Towards a safer sport: Risk factors for cross‐country horse falls at British Eventing competition

Abstract

BackgroundEquestrian eventing is a dangerous Olympic sport, with 16 rider and 69 horse fatalities at competition in the last 10 years. Despite this, there is limited research that aims to improve safety within the sport.ObjectivesThe purpose of this study was to identify risk factors for horse falls, which are the leading cause of rider fatality within the sport.Study designRetrospective cohort study.MethodsCompetition data between January 2005 and December 2015 were analysed. Descriptive statistics followed by univariable logistic regression to identify risk factors for inclusion in a multivariable logistic regression model were conducted. Models were constructed stepwise using a bidirectional process and assessed using the Akaike information criterion. A total of 749 534 cross‐country starts were analysed for association with the risk of horse falls.ResultsSixteen risk factors were identified including: higher event levels, higher dressage penalties and higher number of days since horses' last start. For example, horse and rider combinations competing at BE100 (OR 1.64, confidence interval (CI) 1.37–1.96, p < 0.001), novice (OR 3.58, CI 3.03–4.24, p < 0.001), intermediate (OR 8.00, CI 6.54–9.78, p < 0.001), advanced (OR 12.49, CI 9.42–16.57, p < 0.001) and international (OR 4.63, CI 3.50–6.12, p < 0.001) all had a higher risk of having a horse fall in comparison to combinations competing at BE90 level. Furthermore, for every additional 10 dressage penalties awarded to a horse and rider combination, there was a higher risk of a horse fall (OR 1.20, CI 1.12–1.28, p < 0.001).Main limitationsThe study is not geographically comprehensive (UK only) and does not include any information on training activity of horses and riders.ConclusionsThis is the largest‐scale study ever conducted on horse falls during eventing competition. Study results can be used by sport governing bodies to inform policy which has the potential to reduce the risk of injury and fatality to sport participants.

We have demonstrated the potential to make eventing safer: What will happen next?

“…Since 2021, we have published three papers in EVJ based on the largest ever studies of safety in eventing cross-country. [9][10][11] In those papers, we identified risk factors consistent with those reported in prior work, and we also identified new risk factors that are modifiable by sport governing bodies. Here, we summarise the main findings and make distinct, evidence-based recommendations for interventions that governing bodies could implement relatively quickly to improve safety for both athletes and horses.…”

High‐level competition exercise and related fatigue are associated with stride and jumping characteristics in eventing horses

“…Physiological, metabolic and biochemical responses in eventing training and competition have been studied previously 1,2 and fatigue and related injuries to the musculoskeletal system are among the most frequent reasons for the withdrawal of high‐level eventing horses from the sport 3–5 . Factors associated with adverse outcomes for both horse and rider have been reported 6–8 . Early detection of fatigue and overstrain in the eventing horse is crucial but challenging.…”

“…[3][4][5] Factors associated with adverse outcomes for both horse and rider have been reported. [6][7][8] Early detection of fatigue and overstrain in the eventing horse is crucial but challenging. Assessment of heart rate recovery and blood lactate concentration in relation to exercise intensity is considered the gold standard to assess equine fitness [9][10][11][12] and potentially also predict fatigue.…”

Factors associated with safe completion of Fédération Equestre Internationale eventing cross‐country (2008–2018)

“…Most recent literature about eventing has focussed on safety: following the International Eventing Safety Committee (IESC) review in 2000, several academic studies have been published examining risk factors associated with horse and rider falls during the cross-country phase. [1][2][3][4][5][6][7][8][9] This academic literature is supplemented in the public domain, but not in peer-reviewed journals, by audits and reports published by the Fédération Equestre Internationale (FEI), the international governing body. [10][11][12] Risk factors for XC falls that have been reported in peer-reviewed research and industry reports include:…”

“…higher event levels, higher dressage scores earlier in the competition, less experienced athletes and horses (including experience at their current event level), number of recent competition starts, age/sex of horse/athlete, and if a horse or rider had any prior falls. 2,9 At course design level, factors including fence type, composition and setting have been demonstrated to be associated with falls. 1,[3][4][5]7 Much of the literature for other equestrian disciplines and for horse racing is also predominantly focussed on safety and welfare.…”