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Bentley, T., Macky, K., & Edwards, J. (2006). Injuries to New Zealanders participating in adventure tourism and adventure sports: an analysis of Accident Compensation Corporation (ACC) claims. N Z Med J, 119(1247), U2359.
Abstract: AIMS: The aim of this study was to examine the involvement of adventure tourism and adventure sports activity in injury claims made to the Accident Compensation Corporation (ACC). METHODS: Epidemiological analysis of ACC claims for the period, July 2004 to June 2005, where adventure activities were involved in the injury. RESULTS: 18,697 adventure tourism and adventure sports injury claims were identified from the data, representing 28 activity sectors. Injuries were most common during the summer months, and were most frequently located in the major population centres. The majority of injuries were incurred by claimants in the 20-50 years age groups, although claimants over 50 years of age had highest claims costs. Males incurred 60% of all claims. Four activities (horse riding, mountain biking, tramping/hiking, and surfing) were responsible for approximately 60% of all adventure tourism and adventure sports-related injuries. Slips, trips, and falls were the most common injury initiating events, and injuries were most often to the back/spine, shoulder, and knee. CONCLUSIONS: These findings suggest the need to investigate whether regulatory intervention in the form of codes of practice for high injury count activities such as horse riding and mountain biking may be necessary. Health promotion messages and education programs should focus on these and other high-injury risk areas. Improved risk management practices are required for commercial adventure tourism and adventure sports operators in New Zealand if safety is to be improved across this sector.
Keywords: Adolescent; Adult; Aged; Athletic Injuries/*economics/*epidemiology; Back Injuries/epidemiology; Bicycling/economics/injuries; Female; Humans; Insurance Claim Reporting/*statistics & numerical data; Insurance, Liability/*utilization; Male; Middle Aged; Mountaineering/economics/injuries; New Zealand/epidemiology; *Risk-Taking; Skiing/economics/injuries; Sprains and Strains/epidemiology
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Thomas, K. E., Annest, J. L., Gilchrist, J., & Bixby-Hammett, D. M. (2006). Non-fatal horse related injuries treated in emergency departments in the United States, 2001-2003 (Vol. 40).
Abstract: OBJECTIVE: To characterise and provide nationally representative estimates of persons with non-fatal horse related injuries treated in American emergency departments. METHODS: The National Electronic Injury Surveillance System All Injury Program (NEISS-AIP) is a stratified probability sample comprising 66 hospitals. Data on injuries treated in these emergency departments are collected and reported. NEISS-AIP data on all types (horseback riding and otherwise) of non-fatal horse related injuries from 2001 to 2003 were analysed. RESULTS: An estimated 102,904 persons with non-fatal horse related injuries (35.7 per 100,000 population) were treated in American emergency departments each year from 2001 to 2003 inclusive. Non-fatal injury rates were higher for females (41.5 per 100,000) than for males (29.8 per 100,000). Most patients were injured while mounted on a horse (66.1%), commonly from falling or being thrown by the horse; while not mounted, injuries most often resulted from being kicked by the horse. The body parts most often injured were the head/neck region (23.2%), lower extremity (22.2%), and upper extremity (21.5%). The most common principal diagnoses were contusions/abrasions (31.4%) and fractures (25.2%). For each year that was studied, an estimated 11 502 people sustained traumatic brain injuries from horse related incidents. Overall, more than 11% of those injured were admitted to hospital. CONCLUSIONS: Horse related injuries are a public health concern not just for riders but for anyone in close contact with horses. Prevention programmes should target horseback riders and horse caregivers to promote helmet use and educate participants about horse behaviour, proper handling of horses, and safe riding practices.
Keywords: Accident Prevention/methods; Accidental Falls/prevention & control; Adolescent; Adult; Aged; Animals; Athletic Injuries/*epidemiology/prevention & control; Child; Child, Preschool; Emergency Service, Hospital/*statistics & numerical data; Female; Head Protective Devices/utilization; Health Promotion; *Horses; Humans; Infant; Male; Middle Aged; Patient Education; Sex Distribution; United States/epidemiology
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Pinchbeck, G. L., Clegg, P. D., Proudman, C. J., Morgan, K. L., & French, N. P. (2003). Case-control study to investigate risk factors for horse falls in hurdle racing in England and Wales. Vet. Rec., 152(19), 583–587.
Abstract: Between March 1, 2000 and August 31, 2001, a case-control study was conducted on 12 racecourses in England and Wales to identify and quantify the risk factors associated with horse falls in hurdle races. The cases and controls were defined so that variables relating to the horse, the jockey, the race and racecourse, and the jump could be considered. The cases were defined as a jumping effort at a hurdle flight that resulted in a fall, and the controls were defined as a successful jump over a hurdle at any of the 12 racecourses within 14 days before or after the case fall. Conditional logistic regression was used to examine the univariable and multivariable relationships between the predictor variables and the risk of falling. The risk of falling was significantly associated with the position of the jump in the race, and with the distance and speed of the race. A horse's previous racing experience and history were also significantly associated with the risk of falling and horses participating in their first hurdle race were at almost five times greater risk of falling than horses that had hurdled before.
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Zentall, S. S., & Zentall, T. R. (1986). Hyperactivity ratings: statistical regression provides an insufficient explanation of practice effects. J Pediatr Psychol, 11(3), 393–396.
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Proudman, C., Pinchbeck, G., Clegg, P., & French, N. (2004). Equine welfare: risk of horses falling in the Grand National. Nature, 428(6981), 385–386.
Abstract: As in other competitive sports, the famous Grand National steeplechase, which is held at Aintree in the United Kingdom and is watched by 600 million people worldwide, sometimes results in injury. By analysing data from the past 15 Grand National races (consisting of 560 starts by horses), we are able to identify several factors that are significantly associated with failure to complete the race: no previous experience of the course and its unique obstacles, unfavourable ground conditions (too soft or too hard), a large number of runners, and the length of the odds ('starting price'). We also find that there is an increased risk of falling at the first fence and at the jump known as Becher's Brook, which has a ditch on the landing side. Our findings indicate ways in which the Grand National could be made safer for horses and illustrate how epidemiological analysis might contribute to preventing injury in competitive sport.
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Pinchbeck, G. L., Clegg, P. D., Proudman, C. J., Morgan, K. L., & French, N. R. (2004). Whip use and race progress are associated with horse falls in hurdle and steeplechase racing in the UK. Equine Vet J, 36(5), 384–389.
Abstract: REASONS FOR PERFORMING STUDY: Falls during racing present a risk of injury to both horse and jockey and a risk of fatality to horses. OBJECTIVES: To use video recordings of races to describe the circumstances surrounding horse falls at hurdle and steeplechase fences and to identify and quantify within-race risk factors for horse falls in National Hunt racing in the UK. METHODS: A retrospective, matched, nested case-control study using video recordings of races was conducted on 6 UK racecourses. Cases and controls were matched on both race type and jump number at which the fall occurred. Conditional logistic regression analysis was used to examine the univariable and multivariable relationship between predictor variables and the risk of falling. RESULTS: The risk of falling was significantly associated with whip use and race progress. Horses which were being whipped and progressing through the race were at greater than 7 times the risk of falling compared to horses which were not being whipped and which had no change in position or lost position through the field. CONCLUSIONS: This study has identified whip use and the position of the horse with respect to others in the field as potential risk factors for horse falls. POTENTIAL RELEVANCE: If these findings are confirmed by the use of intervention trials (e.g. with whip-free or restricted whip use races), modifications could be introduced which would reduce the frequency of horse falls, leading to improved equine welfare.
Keywords: Accidental Falls/*statistics & numerical data; Animals; Athletic Injuries/epidemiology/etiology/*veterinary; Case-Control Studies; Cohort Studies; Great Britain/epidemiology; Horses/*injuries; Logistic Models; Odds Ratio; Retrospective Studies; Risk Factors; Running/statistics & numerical data; Sports; Videotape Recording
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Singer, E. R., Saxby, F., & French, N. P. (2003). A retrospective case-control study of horse falls in the sport of horse trials and three-day eventing. Equine Vet J, 35(2), 139–145.
Abstract: REASONS FOR PERFORMING STUDY: Serious injuries to horses and riders in horse trials (HT) and three-day events (3DE) are usually associated with falls of horses, which invariably involve falls of the riders. Many potential causes for these falls have been discussed. OBJECTIVES: The aim of this case-control study was to investigate the risk factors for horse falls on the cross-country phase of horse trials and three-day events. METHODS: Using retrospective data, significant risk factors identified with unvariable analysis (P value <0.2) were entered into a multivariable logistic regression model. Significant risk factors (P value <0.05) were included in the final model. RESULTS: It was revealed that a number of course, obstacle and rider variables were significantly and independently associated with the risk of falling. Falling was associated with obstacles sited downhill (Odds ratio [OR] 8.41) and with obstacles with ditches in front (OR = 5.77). CONCLUSIONS: The relationship between course variables and the risk of falling was characterised and showed a significantly increased risk with increasing numbers of jumps on the course and for jumping efforts later in the course. In contrast, after allowing for the total number of obstacles on the course, an increase in the total number of jumping efforts appeared to have a protective effect. A later cross-country start time was associated with a decreased risk of a horse fall. Amateur event riders were approximately 20 times more likely to fall than professional riders. POTENTIAL CLINICAL RELEVANCE: This study has identified a number of risk factors associated with horse falls and highlights areas that can be altered to improve safety in cross-country competitions.
Keywords: Accidental Falls/prevention & control/*statistics & numerical data; Adolescent; Adult; Animals; Athletic Injuries/epidemiology/etiology/prevention & control/*veterinary; Case-Control Studies; Child; Confidence Intervals; Female; Horses/*injuries; Humans; Logistic Models; Male; Odds Ratio; Retrospective Studies; Risk Factors; Safety; *Sports/standards
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Pinchbeck, G. L., Clegg, P. D., Proudman, C. J., Morgan, K. L., & French, N. P. (2004). Case-control investigation of the factors affecting the risk of horses falling during steeplechase racing in the UK. Vet. Rec., 155(1), 11–15.
Abstract: A concurrent case-control study of 12 UK racecourses was made between March 1, 2000, and August 31, 2001, to identify and quantify the factors associated with the risk of horses falling in steeplechase races. Cases were defined as a jumping effort at a steeplechase fence that resulted in a fall and controls were defined as a successful jumping effort over any steeplechase fence at any of the 12 racecourses within 14 days before or after the case fall. Information on the horse, the jockey and the race were collected and all the fences on all the courses were surveyed. Conditional logistic regression was used to examine the relationships between the predictor variables and the risk of falling. There was one fall per 254 jumping efforts. The risk of a horse falling decreased the more times it had raced on a particular racecourse. The number of fences, the distance from the previous fence and the nature of the previous fence also affected the risk of falling. If the previous fence was a water jump the risk of falling increased; fences that were sited on flat or slight uphill gradients (up to approximately 1 in 25) were associated with a lower risk of horses falling than downhill fences, and higher takeoff boards were associated with a higher risk of falling.
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