step in reaching a new audience for safe horsemanship.
Elizabeth Greene, Ph.D.
Equine Extetnsion Specialist
Washington State University
Clark Hall 126
Pullman, WA 99164
SECURE SEAT(sm)
"Secure Seat(sm) is a defensible and systematic METHOD of teaching the balanced seat, and has been
successfully developed and field tested by American Association for Horsemanship Safety, Inc. This
method of teaching is presented in "Teaching Safe Horsemansip" by Jan Dawson. Storey Publishing.
(AMEA NEWS Vol VII No 2 May 1996)
Betsy Greene
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Jockey Injuries in 1997
The JOCKEY NEWS reports Accidents and Mishaps for their membership's information. These following
figures are from the reports for 1997. The reported accidents were for Jockey's Guild riders only.
Injuries were reported by 365 jockeys who were involved in 620 mishaps with 794 injuries. Five jockeys
reported 6 accidents in 1997, 9 reported 5 accidents, 12 reported 4 accidents, 38 reported 3 accidents,
80 reported 2 accidents, and 221 reported one accident.
TABLE I
Number of Jockey Injuries
No Injuries No Jockeys Total Injuries
Percent
6
5
30
1.37%
5
9
45
2.47%
4
12
49
3.29%
3
38
114
10.41%
2
80
160
21.92%
1
221
Total 365
221
620
60.55%
Percent is based on the number of jockeys injured.
There were 143 race tracks which reported these accidents. The track with the greatest number of
injuries was Charles Town with 48; second was Penn National with 38, followed by Beulah Park 27, Turf
Paradise 26, Calder Race Course 24, and Evengeline Downs with 20 accidents.
TABLE II
Race Tracks with Mishaps
Charles Town
48
Penn National
38
Beulah Park
27
Turf Paradise
26
Calder Race Course 24
Evengeline Down
20
Remington Park
19
Sam Houston
18
Sunland Park
17
Delaware Park
16
Delta Downs
14
Portland Meadows 14
Ladbroke DRC
13
Turfway Park
13
Blue Ribbon Downs 12
Oaklawn Park
11
Retama Park
11
All other race tracks have 30 or below Guild Jockeys in accidents.
The area of the body most often reported was the back with 15.8% of the injuries, followed by the leg
14.9%, shoulder 14.4%, ankle/foot/toes 12.9% with other areas of the body in the single digits. Types of
injuries were reported in only 9% of the accidents. Of these reports 39.3% were sprain/muscle pull,
28.6% bruise/abrasion/contusion, 26.8% fracture with concussion, laceration, and dislocation each
accounting for 1.8%.
The second column of figures are from the National Electronic Injury Surveillance System (1) and the
third are from the survey by Joel Press of professional jockeys. (2)
The National Electronic Injury Surveillance System horse related injuries for the five years of 1992-1996
are given for comparison. Our medical studies have no standard by which findings are reported. In the
Jockey study the leg includes the thigh, knee, as well as the ankle/foot and toes, and the arm contains
the elbow, forearm, wrist, hand and fingers. The injury listing are different but some comparisons can be
made. NEISS figures give 15% for the lower trunk and 10.4% for the upper trunk which includes the back.
The jockey's back has the greatest frequently of injury (15.8%) but comparisons are not possible. The
leg, shoulder, and ankle/foot/toe, knee and neck have greater frequency of injuries in professional
jockeys. All other parts of the body have less frequency of injury.
TABLE III
Body Part Injured
Injuries
Total % Neiss 92-96 Nat'l Jockey
Injury Study
Dorsal/lumbar spine 98 15.8%
10%
Leg
92 14.9% 4.3%
24%
Shoulder
89 14.4% 7.7%
22%
Ankle/foot/toe
80 12.9% 9.8%
0%
Wrist/hand/finger 49 7.9% 14.4%
0%
Face
47 7.6% 5.2%
0%
Arm
47 7.6% 7.6%
19%
Chest/rib
43 6.9% 10 4%
12%
Pelvis/hip
42 6.8% 15.0%
3%
Knee
40 6.5% 3.7%
0%
Neck
36 5.8% 2.4%
0%
Head
33 5.3% 11.6%
9%
Abdomen
10 1.6%
0%
Dental
8 1.3% 0.6%
0%
Clavicle
7 1.1%
0%
Buttock
7 1.1%
0%
Thigh
5 0.8% 2.3%
Elbow
2 0.3% 2.8%
0%
None
6 1.0%
Not known
53 8.6%
Total
794
338710
706
TABLE IV
Type of Injury
Type Injury
Total % Neiss 92-96 Nat'l Jockey
Injury Study
Sprain/muscle pull 22 39.3% 16.5%
10%
Bruise/abrasion 16 28.6% 32.9%
10%
Fracture
15 26.8% 28.1%
64%
Concussion
1 1.8% 3.5%
8%
Laceration
1 1.8% 9.0%
5%
Dislocation
1 1.8% 2.2%
7%
Tear
5%
Puncture
1.2%
5%
Contusion
4%
Internal Injury
2.8%
2%
Neurological Injury
0.1%
2%
Total Reported
56
Percent Reported 7.l%
338710
1757
In reporting injuries immediately, more sprains and muscles pulls are remembered than when the injury
is remembered some time later as in the Jockey Survey figures. After some time from the injury only the
more severe injuries will be reported.
(1) NEISS Horse Related Injuries. AMEA NEWS, August 1998
(2) Press JM, Davis PD, Wiesner SI, et al. The National Jockey Injury Study: An Analysis of Injuries to
Professional Horse-Racing Jockeys. Clin. Jour. of Sports Med. 5:236-240, 1995.
Doris Bixby Hammett, MD
103 Surrey Road
Waynesville, NC 28786
Phone/TAX 704/456/3392
email: dhammett@primeline.com
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United States Pony Clubs’ 1997 Accident Study
Introduction
A total of 136 accident reports of United States Pony Clubs members and 11 adults and one participant
were received. Only Pony Club members appear in the following figures.
Accidents which cause concern were those related to horses bucking and/or rearing without discernible
causes. Whether or not this was related to the rider is less important than the match of a youngster with
a horse that rears or bucks with minimal or no provocation. The rider/horse combination should receive
more attention from the instructor. The instructor will have means by which these unacceptable
behaviors can be minimized. "Old horses teach young riders, old riders reach young horses" is excellent
advise and one which we promote with the D and lower C levels.
The largest area of interest and concern remains the D level. Two horses refused or tripped doing grid
work. Ten mounted accidents included the horse tripping or falling. Ten riders fell off because the horse
refused a jump. Horses "spooked' in 13 accidents, reared in 5 and bucked in 17. An inappropriate match
of rider and horse presupposes the increased likelihood of an accident.
Anytime humans and horses meet accidents are going to happen. The unacceptable behavior of rearing,
bucking or spooking should be monitored closely because these actions have resulted in the most
serious injuries. Children should experience the thrills of victory, even if the victory is simply completing
the task at hand, not the agony of an injury which may have been avoided. We should encourage
positive experiences on which horses and riders can gain confidence.
RATINGS
Rating
Unrated
Data 97 Accidents % Known
8
6.6%
92-96 Accidents
18.2%
D?
7
5.8%
D1
15
12.4%
D2
33
27.3%
D3
21
17.4%
D Total
76
62.8%
C?
2
1.7%
C1
18
14.9%
C2
8
6.6%
C3
7
5.8%
C Total
35
28.9%
B
1
0 8%
HA
1
0.8%
A
0
0.0%
Total Known 121
89.0%
Unknown
15
TOTAL
136
19.1%
8.0%
11.6%
11.9%
50.6%
7.7%
9.3%
6.4%
5.3%
28 7%
1.2%
0.7%
0.5%
561
The records on ratings before 1992 did not break down the D and C ratings-into levels 1, 2, and 3. As one
reviews the above percent the figure for D rated accidents in 1997 (62.8%) appears to be much higher
than in the 5 year report (50.6%). However, if the unrated are added to the D's the figures are the same
(69.4% vs 68.8%). The conclusion is that Pony Club is succeeding in getting the unrated members rated
quickly.
C rated percent of accidents remain the same and the numbers of accidents with B, HA, and A are so
small that any comparisons are not valid.
AGE
Ages are easier to record than ratings so we have comparison with the membership for 1997 and with
the 15 year accident study. If these figures are valid, the USPC gave closer supervision in 1997 for the
members below the age of 9 years so that this group has a lower percent of accidents than the
membership would predict and that occurred during the previous 15 years of accident records. The ages
above 17 years also had fewer accidents than their membership would predict and less than the 15 year
figures. The over 17 year Pony Clubbers have developed maturity, knowledge of safety and skills to
avoid-accidents.
AGE
AGE Accidents % Known % Known
82-96
Number 1997
USPC
Accidents
0-5
0
0
0.4%
6-8
5
4.3%
6.3%
9-11
33
28.2%
23.5%
12-14 35
29.9%
35.0%
15-17 37
31.6%
24.6%
18 & over 7
6.0%
10.2%
Total 117
11953
6.1%
25.3%
35.2%
25.9%
7.5%
906
Unknown 19
TOTAL 136
226
12179
LOCATION
Location
Accidents % Known
82-96
Number
1997
Accidents
Outside Course
31
40.3%
29.2%
Arena
13
16.9%
23.8%
Outside Ring
11
14.3%
7.4%
Barn Area
6
7.8%
Ring
5
6.5%
11.6%
Pasture
4
5.2%
6.5%
Trail
2
2.6%
4.6%
Other
5
6.5%
11.0%
Total
77
Unknown
59
43.4%
TOTAL
136
730
The outside course location remains the area where most Pony Club accidents occur. The Arena and the
Ring follow at a much lesser percent. Only 77 accident locations are known with 43.4% unknown in
1997. Although the percents are different, this same frequency of location of accidents occurred in the
15 year report.
MOUNTED/JUMPING
Pony Clubbers were mounted in 79% of the accidents, 12.6% were not mounted and 7.9% of the
accidents were Pony Club activities but were not horse related. In the 16 not mounted accidents, 37.5%
were stepped on, 18.8% were kicked, 12.5% were bitten, and one accident occurred in each of the
following: vaulting, saddling, loading, horse trampled handler, horse raised head hitting the handler. In
the 10 not horse related accidents three cuts were reported (cut on games equipment, cut finger with
knife, picking up glass in warmup area), two had foreign matter in the eye, one each of bee sting, burn
on a heater, fall from trailer moving jumps, and heat illness.
Of the mounted accidents the PC was jumping in 50% and 50% of the accidents occurred in other
mounted activities.
GENDER
Gender Accidents % Known 1997 82-96 82-96
Number 1997 USPC USPC Accident
Male
11
Female 123
Total
134
Unknown 2
TOTAL 136
8.2% 9.0% 11.3%
9.0%
91.8% 91.00% 88.7% 91.0%
l2179
957
The percent of male/female accidents continue to show that males have fewer accidents than their
membership would predict. The percent of males in the: membership has decreased as have their
percent of accidents compared to the previous 15 years.
AREA OF BODY INJURED
Injuries
Number
% of Injured
1997
82-96
Ankle/foot/toe 20
15.4%
12.2%
Wrist/hand/finger 17
13.1%
13.0%
Head
15
11.5%
18.5%
Dor/lum spine 15
11.5%
11.8%
Face
10 .. 7.7%
12.0%
Shoulder
7
5.4%
8.3%
Leg
7
5.4%
6.6%
Pelvis
5
3.8%
7.3%
Knee
5
3.8%
7.3%
Neck
5
3.8%
6.6%
Upper Arm
4
3.1%
6.6%
Buttock
4
3.1%
2.0%
Chest/rib
4
3.1%
4.3%
Abdomen
3
2.3%
2.9%
Elbow
3
2.3%
5.7%
Dental
2
1.5%
l.0%
Forearm
2
1.5%
7.9%
Clavicle
1
0.8%
4.9%
Thigh
1
0.8%
3.6%
130
None
22.1%
TOTAL REPORTS
136
Injuries
130
1097
DENTAL included in FACE in first 10 years
BUTTOCK included in PELVIS/HIP first 1O years
Two areas of injury could be reported.
PERCENT is figured on the number of injured Pony Clubbers
Body Part
1997
% Injuries
82-96
Upper Extremity
25.4%
33.3%
Lower Extremity
25.4%
29.8%
Head
24.6%
31.5%
Trunk
20.8%
41.5%
Neck
3.8%
6.6%
Number Injury
30
72
# PC Injured
Total Injuries
106
130
768
1097
In 1997, the most frequent body parts injured are the ankle/foot/toe and the wrist/hand/finger with the
head and the trunk third and fourth in frequency. When the body is divided into areas (the clavicle,
shoulder and pelvis are listed as part of the trunk, face and dental as part of the head) the upper and
lower extremities are equal in the percent of injuries. The head, which includes the face and teeth, has
almost one fourth of the injuries (24.6%).
When the 15 year figures are compared, every region of the body has decreased in the percent of areas
injured. There may be two reasons for this: in the early stages of the United States Pony Club study, only
the more severe accidents, with injuries were reported, and secondly the injuries with accidents are less
severe today and involve fewer parts of the body.
TYPE OF INJURY
Injury Types
Number
% Total
1997
82-96
Bruise/abrasion
46
39.0%
37.5%
Closed FX
22
18.6%
12.3%
Sprain/muscle pull 17
14.4%
13.8%
Laceration/no
10
8.5%
4.4%
"Shook Up"
8
6.8%
8.0%
Concussion/unconscious 5
4.2%
8 4%
Laceration/Sutured 3
2.5%
3.2%
OTHER
2
1.7%
0
Sunstroke/Exhaustion 2
7.7%
2.6%
Open FX
1
0.8%
1.3%
Internal Injury
1
0.8%
1.7%
Dental Chipped
1
0.8%
0.7%
Dislocation/Sept
0
0
2.9%
Injuries
118
1070
Total PCs with Injury 104
756
NO INJURY
32
?
TOTAL
136
939
Percent is on the number of PC injured
Several types of injury may be reported
In 1997 the most frequent injury is a bruise or abrasion. At a much lower percent closed fracture
followed by sprain or muscle pull and laceration not requiring sutures.
As the figures for 1982-1996 are compared, the more severe injuries have decreased
(concussion/unconscious, open fracture, internal injuries, heat illness, laceration with sutures, sprain
and muscle pull, heat illness, "shook up" ie emotionally upset) whereas the less severe injuries of
bruise/abrasion and laceration requiring no sutures have increased. One serious injury, closed fracture
has increased in percent. These figures speak well for the safety education of Pony Club.
TREATMENT OF INJURY
Treatment
Number 1997 % Known 82-96 % of Change
Hosp Drs Office/
Unable to return 43
31 6%
37 7% 16.2%
RX Grounds/
Returned to Ride 27
19.9%
13.8% -44.0%
RX Grounds
Unable to return 12
8.8%
6.9% -27.1%
Hosp Drs Office
Returned to Ride 10
7.4%
10.9% 32.5%
Hospitalized
2
1.5%
7.5% 80.3%
Expired
1
0.7%
0
No Treatment
41
30.1%
23.2% -30.0%
Total
136
936
Percent is on total reports.
In 1997, nearly one third of those injured did not require treatment. Of those treated, most went to the
hospital or the doctor's office and were not able to return to the activity. In some cases the activity was
completed. The next most common treatment was those who were treated on the grounds and
returned to the ride. This may be a Band-Aid, ice, or cleaning of the abrasion.
There was one death in 1997 in Pony Club activities (USPC NEWS Summer 1997 Number 74). During the
over 20 years I have followed USPC accidents, there have been no deaths in the Pony Club horse
activities.
These figures indicate that safety education in Pony Club brings results. Hospitalization percent
decreased 80% over the preceding 15 years. Treated at the hospital or the doctors office and returned
to the ride decreased by 33% and those not able to return to ride decreased by 16%. In contrast the
lesser treatments; treated on the grounds and returned to ride increased by 44% and unable to return
to ride increased by 27% while those receiving no treatment increased by 30%.
This trend of lesser severity of injury has been occurring every year. The United States Pony Clubs have a
program of instruction for the leaders and members which is modified every year as indicated by needs.
The Safety Committee gives input into the instruction council relative to needed changes for safety.
Education concerning the safety and health of the Pony Club member is one of the chief contents of
instruction.
Doris Bixby Hammett, MD
Safety Committee
United States Pony Clubs
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EQUITATION 1960
In the 1960's, Jack C. Hughston, MD, Hughston Sports Medicine Foundation, Inc. wrote in SPORTS
SAFETY, Accident Prevention and Injury Control in Physical Education, Athletics, and Recreation:
The majority of serious injuries incurred in horseback riding fit into three categories.
First, it is the inexperienced rider who buys a country place and a horse and then puts the horse out to
pasture. The owner goes to the county every few weeks and on one weekend decides to ride the horse.
The rider is either frightened or overconfident. In either case, the horse gets going at too great a speed
and the rider falls, or the girth isn't fastened and the rider falls, or the stirrup straps are not inspected
and they break.
Secondly, a youngster is having a birthday party. The mother thinks it would be nice for all the children
to ride around on a horse as a part of the entertainment. She knows a neighbor who owns a horse, but
she does not know the horse and usually does not know the essentials of safety in riding. The most
frequent cause of the resultant broken wrist or broken arm is a loose girth, which allows the child to roll
off the horse, even at a walk.
The third example involves teenagers who rent horses from a riding stable which rents horses by an
hourly rate to anybody who wants to ride, without inquiring about the person's riding ability, and where
the rider does not know enough to ask any questions about the horse and equipment. The result is
usually an inexperienced rider on a horse that is accustomed to galloping vigorously for the entire hour,
or on a horse accustomed to turning back and heading for the barn at the first opportune moment.
Such horses are often untrained or incorrectly handled; and frequently the riding equipment is in poor
condition....
Fox hunting, show jumping, pony clubs, one day events of the United States Combined Training
Association, and general horse shows seldom involve injury. Why are injuries in these areas so
infrequent? The answer lies in the proficiency of skills attained by the riders and horses participating in
these activities.
Editorial Note
The first scientific study of horse related accidents in the United States was in 1975 by Leslie Williams,
DVM, Dr.PH, et al. then at Colorado State University, "The Blue Tail Fly Syndrome: Horse-Associated
Accidents." and presented at the American Public Health Association at its annual conference. The
figures were from hospital emergency rooms in Colorado. At the same time, Anthony Seaber and W. S.
Mahaley, Jr. MD. Ph.D. at Duke University Medical Center from their study of The United States
Combined Training Association recommended protective headgear for horseback riders to prevent head
injuries which were frequent in the study.
The first attempts at protective headgear for U.S. equestrians used the
Snell motorcycle helmet standards. The only passing model, the Buco, was made in Mexico in 1974, and
was never put into production In 1978 the U.S. Polo Foundation paid Wayne State University's Dr.
Voight Hodgson to develop a standard for their sport. The resulting helmets from both these standards
were bulky, heavy, and sometimes poorly balanced. They were not accepted by the equestrian
community.
The United States Pony Clubs appointed an ad hoc headgear committee in 1979 which used the NOCSAE
football and United States Polo Association standards to test helmets to what became known as the the
United States Pony Club standard. The USPC Standard helmets were lighter and smaller than the Snell
and USPA models, and were mandated by the USPC in 1983 and by other organizations in 1984.
The American Society for Testing and Materials developed its equestrian helmet standard from 1984 to
1988, when it was published. It replaced the USPC standard starting in that year.
An industry wide meeting of the equestrian community, organized by Haborview Injury Prevention
Center, Abraham Bergman, MD, and held in Washington, DC, in 1994 and attended by representatives
of many national horse organizations including the American Medical Equestrian Association. Since then
many medical studies of horse activities have been done including the USPC which is now in its 17th
year. Many of these studies appear in the AMEA NEWS with other studies being summarized in the
publication..
These studies give more figures than were available to Dr. Jack Hughston in the 1960's. Different
recommendations for prevention are now made from these studies. His examples still may occur, but
we know that ASTM SEI protective headgear measurably reduces injuries, and experience does not
prevent accidents and injuries. Rider knowledge has a better effect on accident reduction than
experience does.
Doris Bixby Hammett, MD
Editor AMEA NEWS
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WORLD EQUESTRIAN GAMES, 1998
With barely a year to prepare, the Italians staged the World Equestrian Games in an admirable fashion.
The Three Day and Driving competitions were held at Pratoni del Vivaro, an hours drive outside of
Rome. Medical Director Dr. Stefano Dragoni had few problems with which to contend during the cross
country phase as there were no major falls or accidents. Equestrian athlete care was aided by those
countries which brought their own team physicians. Team physicians in attendance were: Dr. Craig
Ferrell, U.S.A., Dr. Eric Favory, France, Dr. Craig Macauley, Australia, and Dr. Micheal Dooley, Britain.
The American team was glad it had Dr. Ferrells' services when an American dressage rider suffered a
significant knee injury the night before her competition ride.
The indispensable Dr. John Lloyd Parry, Medical Advisory to the FEI, coordinated discussions about
medical problems at the equestrian events. In addition, he is helping the FEI develop a consistent policy
on drug testing for equestrian athletes at international competition. The next world games will be held
in Spain, 2002.
Julie E. Ballard, MD
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Ten Legal Commandments
As a professional instructor or coach, you have a responsibility to your students. Our legal system makes
it very clear that you must do what is reasonable and prudent to keep your students from getting hurt.
To help you determine how you should act, I turned to a list of 10 commandments compiled by Sandra
Tozzini, Esq., editor and publisher of Horse Law News (Negligent Trainer Supervision: Could This be You?
May–June 1998). The author states, "These 'Ten Commandments' certainly are not all inclusive, but
they'll give you a leg up on acting reasonably."
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Suit the horse to the rider.
Don't put riders on injured or sick horses.
Make certain that all riders are adequately supervised.
Advance students appropriately.
Assess which students may be at higher risk of injury and adjust instruction accordingly.
Make fitted secured ASTM SEI safety helmets mandatory.
Verify that all subordinate trainers [coaches or instructors] are qualified for their job level.
Inspect/clean tack on a regular basis.
Set forth written procedures and policies and review and update them regularly.
Post safety instructions conspicuously and have all riders sign a copy of the instructions.
[To learn more about the newsletter Horse Law News – Horse Law for Horse Lovers, visit
www.piebaldpress.com or call 1-888-NAGS-001.]
Johanna Harris
from "Equestrian Athlete"
118 Lower Sand Branch Road
Black Mountain, NC 28711
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STATUS REPORT ON RODEO STANDARD FOR PROTECTIVE HELMET
A proposal for the testing to be included in a standard for evaluating rodeo helmets will be presented at
the ASTM winter meeting on December 9, 1998. Feed back from the members of ASTM will be collected
and reviewed for possible inclusion in the standard. In early 1999 a draft standard will be prepared by
the rodeo helmet task group chaired by Karen Strumlock and sent out to the headgear committee for a
vote to accept the standard. Discussion of the vote by the ASTM F09 Headgear Committee members
will take place in spring of 1999. If there are no negative votes from the ASTM committee members on
the content of the standard (this is sometimes difficult to get; my guess is that we will have to go
through the process twice to get out all the negative votes. ) we should keep the publishing date for the
standard. Also the possibility of SEI accepting and offering certification to the standard might be
included. After the publication of the standad manufacturers can submit for voluntary testing to the
standard as early as the year 2000.
Karen Strumlock
Intertek Testing Services
3933 US Route 11
Cortland, NY 13045
Ph - 607-758-6357, Fax - 607-756-4173
E-Mail - kstrumlock@itsqs.com
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EXECTUIVE SECRETARY'S REPORT
By the time most of you read this issue of the AMEA News, the Annual Meeting will be upon us. My first
year at AMEA has been informative, exciting, and disappointing. Working with the excellent individuals
on the Board has been a pleasure. Responding to calls, letters and email from members and from
members of the public and media has also been very interesting.
The greatest disappointment for 1998 has been the failed efforts to involve more industry organizations
in safety programs. Two separate attempts to hold a Rider Safety Summit attracted attendance from
many organizations already active in this area and from a few other breed associations and show
disciplines, but -- with two exceptions -- the organizations representing English riding had too little
interest to participate.
The second major disappointment is the difficulty in getting out the message about approved protective
headgear to riders (and the parents of young riders). The office has received many calls this year from
parents who have just learned about the ASTM/SEI helmets. Most learned in time, and were primarily
interested in information about different types of headgear or proper fit of helmets (see accompanying
article by Dru Malavase). In two cases, a member of the family had suffered a head injury, and wanted
to learn about head protection.
There are many myths and a great deal of misinformation circulating in the horse world. "Helmets
cause heat stroke." "The weight of a helmet can increase the risk of neck injuries." "All helmets give
some protection, regardless of whether they meet the ASTM standard." Tragically, much of the bad
information is coming from trainers, coaches or other riders.
A major riding program (hunter/jumper) I visited recently does not require helmets for riders over 18,
and does not require ASTM helmets for the younger riders because, "they don't fit well and they are too
heavy." This program had a riding fatality last year from a head injury, but learned nothing!
As members of ASTM, I urge you to redouble your efforts and to speak out about rider safety. If you talk
with riders -- particularly novice riders -- be certain they understand the value of a protective helmet. If
you do not have copies of AMEA's brochure "When Can My Child Ride a Horse?" please contact the
office for free copies. If you have an opportunity to use a video, the Washington State 4-H Foundation
video Every Ride...Every Time can be purchased for $15, or members may borrow a copy from the office
for 30 days for a rental of $3. The AMEA's Rider Safety Video is available for $17.95, and covers a variety
of safety issues.
The AMEA is slowly making a difference, but the daily involvement of AMEA members can help speed
the process, and that can mean many lives saved.
Michael Nolan
AMEA Executive Secretary