
Children's Safety Network
Horses
and Children Table of Contents
The American
Horse Council has reported that there were 258,434 youth involved
in 4-H horse and pony programs in 1994 and 13,000 youth members
of the United States Pony Clubs.1 Youth at risk
for horse-related injury is much greater than these numbers
suggest because many children who are involved with horse-related
activities are not registered horse owners or members of equestrian
organizations.
The American
Horse Council estimates that there are 1.9 million horse owners
in the United States. 3.6 million persons are involved in
showing; 4.3 million in recreational activities. Approximately
619,400 persons are directly employed by the horse industry.2
The most
common equestrian group receiving treatment for equestrian-related
injury is young female riders.3,4 It has not been
determined whether this is attributable to the ratio of female
to male youth riders or other factors.
Participants
in a 1991 survey research study reported more girls than boys
and more children involved in English style riding than Western
wore helmets regularly. Reliable information on helmet use
among occasional riders is not available.5
The most
common cause of death and serious injury in all riders is
head injury; the percentage of these injuries causing death
and serious injury is higher in young riders.3,6
The cost
of horse-related injuries among children and adults younger
than 25 years seen in emergency departments in 1996 is estimated
at over $88 million. The average cost per injury is estimated
at $7,411.6
In 1996,
25,446 emergency department visits were made by individuals
in the U.S. younger than 25 years as a result of horse-related
injuries.7 The most common types of horse-related
injury treated in emergency departments in 1996 to individuals
in the U.S. younger than 25 years included contusions, fractures,
and strains.7
In 1996,
emergency department visits by individuals in the U.S. younger
than 25 years involved in horse-related injuries involved
head/neck (25%), upper body (55%), and lower body (20%).8
Emergency
department studies show that a high percentage of equestrian
injuries tend to be serious in nature, with up to 38 percent
(dependent upon study cited) resulting in hospitalization
and 28 to 48 percent involving fractures.3
Most
serious injuries to equestrians are caused by being separated
from (e.g., propelled from or fall off) the horse while riding
or by falling with the horse.3
Many
children are injured during non-riding activities such as
leading, grooming, and feeding.9 In one study,
15 percent of the children hospitalized had been kicked by
a horse.10
A population-based
study in rural Wisconsin revealed that 30 percent of those
under 19 years who sought treatment for horse-related injuries
were injured while engaged in non-riding, horse-related activities.
The injury rate for children in this study was 5.6 per 10,000
person years.11
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.
12
In a
review of all equestrian fatalities in Alberta, Canada, 1975-1990,
47.4 percent of the fatalities were younger than 20 years,
with seven children (18.4 percent of total fatalities) younger
than six years.13
A survey
of 2,195 frequent riders showed a high prevalence of hospitalization
and prolonged disability among injured equestrians.14
A study
of 557 frequent riders younger than 25 years estimated an
injury rate of 0.6 per 1,000 riding hours.15 In
contrast, the overall injury rate for persons age 15-24 years
is 0.05 per 1,000 working hours.5
Approximately
two-thirds the injuries were attributed to the horse's behavior,
with "spooking" being the most common horse behavior. Additional
primary causes were attributed to human behavior or practices.15
Consistent
use of secured, ASTM* standard, SEI† certified
equestrian helmets will lead to a decrease in equestrian deaths
and serious injuries.3,9,13,14,17,19
Bicycle
helmets reduce traumatic brain injuries in bicyclists by 88
percent.20 The effectiveness of ASTM/SEI equestrian
helmets is estimated to be comparable.17
The American
Academy of Pediatrics (AAP) recommend that young riders in
all organizations and activities that promote or sanction
horseback riding wear helmets that meet the 1988 ASTM testing
standard as certified by SEI when riding horses.21
Young
riders should be supervised and matched with horses appropriate
for their levels of cognitive development and riding ability.21
*American
Society of Testing Materials, ASTM F-1163
†Safety
Equipment Institute, SEI
- Horse
Industry Directory. (1996). Washington, DC: American Horse
Council.
- Horse
Industry Directory. (1997). Washington, DC: American Horse
Council.
- Nelson,
D. E. & Bixby-Hammett, D. (1992). Equestrian injuries
in children and young adults. American Journal of Diseases
in Children. 146, 611-614.
- Chitnavis
JP, Gibbons CLMH, Hirigoyen M, Lloyd Parry J. & Simpson
AHRW (1996). Accidents with horses:What has changed in 20
years? Injury 27(2): 103-105.
- Computation
from annual injury rates in Rice, P., MacKenzie, D. P. and
Associates (1989). Cost of Injury in the United States:
A Report to Congress.
- U.S.
Consumer Product Safety Commission (1997). Cost estimate
injury model for 0-24 year olds emergency room injuries on
horseback 1996: National Electronic Injury Surveillance
System, Washington, D.C.
- U.S.
Consumer Product Safety Commission (1997). Horseback riding
injuries ages 0-24 1996: National Electronic Injury Surveillance
System, Washington, D.C.
- U.S.
Consumer Product Safety Commission (1997). Unpublished tabulation
and analysis of 1996 national electronic injury surveillance
system data, horseback riding injuries ages 0-24, 1996.
Children's Safety Network Rural Center, Marshfield, WI:
NFMC 1997.
- Firth,
J. L. Equestrian injuries. (1985). In: Schneider, R. C.,
Kennedy, J. C., Plant, M. L. eds. Sports Injuries: Mechanism,
Prevention and Treatment. Baltimore, MD: Williams and Wilkins,
431-439.
- Barone,
G. W. & Rodgers, B. M. (1989). Pediatric equestrian
injuries: A 14-year review. The Journal of Trauma, 29(2),
245-247.
- Young
NB, Stueland DT, Berg R, Follen M, and Wittman L. (1996)
Surveillance of riding and non-riding equestrian injuries
at a rural medical center. Poster presented at American
Public Health Association Annual Meeting, 1996.
- Bijur
PE, Trumble A, Harel Y, Overpeck MD, Jones D, and Scheidt
PC (1995) Sports and recreation injuries in US children
and adolescents. Archives of Adolescent Medicine, 149:1009-1016.
- Aronson,
H. & Tough, S. C. (1993). Horse-related fatalities in
the Province of Alberta, 1975-1990. The American Journal
of Forensic Medicine and Pathology 14(1), 28-30.
- Nelson,
D. E., Rivara, R. P., Condie, C., & Smith, S. (1994).
Injuries in equestrian sports. The Physician and Sportsmedicine,
22(10).
- Christey,
G. L., Nelson, D. E., Rivara, F. P., Smith, S. M., &
Condie, C. (1994). Horseback riding injuries among children
and young adults. The Journal of Family Practice, 39(2).
- Thompson
JM and Von Hollen B (1996). Causes of horse-related injuries
in a rural western community. Canadian Family Physician,
42:1103-1109.
- Center
for Disease Control and Prevention (1990). Injuries associated
with horseback riding: United States, 1987 and 1988. MMWR
39(20), 329-332.
- Center
for Disease Control and Prevention (1996). Horseback-riding-associated
traumatic brain injuries - Oklahoma, 1992-1994. MMWR 45(10),
209-11.
- Bond
GR, Christoph RA, Rodgers BM (1995). Pediatric equestrian
injuries: Assessing the impact of helmet use. Pediatrics,
95(4), 487-489.
- Thompson
RS, Rivara FP, Thompson DC (1989). A case-control study
of the effectiveness of bicycle helmets. New England Journal
of Medicine 1989;320:1361-7.
- American
Academy of Pediatrics. 1992. Horseback riding and head injuries
(Statement from the Committee on Sports Medicine and Fitness).
Pediatrics 89(3), 512.

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