Epidemiology of Equestrian Accidents: a Literature Review

Purpose: This manuscript aimed to present a review of the literature pertaining to horse riding and other horse-related injuries. Method: A review of the literature was performed, searching for appropriate terms with regards to horse accidents, horse riding injuries and protective clothing for the horse riding context. The literature review search returned 151 relevant full-text articles, with 71 of these detailing the overall injury epidemiology of horse-related accidents. Most of these studies were conducted in the USA and used a retrospective review of hospital data methodology. Results: Of the 71 articles investigated, 60 suggested that those most frequently involved in horse-related accidents are young females and 97% of papers investigating injury mechanisms found the most commonly involved was a fall from horseback. It was suggested in multiple studies that these injury events mostly occurred in warm weather conditions, when the horse behaved in an unexpected manner. Injury type and location varied by the primary mechanism of injury; but frequently involved body regions were the head and upper extremities, and the most common injuries observed were fractures and soft tissue injuries. Neurological trauma was reported by all relevant studies to be the most frequent cause of fatality. Conclusion: Some improvements in horse-related accident numbers and outcomes have been observed with the development and introduction of protective devices such as helmets and vests. Yet despite the benefits of helmet and vest usage, there is evidence to suggest helmets do not perform as well as they could. Further work could investigate improvements in safety measures and risk factors associated with fatalities