Helmet under-utilization by children during equestrian events is associated with increased traumatic brain injury.
Abstract: Awareness of equestrian related injury remains limited. Studies evaluating children after equestrian injury report under-utilization of safety equipment and rates of operative intervention as high as 33%. Methods: We hypothesized that helmets are underutilized during equestrian activity and lack of use is associated with increased traumatic brain injury. We queried the trauma database of a level one pediatric trauma center for all cases of equestrian and rodeo related injury from 2005 to 2015. Analysis was conducted using SAS 9.4. Results: Of 312 children identified, 142 were assessed for use of a helmet. Only 28 children (19.7%) had documented use of a helmet. Most injuries occurred while riding a horse (83%) or bull (13%) with traumatic brain injury being the most common injury (51%). Helmet use was associated with decreased ISS (7.1 vs. 11.3, p<0.01), TBI (32.4% vs. 55.3%, p=0.03), and ICU admission (10.7% vs. 29%, p=0.05). Multivariable analysis reveals lack of helmet use to be an independent predictor of TBI (OR 2.5, 95% CI 1.1-6.3). Conclusions: Helmets are underutilized by children during equestrian related activity. Increased awareness of TBI and education encouraging helmet use may decrease morbidity associated with equestrian activities. Methods: Retrospective comparative study, Level III.
Copyright © 2017 Elsevier Inc. All rights reserved.
Publication Date: 2017-03-20 PubMed ID: 28365105DOI: 10.1016/j.jpedsurg.2017.03.043Google Scholar: Lookup
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Summary
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The research paper focuses on understanding the association between helmet usage by children during equestrian events and the rate of traumatic brain injury (TBI). The study reveals a significant underutilization of helmets, which is associated with an increased occurrence of TBI.
Methodology
- The researchers hypothesized that helmets are underutilized during equestrian activities, and this lack of use increases the incidences of TBI.
- A retrospective comparative study was conducted and the trauma database of a level one pediatric trauma center was queried for all cases of equestrian and rodeo related injuries from 2005 to 2015.
- The analysis was carried out with the aid of SAS 9.4 statistical software.
Results
- Out of the 312 children identified, helmet usage was evaluated for 142 of them.
- Of these, only 28 children (approximately 19.7%) were documented to have used a helmet.
- The majority of injuries occurred while the child was riding a horse (83%) or bull (13%), with TBI being the most common injury sustained (51%).
- Helmet use was found to be associated with decreased Injury Severity Score (ISS – 7.1 vs. 11.3), TBI (32.4% vs. 55.3%), and Intensive Care Unit (ICU) admission rates (10.7% vs. 29%).
- Through multivariable analysis, the researchers found lack of helmet use to be an independent predictor of TBI (Odds Ratio [OR] 2.5, 95% Confidence Interval [CI] 1.1-6.3).
Conclusion
- Based on the findings, the researchers conclude that helmets are underutilized by children during equestrian activities.
- They advocate for increased awareness about TBI and the necessity of education encouraging helmet use in an attempt to lower the morbidity associated with equestrian activities.
Cite This Article
APA
Short SS, Fenton SJ, Scaife ER, Bucher BT.
(2017).
Helmet under-utilization by children during equestrian events is associated with increased traumatic brain injury.
J Pediatr Surg, 53(3), 545-547.
https://doi.org/10.1016/j.jpedsurg.2017.03.043 Publication
Researcher Affiliations
- Division of Pediatric Surgery, Department of Surgery, University of Utah School of Medicine, 100 N. Mario Ceppechi Drive, Suite 3800, Salt Lake City, UT 84113, United States. Electronic address: Scott.Short@imail2.org.
- Division of Pediatric Surgery, Department of Surgery, University of Utah School of Medicine, 100 N. Mario Ceppechi Drive, Suite 3800, Salt Lake City, UT 84113, United States. Electronic address: Stephen.Fenton@imail2.org.
- Division of Pediatric Surgery, Department of Surgery, University of Utah School of Medicine, 100 N. Mario Ceppechi Drive, Suite 3800, Salt Lake City, UT 84113, United States. Electronic address: Eric.Scaife@imail2.org.
- Division of Pediatric Surgery, Department of Surgery, University of Utah School of Medicine, 100 N. Mario Ceppechi Drive, Suite 3800, Salt Lake City, UT 84113, United States. Electronic address: Brian.Bucher@imail2.org.
MeSH Terms
- Adolescent
- Animals
- Athletic Injuries / epidemiology
- Athletic Injuries / prevention & control
- Awareness
- Brain Injuries, Traumatic / epidemiology
- Brain Injuries, Traumatic / prevention & control
- Cattle
- Child
- Child, Preschool
- Databases, Factual
- Female
- Head Protective Devices / statistics & numerical data
- Horses
- Hospitalization
- Humans
- Male
- Retrospective Studies
- Trauma Centers
Citations
This article has been cited 9 times.- Troy BM, Fraser Doh K, Linden AF, Xiang Y, Gillespie S, Agarwal M. Changes in pediatric injuries sustained while engaged in activities where helmet usage is recommended during the COVID-19 pandemic. Inj Epidemiol 2023 Aug 1;10(Suppl 1):38.
- Carter BT, Richardson MD. A retrospective study of helmet use and head injury in severe equestrian trauma. J Neurosci Rural Pract 2023 Jan-Mar;14(1):161-164.
- Stanfill AG, Wynja K, Cao X, Prescott D, Shore S, Baughman B, Oddo A, Tsao JW. Helmet use in equestrian athletes: opportunities for intervention. Concussion 2020 Dec 14;6(1):CNC85.
- Schneuer FJ, Bell JC, Adams SE, Brown J, Finch C, Nassar N. The burden of hospitalized sports-related injuries in children: an Australian population-based study, 2005-2013. Inj Epidemiol 2018 Dec 17;5(1):45.
- Andres SA, Bushau-Sprinkle AM, Brier ME, Seger YR. Effects of body protection vests and experience levels in prevention of equestrian injuries. BMJ Open Sport Exerc Med 2018;4(1):e000426.
- Boije Af Gennäs K, Jungmalm J. Youth horse-related injuries (2014-2024): a scoping review of epidemiological and disciplinary insights. BMJ Open Sport Exerc Med 2025;11(3):e002589.
- Troy BM, Agarwal M, Linden AF, Jergel A, Giarusso A, Fraser Doh K. Child and neighborhood factors associated with pediatric injuries sustained while engaged in activities where helmet usage is recommended. Inj Epidemiol 2025 Jul 7;12(Suppl 1):39.
- Crawford AE, Picken LK, Gabriel FD, Quade J, Gould S. CNS and Thorax Injury and Associated Risks Factors in Equestrian Sports. Sports Health 2025 Jul;17(4):697-702.
- Box MW, Wilson F, Pasque CB, Smith CD. Characteristics of Rodeo Injuries and Suggestions for Injury Prevention: A Systematic Review. Orthop J Sports Med 2024 Apr;12(4):23259671241227217.
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