Introduction

Horse riding is a popular sport and recreational activity in Australia. In the Equestrian Federation of Australia, with a membership of 13,800 equestrians, 28,500 horses are registered to compete in events sponsored by its 500 affiliated clubs. An additional 60,000 equestrians are members of Pony clubs and about 5,000 horse riders actively compete in rodeos (personal communication, Denzil O'Brien, The Equestrian Federation of Australia, February 2000).

Deaths and injury from horse-related activities have been well documented in Australia and overseas (Pounder 1984), (Bixby-Hammett & Brooks 1990), (Ingemarson et al. 1989), and (Paix 1999), but studies using national population figures to calculate mortality and morbidity rates for horse-related injury in Australia and overseas are few. Estimates of injury rates based on exposure (riding hours or horse riding participation) among all classes of horse riders combined are generally of the order of one injury per 1000 riding hours. This rate suggests horse riding is more dangerous than motorcycle riding and automobile racing (Gierup et al. 1976); (Firth 1985); (Nelson et al. 1994); and (Paix 1999). The danger from horse riding is compounded by the interaction of two species, human and horse, which may result in unpredictable events.

Although in population terms, the frequency of death and injury is low, the severity of horse related injuries is high, particularly in children and young adults (based on estimated numbers of annual sports injuries and hospitalisations) (Silver and Lloyd Parry 1991). Horse riders were recognised in the Commonwealth Department of Human Service and Health's Injury Prevention and Control Implementation Strategy as one of four priority population groups to be targeted in order to reduce severe injuries in sport and recreational activities (Nutbeam et al. 1993).

This document reports deaths and injuries associated with riding animals or from animal-drawn vehicle accidents and reviews their magnitude in Australia. In this report, it is assumed that deaths and injuries of "riders" were horse-related as it is assumed that deaths and injuries from riding animals other than horses would be rare. Australian Bureau of Statistics (ABS) mortality unit record data collection, 1979-98, and hospital separation unit record data collection, 1996-97 provided by the Australian Institute of Health and Welfare (AIHW) were used in this review. Reference is also made to other data sources and overseas horse-related injury studies.

Deaths and hospital separations for horse-related injury were selected from the 9^th International Classification of Diseases (ICD-9) animal-related injury external cause code categories E810.5 to E825.5 (motor vehicle traffic accident) and E826.2 to E829.2 and E826.3 to E829.3 (other road vehicle accident) where fourth-digit subdivisions refer to rider of animal or occupant of animal-drawn vehicle. It is assumed that horses are the animal most likely to be associated with these external cause category subdivisions. Although subdivisions of E-code category 906 (`other injury caused by animals') contain external causes (`fallen on by horse or animal not being ridden'; `run over by animal, not being ridden'; `stepped on by animal, not being ridden'; and to a lesser extent, `animal bite') which are known to cause injury and death in horse riders or handlers, they cannot be used to select deaths and hospital separations attributed specifically to horses. These subdivisions do not distinguish between horses and other animals and will not be used in this review. Data issues, with a summary table of horse-related E-codes (Table A) are discussed in the section "Data Issues".