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.

Abstract: Reasons for performing study: Studies on the prevalence and predisposing factors of bite and kick injuries in horses have not been reported in a population-based data sample. Objectives: To investigate the prevalence of bite and kick injuries in horses and associated risk factors in a representative sample of horses in Switzerland. Methods: A questionnaire on the incidence of disease and injury, which included the frequency of bite and kick injuries and their association with breed, housing, use and feeding regime, was sent to 2559 horse owners randomly selected throughout Switzerland. Results: The data of 2912 horses with 897 disorders diagnosed by a veterinarian were analysed. There were 231 injuries, 50 (21.6%) caused by a bite or kick from another horse; this number corresponded to 5.6% of all diseases and injuries and concerned only 1.7% of all the horses evaluated. Warmblood, Thoroughbred and Arabian horses had a 4.3 times higher risk of bite or kick injuries than horses of other breeds. Eighteen per cent of injuries were associated with a change in housing management and occurred regardless of whether horses were kept in groups permanently or sporadically. Conclusions and potential relevance: A stable group hierarchy and a housing system that provides adequate space and is adapted to horse-specific behaviour are important factors in prevention and kick and bite injuries.

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.

Abstract: In order to gain insight into those training regimens that can minimise the risk of fracture in athletic populations, we conducted a large epidemiological study in racehorses. Thoroughbred racehorses provide a suitable model for studying fracture development and exercise-related risk factors in physically active populations. They represent a homogeneous population, undertaking intensive exercise programmes that are sufficiently heterogeneous to determine those factors that influence injury risk. Daily exercise information was recorded for a cohort of 1178 thoroughbreds that were monitored for up to 2 years. A total of 148 exercise-induced fractures occurred in the study population. Results from a nested case-control study showed a strong interactive effect of exercise distances at different speeds on fracture risk. Horses that exceeded 44 km at canter (< or =14 m/s) and 6 km at gallop (>14 m/s) in a 30-day period were at particularly increased risk of fracture. These distances equate to ca. 7700 bone loading cycles at canter and 880 loading cycles at gallop. Fifty-six fractures occurred in the subset of study horses that were followed since entering training as yearlings, when skeletally immature (n = 335). Cohort analysis of this data set showed that, in previously untrained bones, accumulation of canter exercise increased the risk of fracture (P < or = 0.01), whereas accumulation of high-speed gallop exercise had a protective effect (P < 0.01). However, increasing distances at canter and gallop in short time periods (up to one month) were associated with an increasing fracture risk. All training exercise involves a balance between the risk of fracture inherent in exposure to loading and the beneficial effect that loading has by stimulating bone cells to produce a more robust architecture. Results from our study provide important epidemiological evidence of the effects of physical exercise on bone adaptation and injury risk and can be used to inform the design of safer exercise regimens in physically active populations.

Abstract: REASONS FOR PERFORMING STUDY: Fractures below the level of the radius or tibia (distal limb fractures) are the most common cause of equine fatality on UK racecourses; however, little is known about their epidemiology or aetiology. Identification of risk factors could enable intervention strategies to be designed to reduce the number of fatalities. OBJECTIVES: To identify horse-level risk factors for fatal distal limb fracture in Thoroughbreds on UK racecourses. METHODS: A case-control study design was used. Fractures in case horses were confirmed by post mortem examination and 3 matched uninjured controls were selected from the race in which the case horse was running. One hundred and nine cases were included and information was collected about previous racing history, horse characteristics and training schedules. Conditional logistic regression was used to identify the relationship between a number of independent variables and the likelihood of fracture. RESULTS: Horses doing no gallop work during training and those in their first year of racing were at significantly increased risk of fracture on the racecourse. Case horses were also more likely to have trained on a sand gallop, i.e. a gallop described by trainers as being primarily composed of sand. CONCLUSIONS: Modifications to training schedules, specifically within the first year of racing, may have a large impact on the risk of fatal distal limb fracture on the racecourse. Horses should do some gallop work in training and our results suggest that the minimum distance galloped should be between 805-2012 m (4-10 furlongs)/week. POTENTIAL RELEVANCE: The information from this study can be used to alter training schedules in an attempt to reduce the incidence of fatal distal limb fracture in Thoroughbred racehorses. Training should include some gallop work, and further studies, recording the exact level of work, will help to identify an optimum range of training speeds and distances which will reduce the liklihood of catastrophic fracture on the racecourse.