It’s no secret that horses are large and potentially flighty and therefore can be very dangerous to handle. Studies have been undertaken to determine the epidemiology of horse-related injuries that occur during the unmounted handling of horses, and it is kicks which are the most likely mechanism of action. This is followed by trampling, bites, being squashed or being injured by riding equipment such as bits or reins. Further analysis of the injuries received by ‘unmounted equestrians’ has found that most commonly injuries occur to the face and abdomen, with head injuries occurring at the same rate for unmounted equestrians as for mounted equestrians.
In a recent study by Tulloch et al, investigating injuries experienced in equine, production animal and mixed veterinary practices, it was found that 94.3% of equine clinical staff had received a work-related injury during their career, with the annual rate of injury being 48.6 per cent for equine clinical staff.
The study investigated the injuries experienced by equine clinical staff (which included vets and vet nurses) and the most common injury was a kick to the leg, which accounted for 30 per cent of recent injuries. This was followed by kicks to the head (12 per cent of recent injuries), a crushed foot (8 per cent), a horse rearing and landing on a foot (8 per cent). One in six most recent injuries resulted in a fracture.
When looking further into the exact procedures that were involved in the injury, it was found to be most linked with the examination of the distal limb (43 per cent of people’s most recent injuries). Specifically, they included: lifting the hoof for examination, performing distal limb nerve blocks and ultrasound scanning of the distal limb.
Kicks to the head accounted for 12 per cent of individuals most recent injuries, and could cause a facial fracture, soft tissue injuries, a traumatic brain injury or even death. Most Australian equine veterinary staff know of an individual for whom a severe kick to the head has caused devastating consequences.
Despite this information, there is frequent debate about the usefulness of wearing a helmet when examining the distal limb of the horse. In some equine clinics, helmets are worn for stallion work only and a few helmets may be available. In other clinics, helmets are expected to be always worn when working with horses. What is the best approach?
There is also debate around which type of helmet would provide adequate protection in the event of a direct kick, however this argument is faulty, as research has shown that kicks do not always contact the head, and may in fact strike the leg or chest, resulting in the worker suddenly falling or flying through the air, and hitting their head on the ground or a nearby wall. In all instances, any helmet is likely to provide better protection than not wearing anything at all. In fact, CVS vets (a very large employer of hundreds of practices across Europe) in the UK are now required to wear protective headgear for all equine work as part of a new mandatory helmet policy introduced after CVS-funded research by Dr. John Tulloch of the University of Liverpool highlighted the high risk of head injuries among equine vets. Current helmet styles being worn in practice include riding helmets, ice hockey helmets and those worn by emergency services. Further research is being undertaken by the University of Liverpool to identify a helmet suitable for equine veterinary work, however, in the short term, the use of a helmet designed for another purpose is better than none.
There is often a sense of inevitability in the sector around horse injuries; in that they are considered a normal part of work and to be accepted. However, in following up with individuals who have been severely injured during veterinary work, on reflection, they would change their behaviour if placed in the same scenario in the future, often through the use of additional PPE, or better animal restraint (through physical or pharmacological restraint). Helmet use may be the difference between a long, enjoyable career, or one cut devastatingly short.
References:
Tulloch JSP, Schofield I, Jackson R, Whiting M. ‘It’s only a flesh wound’ – Understanding the safety culture in equine, production animal and mixed veterinary practices. Prev Vet Med. 2025 Aug;241:106541. doi: 10.1016/j.prevetmed.2025.106541. Epub 2025 Apr 22. PMID: 40286392.
Carmichael SP 2nd, Davenport DL, Kearney PA, Bernard AC. On and off the horse: mechanisms and patterns of injury in mounted and unmounted equestrians. Injury. 2014 Sep;45(9):1479-83. doi: 10.1016/j.injury.2014.03.016. Epub 2014 Apr 1. PMID: 24767580; PMCID: PMC4125461.
Neville EK, Hicks H, Neville CC. Epidemiology of horse trauma: a literature review. Eur J Trauma Emerg Surg. 2024 Jun;50(3):741-754. doi: 10.1007/s00068-023-02436-0. Epub 2024 Jan 24. PMID: 38265443; PMCID: PMC11249411.
Louisa Johnson