title: Risk factors for horse falls and injuries in National Hunt horse racing in the UK
Creators: name: Louise Pinchbeck, Gina
Publisher: name: University of Liverpool Repository
Year: 2023

description: The aim of this study was to identify factors associated with an increase or decrease in the risk of falling in National Hunt racing in the UK and to quantify the contribution of falling to injury and fatality in horsesp articipating in hurdle and steeplechasera cing. Analysis of retrospective data from the 1999 racing year on all UK racecourses identified falling risks of 6.0 per 100 starts in steeplechaser acing and 2.1 per 100 starts in hurdling. The death risk among fallers was 3.7% in steeplechasinga nd 7.1% in hurdling. Of all deaths recordedt hat year, during steeplechasea nd hurdle racing, 38% were associatedw ith a fall. Examination of the sources of variation in the risk of falling, with the start as level-1, showed that a proportion of level-2 variation resided at the horse, the race and the sire level in steeplechasing, with very little clustering at any level in hurdling other than level-1. Trainer and jockey contributed very little to the variation in the risk of falling. Results of multivariable analyses of these data also showed that some of the risk factors for falling are different for hurdling and steeplechasing. In steeplechasing younger horses, increasing race distance and lack of previous racing experience were all associated with an increase in the risk of falling. In hurdling, starting hurdling at an older age and less experienced jockeys were associated with an increase in the risk of falling. A prospective cohort study of hurdle and steeplechaser acing was performed on 6 UK racecourses over a 2- year period providing information on the frequency of exposures of particular racing practices. The fatality risk of fallers was 6.5% and the injury risk of fallers was 8.9%. This study identified that longer journey times to the racecourse were associated with an increased risk of falling and that sunny weather also increased the risk of falling. There was also some evidence that pre-race behaviour was associated with falling. The injury risk in the cohort study was 2.8 per 100 starts. The commonest types of injury were superficial digital flexor tendon injuries and lacerations. Risk of injury was associated with race distance and weight carried. Withholding water was associated with an increase risk of all types of injury including medical events, and both fast races and poor foot conformation were associated with an increased risk of musculoskeletal injuries. A nested case-control study, utilising video analysis of races, identified that the majority of falls were due to mistakes at fences and not due to horse injury prior to jumping the fence. The study also identified that horses which were being whipped and which were progressing through the race were at greater risk of falling. Case-control studies in hurdle and steeplechase racing were conducted using a novel approach in which the jumping effort was the outcome of interest. Cases were jumping efforts that resulted in a fall and controls were selected from all successful jumping efforts. In hurdling the frequency of falls was 1 per 447 jumping efforts and in steeplechasing 1 per 254 jumping efforts. In hurdling the risk of falling increased at later flights in the race, with the exception of the first flight. Speed and distance were also associated with the risk of falling with the shortest (2 mile), fastest races having the greatest risk. Horses participating in their first ever hurdle race were at almost 5 times the risk of falling compared to those that had hurdled before. In the steeplechasec ase-control study, downhill approaches to fences and higher take off boards were associated with an increased risk. The distance from the previous fence and the previous fence type were also associated with falling; if the previous fence was a water jump, the risk of falling was increased. The greater number of times a horse had run on the steeplechasec ourset he lower the risk of falling. This study has confirmed that falling contributes to fatality and injury in hurdle and steeplechasera cing in the UK. It has identified a number of risk factors, someo f which are modifiable. Controlled intervention studies evaluating these modifications are now required.