Evaluation of safety vests
Transcription
Evaluation of safety vests
Evaluation of safety vests Health and safety in Australian racing APRIL 2014 RIRDC Publication No. 14/037 Evaluation of safety vests Health and safety in Australian racing by Foote, C.E., Gibson, T.J. and McGauran, P.J. April 2014 RIRDC Publication No 14/037 RIRDC Project No. PRJ-008125 1 © 2014 Rural Industries Research and Development Corporation. All rights reserved. ISBN 978-1-74254-653-7 ISSN 1440-6845 Health and safety in Australian racing –Evaluation of safety vests Publication No. 14/037 Project No. PRJ-008125 The information contained in this publication is intended for general use to assist public knowledge and discussion and to help improve the development of sustainable regions. You must not rely on any information contained in this publication without taking specialist advice relevant to your particular circumstances. While reasonable care has been taken in preparing this publication to ensure that information is true and correct, the Commonwealth of Australia gives no assurance as to the accuracy of any information in this publication. The Commonwealth of Australia, the Rural Industries Research and Development Corporation (RIRDC), the authors or contributors expressly disclaim, to the maximum extent permitted by law, all responsibility and liability to any person, arising directly or indirectly from any act or omission, or for any consequences of any such act or omission, made in reliance on the contents of this publication, whether or not caused by any negligence on the part of the Commonwealth of Australia, RIRDC, the authors or contributors. The Commonwealth of Australia does not necessarily endorse the views in this publication. This publication is copyright. Apart from any use as permitted under the Copyright Act 1968, all other rights are reserved. However, wide dissemination is encouraged. Requests and inquiries concerning reproduction and rights should be addressed to RIRDC Communications on phone 02 6271 4100. Researcher Contact Details Dr Caroline Foote Equine Consulting Services P.O. Box 3361 Dural NSW 2158 Email: [email protected] In submitting this report, the researcher has agreed to RIRDC publishing this material in its edited form. RIRDC Contact Details Rural Industries Research and Development Corporation Level 2, 15 National Circuit BARTON ACT 2600 PO Box 4776 KINGSTON ACT 2604 Phone: Fax: Email: Web: 02 6271 4100 02 6271 4199 [email protected]. http://www.rirdc.gov.au Electronically published by RIRDC in April 2014 Print-on-demand by Union Offset Printing, Canberra at www.rirdc.gov.au or phone 1300 634 313 ii Foreword Jockey safety is of paramount importance to the Australian horse racing industry and the equipment available to jockeys must find a balance between offering effective protection and being comfortable. Compulsory for jockeys and trackwork riders since 1998, safety vests are now an established part of the kit worn by jockeys. This study aimed to investigate the effectiveness of existing safety vests for jockeys and trackwork riders in Australia. The adoption of this report’s research findings will make long-lasting improvements to the safety of jockeys and trackwork riders in Australia. Industry information from Racing NSW suggests that the average time lost following a fall is over 500 hours per incident, with the claim cost from horse-related falls amounting to approximately $3 million per annum. Since safety vests were made mandatory in Australia in 1998, there had been concerns that one or more of the currently used safety vests may offer limited protection and may even contribute to neck and/or spinal injuries. The report makes a number of recommendations aimed at improving jockey safety. These include changes to the Australian Racing Board’s standard for vests, improving systems for approving vests and better systems for monitoring compliance and vest performance. It is now for the racing industry to adopt the report’s recommendations. This project was funded primarily from industry revenue with additional funds provided by the Australian Government. This report is an addition to RIRDC’s diverse range of over 2000 research publications and it forms part of our Horse RD&E program, which includes an objective to improve the safety of industry participants. Most of RIRDC’s publications are available for viewing, free downloading or purchasing online at www.rirdc.gov.au. Purchases can also be made by phoning 1300 634 313. Craig Burns Managing Director Rural Industries Research and Development Corporation iii Contents Foreword............................................................................................................................................... iii Contents ................................................................................................................................................. iv Executive Summary .............................................................................................................................vii Introduction ............................................................................................................................................ 1 Objectives................................................................................................................................................ 2 Overview of methods ............................................................................................................................. 2 Australian Jockey Survey...................................................................................................................... 3 Method ................................................................................................................................................ 3 Results ................................................................................................................................................. 3 Discussion ........................................................................................................................................... 9 Review of insurance claim data prior to and following the introduction of the vests.................... 11 Method .............................................................................................................................................. 11 Results ............................................................................................................................................... 11 Discussion ......................................................................................................................................... 17 Biomechanical review of the effectiveness of safety vests ................................................................. 19 Method .............................................................................................................................................. 19 Results ............................................................................................................................................... 19 Discussion ......................................................................................................................................... 20 Evaluation of Protective Equipment Standards ................................................................................ 23 Method .............................................................................................................................................. 23 Results and Discussion ..................................................................................................................... 23 Safety Equipment Testing ................................................................................................................... 27 Method .............................................................................................................................................. 27 Results ............................................................................................................................................... 28 Discussion ......................................................................................................................................... 36 Implications .......................................................................................................................................... 38 Recommendations ................................................................................................................................ 40 Appendices ............................................................................................................................................ 41 References ............................................................................................................................................. 54 iv Tables Table 1 Breakdown of Jockey Survey respondents from riders in NSW and Vic ........................... 3 Table 2 Responses of riders on whether the safety vests impact on their ability to minimise risk of injury during a fall ................................................................................................... 7 Table 3 Percentage of respondents supporting the review of safety standards ................................ 7 Table 4 Opinion of riders on the use of additional safety equipment .............................................. 8 Table 5 Rate of fall claims prior to and following the introduction of the vests in Vic ................. 11 Table 6 Average time lost (days) due to injury prior to and following the introduction of the vests in Vic ........................................................................................................................ 12 Table 7 Rate of fall claims prior to and following the introduction of the vests in NSW.............. 13 Table 8 Average time lost (hours) due to injury prior to and following the introduction of the vests in NSW ..................................................................................................................... 13 Table 9 Average gross value of claims and age of riders in the pre- and post-vest periods .......... 14 Table 10 Injury types in the pre- and post-vest period excluding sprains and strains...................... 15 Table 11 Severity of injuries at specific bodily locations ................................................................ 16 Table 12 Results of the case analysis with the body region, the injury and the type and area of injury causing contact summarised for each case. ............................................................ 20 Table 13 Jockey vest sample specifications. .................................................................................... 28 Table 14 EN 13158 Level 1 impact performance testing results. .................................................... 29 Table 15 Specifications of the additional Tipperary Ride-Lite sample............................................ 30 Table 16 Results of Tipperary Ride Lite when tested to SATRA Jockey Vest Standard M6 Issue 5. .............................................................................................................................. 30 Table 17 Sizing dimensions supplied with the jockey vest samples ................................................ 31 Table 18 Dimensions of the jockey vest samples ............................................................................ 31 Table 19 EN 13158 Level 2 body protector specifications. ............................................................. 32 Table 20 EN 13158 Level 1 impact performance. ........................................................................... 32 Table 21 High level body protector specifications........................................................................... 33 Table 22 EN 13158 Level 3 impact performance results. ................................................................ 33 Table 23 EN 13158 Test 1 (flat impactor) ambient v hot conditioning comparison........................ 34 Table 24 EN 13158 Test 2 (narrow bar) ambient v hot conditioning comparison.. ......................... 35 v Figures Figure 1 Hows Racesafe (1) and Phoenix Tipperary (2) vest examples............................................ 3 Figure 2 Vests most frequently worn in racing ................................................................................. 4 Figure 3 Vests most frequently worn in racing: separated by state ................................................... 4 Figure 4 Flexibility of each vest rated by surveyed riders ................................................................ 5 Figure 5 Restrictiveness of each vest rated by surveyed riders ......................................................... 5 Figure 6 Heat retention of each vest as rated by surveyed riders ...................................................... 6 Figure 7 Protective capabilities of each vest from falls as rated by surveyed riders ......................... 6 Figure 8 Protective capabilities of each vest from kicks as rated by surveyed riders ....................... 6 Figure 9 Importance of issues associated with wearing a safety vest................................................ 7 Figure 10 Frequency of injuries prior to and following the introduction of the vests in each bodily location analysed.................................................................................................... 12 Figure 11 Injury types expressed as a percentage of Vic rider fall claims in years prior to and following the introduction of the vests.............................................................................. 13 Figure 12 Frequency of injuries prior to and following the introduction of the vests in each bodily location analysed (NSW data). .............................................................................. 14 Figure 13 Injury types expressed as a percentage of Vic rider fall claims in years prior to and following the introduction of the vests.............................................................................. 15 Figure 14 SATRA Test Setup............................................................................................................ 25 Figure 15 The jockey vest samples (left to right) - Racesafe, Tipperary, Descente and Komperdell Ballistic ......................................................................................................... 28 Figure 16 Additional Tipperary Ride-Lite sample (size small) ......................................................... 30 Figure 17 Coverage area templates for SATRA and ARB Standards (left) and EN 13158 (right) ... 30 Figure 18 Airowear Swift EN 13158 Level 2 body protector. .......................................................... 32 Figure 19 High level body protectors (from left to right) - Knox Kan Teq, Komperdell Cross Protection vest, Komperdell Cross body protector. .......................................................... 33 vi Executive Summary This project was designed to investigate the effectiveness of existing safety vests for jockeys and trackwork riders in Australia. The findings of this report are particularly relevant to the Australian Racing Board (ARB), Principal Racing Authorities and stewards, race clubs, the Australian Jockeys Association, insurance companies, vest manufacturers worldwide but most of all jockeys and trackwork riders and their employers. Background Several studies have identified a concerning rate of incidents and injuries to jockeys in racing. Based on information received from Racing NSW, the average time lost due to injury as a result of a raceday or trackwork fall is over 500 hours per incident, with a total annual claim cost of all injuries due to a fall from a horse amounting to approximately $3 million. Safety vests were made mandatory in Australia in 1998, however there are concerns that one or more of the currently used safety vests may offer limited protection and may even contribute to neck and/or spinal injuries. Aims/objectives The aims of this study were: to evaluate the performance of safety vests as a means of preventing or lessening the severity of injuries amongst jockeys and others in Australian racing; to determine whether there is a risk that one or more of the types of currently used safety vests may cause neck or spinal injuries; to ascertain whether the current safety standards used to evaluate safety vests adequately replicate the conditions faced by jockeys whilst riding and during falls; and to evaluate alternative safety vests used elsewhere. Methods used A series of studies were conducted including a survey of jockeys and apprentice riders, analysis of insurance claim data in the years prior to and following the introduction of the vests to determine if there has been a change in the frequency and severity of injuries as a result of wearing of the vests; review of raceday footage to identify injury causation; analysis of safety vest standards; and testing of current and alternative safety vests. Results/key findings Despite an apparent growing acceptance of the vests, most riders felt the protective capabilities of the vests and the vest comfort levels should be improved. While a reduction in sprain and strain injuries in the chest and back were identified (suggesting a vest meeting current standards may be reducing these lesser injuries), an increase in neck and spinal fractures was also identified. There was no evidence that the increase in neck and spinal fractures was related to wearing the vests (as suggested by some riders). Instead a review of raceday footage carried out by a biomechanical engineer showed that most of these injuries are “indirect injuries” and a result of a rider taking a forward dive into the track. This theory was supported by the identification of a significant increase in head and facial fractures during the same period of study. Several vests were tested as part of this work, with the widely used Tipperary Ride Lite vest failing testing requirements. As a result of the project the ARB immediately began further investigations into the Tipperary vest and subsequently ruled to suspend the use by licensed jockeys, track riders and stable hands of the Tipperary Ride Lite vest. The ARB is continuing to work with the manufacture of the Tipperary Ride Lite vest to address safety concerns. That action alone is a significant outcome of this project. vii Implications for relevant stakeholders The results of this work are primarily for the benefit of jockeys, apprentices and trackwork riders however there is much work to be done by the ARB. Following further investigation, certain manufacturers will be required to answer questions regarding the failure of their vests to meet safety standards and the implications of this issue are yet to be realised. Implementation of new rulings and policies by the ARB will be imperative to avoid similar issues in the future. Recommendations Recommendations include: 1. The provision of a list of Approved Vests within the rules of racing, as opposed to simply listing approved safety standards which is a system of self-certification only; 2. The establishment of a system of surveillance testing of vests (batch testing) currently being used by jockeys to ensure protection to meet current standards is provided; 3. The attachment to vests of a highly visible microchipped ARB badge thereby easily identifying Approved Vests; 4. The recommendation of a vest providing a higher level of protection (such as a Level 2 vest or a high performing Level 1 vest such as the Hows Racesafe) for higher risk activities such as trackwork riding; 5. Consideration of the introduction of one uniform ARB standard to assist in the design of a superior vest with a higher impact performance and level of comfort with more simplified testing requirements better suited to Australian conditions; 6. Improved communication between racing regulatory authorities and jockeys and track riders to help to alleviate confusion amongst riders on the protective capabilities of the vests. Riders should be allowed the opportunity to review the results of the surveillance testing of vests so they can select vests based on performance testing. viii Introduction Safety vests are mandatory in Australian racing however there is a concern that the currently used safety vests may provide limited protection and may even contribute to injuries sustained by riders during falls. In 2004, a RIRDC publication explored the use of available vests and their influence on neck injury frequency in Australia (McLean, 2004). An increase in neck injuries was observed in the four years following the introduction of the vests, however as there was no other information obtained regarding circumstances under which the injuries were sustained, the author stated this increase may have arisen due to factors unrelated to the requirement to wear the protective vest. A subsequent RIRDC funded project entitled “Health and Safety in Australian Racing” (Foote et al., 2011) described the incidence of injuries to jockeys in Australian racing, with injury rates being similar to that reported elsewhere (Whitesel, J. 1976; Edixhoven et al., 1981; Waller et al., 2000; Turner et al., 2002; Hitchens et al., 2009). As part of this research a preliminary investigation was carried out using insurance claim data obtained from Racing NSW and Racing Victoria with the aim of determining if there had been any change in the incidence of injuries since the introduction of the safety vests in 1998. The findings did not identify any increase in injury rates using race day data but did raise other concerns. There were limitations associated with use of insurance claim data for the purpose of assessing injury rates and potential causal factors. The findings also suggested that injuries to the back, chest, neck, ribs and abdomen (i.e. the areas meant to be protected by a vest) were accounting for 30% of insurance claims. Further investigation of the role of vests in protecting jockeys against injury was warranted, leading to the current project. While the insurance claim data analysis work offered some information on the types and frequency of injuries being sustained, it provides little detail on injury causation. A biomechanical review of the effectiveness of safety equipment was also undertaken as part of this work. This part of the project involved the detailed analysis of race falls in an attempt to present the various types of injuries being sustained and their causation. When the causation of the specific injury is known, then it is possible to assess the effectiveness of the protective equipment used. Based on this information, possible revisions to the standards defining the protective capabilities of the equipment may then be assessed. A review of current safety standards used in racing was conducted to assist in understanding the test requirements and also to indicate where improvements could possibly be made while still following accepted practice internationally. A number of currently used and alternative safety vests were tested according to these safety standards. The aim of this part of the project was to determine whether current vests are adequately protecting the jockeys and whether the currently prescribed standards are appropriate. The major concerns include the level of impact protection provided by the vests; the extent of padding coverage provided by the vests and the suitability of the current padding materials (including temperature sensitivity). The results of this part of the project were unexpected and have already resulted in action undertaken by the racing regulatory authority. 1 Objectives This study was designed as an investigation of the effectiveness and suitability of currently used safety vests in Australian racing. The objectives were as follows: 1. To evaluate the performance of safety vests as a means of preventing or lessening the severity of injuries amongst jockeys and others in Australian racing; 2. To determine whether there is a risk that one of more of the types of currently used safety vests may cause neck or spinal injuries; 3. To review and identify factors that may be contributing to the types of injuries sustained in racing; 4. To determine if current safety standards are suitable; 5. To evaluate alternative safety vests and equipment. Overview of methods Several studies were conducted to address these objectives. A survey of professional race day, apprentice and retired jockeys was conducted in collaboration with metropolitan, provincial and country race clubs and stewards in NSW and Victoria. The information gathered by this survey provided an insight into rider opinions on the comfort and protective capabilities of currently used safety vests. An epidemiological study using up-to-date data and resources was then conducted to evaluate the effectiveness of existing vests in reducing the incidence and severity of injuries. This work involved the detailed analysis of insurance claim data gathered from NSW and Victoria in years prior to and following the introduction of the vests to determine if there has been a change in the incidence and types of injuries being sustained. The biomechanical causation of injuries to jockeys in race falls was also investigated. This work involved the review and analysis of race day video footage to give estimates of fall velocity, body region involved in the fall and objects struck during the fall. Characteristics of the fall were combined with injuries sustained to the jockey to define injury causation. Observations were made regarding fall characteristics, injury-causing impacts, the role of vests and any apparent injury-avoiding actions of the jockey. Summaries were compiled of the major international standards for vests used by jockeys in racing. These were to assist in understanding the test requirements and also to indicate where improvements could possibly be made while still following accepted practices internationally. Finally, a number of samples of jockey and general equestrian body protectors were tested as part of the investigation into the effectiveness of vests in preventing injury to jockeys. These samples were tested at Human Impact Engineering1 to compare the performance of currently available jockey vests and to investigate whether other types of protectors have the potential to provide additional protective benefits. 1 http://www.humanimpactengineering.com/ 2 Australian Jockey Survey Method An Australian Jockey Survey was developed in collaboration with the Chairman for Racing NSW Stewards, the Australian Racing Board National Medical Officer, the General Manager of the Australian Jockeys’ Association, the National Occupational Health and Safety Officer for the Australian Jockeys’ Association and the Racing Victoria Jockey Wellbeing and Safety Officer and was distributed to professional, apprentice and retired jockeys with the assistance of New South Wales and Victorian stipendiary stewards. Riders were asked a series of questions relating to their opinions of the protective capabilities and other qualities of their preferred safety vest. Riders were also asked to comment on previous injuries sustained during their careers, current safety standards and alternative protective equipment. Results Response to survey A total of 138 surveys were returned, 88 from professional race day jockeys (representing 32.7% of jockeys in NSW and Vic); 44 from apprentice riders (representing 32.1% of apprentice riders in NSW and Vic) and 4 from retired riders. The breakdown of respondents is shown in Table 1. Table 1 Jockeys Apprentices Retired Breakdown of Jockey Survey respondents from riders in NSW and Vic NSW Victoria Total 45 18 43 26 4 88 44 4 Rider numbers NSW and Vic (RISA, 2012) 269 137 % respondents NSW and Vic 32.7 32.1 Vests most frequently worn in racing The four vests most commonly referred to by respondents in the survey were: • Hows Racesafe Jockey vest, manufactured from up to 70 individually hinged perforated foam strips (weight starting at less than 400g); • Phoenix Tipperary Ride-Lite Vest consisting of polyester closed cell cross-linked foam blocks covered by a mesh fabric (weight 530g); • Velocity Impact Protection Apparel (VIPA) Body Protector, designed by ex-Jockey Greg Childs and incorporating a Nitrex closed cell PVC foam core covered by a light weight Air Mesh (weight of vest from 600g); • Ozvest II vest, made in Australia by R & A Racewear Pty Ltd and incorporating a one-piece, closed cell foam core at the back of the vest with full thickness grooves laterally to allow the vest to contour to the body. The front of the vest comprises two halves joined by a vertical zip (370g). All four vests are claimed to meet standards for use of vests on race day as defined by the Australian Rules of Racing. Figure 1 Hows Racesafe (1) and Phoenix Tipperary (2) vest examples 3 (1) (2) Combining data from both states, the vest most frequently worn in racing is the Hows Racesafe, with approximately 40% of respondents identifying this vest type as their preferred model (Figure 2). Vests most frequently worn - NSW and VIC data (%) 45 40 % of respondents 35 30 25 20 15 10 5 0 Racesafe Figure 2 Tipperary VIPA Ozvest Vests most frequently worn in racing Figure 3 describes the results of each state when analysed separately. Interestingly the majority of NSW riders prefer to ride in the Hows Racesafe vest while the majority of Victorian riders wear the Phoenix Tipperary. Vests most frequently worn: VIC 70 70 60 60 50 50 % of respondents % of respondents Vests most frequently worn: NSW 40 30 20 10 30 20 10 0 0 Racesafe Tipperary Figure 3 40 VIPA Ozvest Racesafe Tipperary Vests most frequently worn in racing: separated by state 4 VIPA Ozvest Jockeys’ opinions: vests currently worn in racing Riders were asked to rate the flexibility, restrictiveness, heat retention, and protective capabilities of their preferred vests on a scale of 1 to 5 where 1 represented “extremely”; 2 represented “moderately”; 3 represented “slightly”; 4 represented “not at all” and 5 represented “undecided”. Flexibility Flexibility of each vest 80 % of respondents 70 60 50 40 VIPA 30 RACESAFE 20 OZVEST 10 TIPPERARY Figure 4 Undecided Not at all Slightly Moderately Extremely 0 Flexibility of each vest rated by surveyed riders Restrictiveness Restrictiveness of each vest % of respondents 60 50 40 30 VIPA 20 RACESAFE OZVEST 10 TIPPERARY Figure 5 Restrictiveness of each vest rated by surveyed riders 5 Undecided Not at all Slightly Moderately Extremely 0 Heat Retention 60 50 40 30 20 10 0 VIPA RACESAFE Figure 6 TIPPERARY Undecided Not at all Slightly Moderately OZVEST Extremely % of respondents Heat retention of each vest Heat retention of each vest as rated by surveyed riders Protective capabilities from falls 60 50 40 30 20 10 0 VIPA RACESAFE Figure 7 TIPPERARY Undecided Not at all Slightly Moderately OZVEST Extremely % of respondents Protective capabilities of each vest from falls Protective capabilities of each vest from falls as rated by surveyed riders Protective capabilities from kicks 80 70 60 50 40 30 20 10 0 VIPA RACESAFE Figure 8 Undecided Not at all Moderately Slightly OZVEST Extremely % of respondents Protective capabilities of each vest from kicks Protective capabilities of each vest from kicks as rated by surveyed riders 6 TIPPERARY Importance of issues associated with wearing the vest Riders were asked to rate the importance of various issues including vest comfort, price, safety, thermal qualities and popularity on a scale of 1 (not important) to 5 (very important). Importance of issues associated with wearing a safety vest 90 % of respondents 80 70 60 1 (not important) 50 2 40 3 30 4 20 5 (very important) 10 0 Vest comfort Figure 9 Vest price Safety /Protection Thermal qualities Friends use them Importance of issues associated with wearing a safety vest Impact of the vest on injury minimisation Riders were asked if they believed their vest restricted or prevented their ability to minimise the risk of injury when falling by taking a “tucked” position. Table 2 Responses of riders on whether the safety vests impact on their ability to minimise risk of injury during a fall “Does the vest impact on the rider taking the tucked position during a fall” Yes No No response Both states % of respondents NSW only VIC only 32.6 47.8 19.6 17.5 63.5 19.0 45.3 34.7 20.0 Current safety standards Riders were asked if they thought the current safety standards should be reviewed to allow other vests to be approved for racing in Australia. Further, the riders were asked if they felt the protection offered under the current safety standards should be maintained as a minimum. The data shown in Table 3 incorporates responses from both NSW and Vic. Table 3 Percentage of respondents supporting the review of safety standards Yes No No response % of respondents “Should standards be reviewed “Should the standards be to allow other vests in racing” maintained as a minimum” 78.3 51.4 18.1 11.6 3.6 37.0 7 Injuries in racing The overwhelming majority of respondents (73.9%) stated that they had suffered significant injury resulting in broken bones or hospitalisation during their careers. Fractures was the most common type of injury (73.2% of respondents) followed by sprains and strains (69.6%), head injuries (55.0%), shoulder injuries (50.0%), facial injuries (39.9%) and spinal injuries (21.0%). Additional safety equipment Riders were asked if they would like to have the option of wearing additional safety equipment during racing or track work. The percentage of respondents in support of the additional equipment is shown in Table 4. Table 4 Opinion of riders on the use of additional safety equipment Equipment type Padded clothing (similar to materials used by Moto GP riders) Light weigh shoulder padding Inflatable vests Facial protection Mouth guards % of respondents in support 15.9 10.1 9.4 8.0 3.6 Rider comments Riders were asked to comment freely on their opinions of the vests. A sample of comments is shown below. “Majority of jockeys ride with toe in now, spearing them into the ground. This could be a factor. I have no doubt that you would not roll or move naturally with the vest on” “Everybody is different. If they could custom fit them then I believe they would have better fit and comfort and protection. I have a very short body where some have a very long body” “I feel the vests are far too restrictive in movement and keep you straight like a board, hence the reason when you fall you can’t bend and all the pressure goes to head and neck. I started riding when vests were not compulsory and have noticed a lot more head, neck, back injuries since being introduced. If I had the choice I would not wear a vest” “Vests should be outlawed. They have no protection for jockeys what-so-ever. There have been more bad injuries since vests came in than there ever was before e.g. spinal and neck more so than other parts of the body” “Obviously safety is of the upmost importance! And regardless of how good something is (e.g. helmet) there can always be something better! We should never stop investigating improvements in all walks of safety. I’m a jockey and know there are smarter people than me to investigate and trial new vests. I am very concerned of what to me appears to be a significant increase in back injuries! Is it the tracks? The way we race nowadays? I don’t know? Maybe there is actually a decrease in back injuries? I think it is imperative that we have the stats to better understand what is causing these back injuries and I would think it not be just a coincidence with many years of data since the vests have been introduced and compared to the previous 10 years…or maybe it’s just particular vests that cause the back injuries? I don’t know but would like to know!” “Vests are good protection from impact from other horses when you fall but I don’t think they can help much when you fall and hit the ground at speed” “In one particular fall I had, I was kicked in the ribs by passing horses which resulted in 1 month off with bruised ribs but I feel that without the vest they would have been broken ribs” 8 Discussion The Australian Jockey Survey completed as part of this work provided the research group with a great insight into the opinions of jockeys on the currently used safety vests and safety issues in general. The survey was divided into key sections assessing the rider’s opinions on commonly used safety vests, current safety standards, injuries they had sustained during their careers and their views on alternative safety equipment. It was revealed that the majority of riders preferred to ride in the Hows Racesafe vest. However when the comfort and safety properties as rated by the riders of each vest were further examined, the VIPA vest appeared to be superior in terms of flexibility, restrictiveness and heat retention. This vest weighs approximately 200g heavier than an equivalent size in the Hows Racesafe model. In order to compensate for the wearing of a vest, jockeys are provided with a 1kg allowance when they “weigh in” and “weigh out”. If a rider is struggling to make weight, the choice of a lighter vest will provide them with a weight advantage. Interestingly, the Ozvest was considered by wearers to be extremely protective against falls, however this vest was not a commonly worn vest. This may be due to the poor comfort qualities of this vest as identified by this study. Rider safety was considered to be of key importance in the survey. The survey suggests that riders tend to prefer a flexible and comfortable vest, but often need to sacrifice comfort (and potentially safety) for a lighter vest due to weight restrictions. When asked to rate certain qualities of a vest, the majority of riders considered vest comfort and safety/protective capabilities to be very important, while vest price, thermal qualities and whether or not friends wore the same vest were less important. In the past there has been the suggestion that the safety vests impact on the ability of riders to minimise risk of injury during a fall, for example by taking a tucked position. In a tucked position the head and arms are “tucked” or pulled closely to the body and the spine flexed. The intent is to minimise flail of the limbs and to reduce the exposure of the neck when the jockey tumbles as a result of the fall. When responses from both states were combined, the majority of riders did not think the vest restricted or prevented their ability to take the tucked position. This is in contrast to results of a previous survey (Foote et al., 2011) suggesting a change towards a more positive attitude of some riders towards the vests. Interestingly, when the results from each state were analysed separately in contrast to NSW riders, the majority of Victorian riders did feel the vest impacted on their ability to take the tucked position. The survey previously showed that the majority of NSW riders prefer to wear the Hows Racesafe vest while the majority of Victorian riders opt for the Phoenix Tipperary. Both vests were considered by the majority of respondents to be “moderately” flexible and “slightly” restrictive suggesting that other factors may be contributing to the opinions of the jockeys on the vests impacting on injury minimisation. When asked if the current safety standards should be reviewed to allow other vests to be approved for racing, the majority of respondents supported this idea however most of these respondents believed that the current safety standards should be maintained as a minimum. The Japanese “Descente” vest is one such vest that is popular with jockeys due to its “flexibility” however this vest does not meet current safety standards and is therefore not permitted to be worn under the Australian Rules of Racing. Several riders commented that they would like to see alternative vests available to them that fit the criteria of being lightweight, comfortable and offering superior protection to that currently available. The results of this survey support previous findings outlining a relatively high rate of injuries in racing. The majority of respondents had sustained serious injury during their careers most commonly resulting in fractures. Head, facial, shoulder and spinal injuries were significant. In the US, Press et al., (1995) reported a retrospective questionnaire study of 706 experienced professional jockeys and their injuries and health concerns. Similar to the results of the current study, fractures were the most 9 common (64% of total injuries). In contrast to the US study, a British study (Turner et al., 2002) found most injuries were soft tissue (80%), and upper limb/clavicle fractures predominated. This may in part be related to the surface on which horse racing occurs, but is more likely to be because jockeys take soft tissue injuries as part and parcel of everyday life and often omit details of them from any questionnaires. Riders were asked if they would like to have the option of wearing additional safety equipment during racing or trackwork. While some riders entertained the idea of wearing padded clothing, shoulder pads and inflatable vests, fewer respondents supported the use of facial protection and mouthguards due to these items interfering with the rider’s ability to breathe and “vocalise” during the ride. Riders were asked to comment freely on their opinions of the vests. While most respondents did not provide any feedback, those that did provided very mixed opinions. Some riders suggested that injuries (particularly spinal and neck) had increased since the vests were introduced. There was also a suggestion that a change in riding style may be contributing to the severity of injuries. Some riders identified issues with currently used vests such as fit which may impact on protection. However some respondents were very supportive of the vests and suggested that they may have sustained more serious injuries had they not been wearing the vests. Overall the comments made by riders highlight an element of confusion over the effectiveness of the vests and their understanding of what the vests are designed to do. This study clearly identifies the need to increase communication between riders and regulatory authorities as information becomes available on the effectiveness of vests in racing. Furthermore, if factors such as riding style are found to be contributing to injuries, this information needs to be clearly relayed to riders so they fully understand the risk of their actions. Overall there was a strong sense that riders would like to see the vests improved in terms of comfort and protection and this should be the objective for the future. 10 Review of insurance claim data prior to and following the introduction of the vests Method Insurance claim data was obtained from Racing NSW and Racing Victoria for the period 1986 – 2011. A total of 9568 and 3005 records respectively from each state were made available incorporating claims from all workers associated with racing. These claims were sorted according to fall data. Data obtained from Victoria represented race day rides by professional jockeys, however data from NSW included race day, trackwork and barrier trials for jockeys and trackwork riders and despite our best attempts it was impossible to separate race day only data due to limitations in the available data. Furthermore, data entered prior to 1993 was incomplete and for this reason the study periods were limited to 5 years prior to the introduction of the vests (1993/94 – 1997/98) and 11 years following the introduction of the vests (2000/01 – 2010/11). The intermediary years were omitted as there was a change in rulings of vest standards during this period. Data were analysed by Dr Mick O’Neill from Statistical Advisory and Training Service Pty Ltd using the following methods: - Relative frequency (percentage) data pre and post vests were compared using maximum likelihood χ2 statistics for two-way tables. This method generalises to logistic regression when the annual percentage data was used as replication. When there were more than two possible outcomes, log-linear modelling was used. - When means of variants such as age, average time lost and average gross value of claims were approximately normally distributed, an analysis of variance (ANOVA) or Linear Mixed Models (REML) were used. REML gives identical answers to ANOVA, but clarified whether the variation in annual means was consistent pre and post vests. Results Victorian Insurance Claim Data: Race day only Rate of fall claims There has been a significant reduction in the total number of fall claims as a percentage of starters (RISA, 2012) in the years following the introduction of the vests (X2 = 38.12, P<0.001) (Table 5). Table 5 Rate of fall claims prior to and following the introduction of the vests in Vic Total fall claims Starters Percentage Pre-vest 367 243460 0.15% Post-vest 502 511967 0.10% Time lost due to injury The average time lost due to injury was reduced in the years following the introduction of the vests however this did not reach statistical significance due in part to the large variation in annual average time lost (Table 6). 11 Table 6 Average time lost (days) due to injury prior to and following the introduction of the vests in Vic Average time lost (days) Pre-vest 115 Post-vest 99 Change 16 P value 0.661 Incidence of injury in specific bodily locations Figure 10 describes the frequency of injuries in each bodily location (expressed as a percentage of Victorian rider fall claims) prior to and following the introduction of the vests (please refer Appendix 1a for raw data). The frequency distribution of injury location pre-vests was not significantly different to that post-vests (X2 = 3.39, df = 6, P = 0.758) indicating there has been no significant change in the frequency of injuries in specific bodily locations in the years following the introduction of the vests. Head and face 10.9% PRE 12.2% POST Neck injuries 5.7% PRE 7.8% POST Back injuries 12.0% PRE 12.4% POST Trunk injuries* 9.3% PRE 8.2% POST Unspecified 8.2% PRE 6.0% POST Upper limb injuries 32.7% PRE 32.7% POST Lower limb injuries 21.3% PRE 20.9% POST * Includes chest, ribs, pelvis, abdomen Figure 10 Frequency of injuries prior to and following the introduction of the vests in each bodily location analysed. 12 Severity of injury in years prior to and following the introduction of the vests Types of injuries as a % of all fall claims for each study period Figure 11 describes the percentages of injury types in years prior to and following the introduction of the vests (expressed as a percentage of Victorian rider fall claims). The frequency distribution of injury type pre-vests was not significantly different to that post-vests (X2 = 3.02, df = 4, P = 0.554) indicating there has been very little change in the types of injuries occurring since the introduction of the vests. Please refer to Appendix 1b for raw data. 100.0 90.0 80.0 70.0 60.0 50.0 46.346.0 Pre-vest 40.0 Post-vest 25.9 22.1 30.0 20.0 13.5 10.6 10.0 5.4 5.4 11.712.9 0.0 Fracture Contusions Sprains/strains Intracranial and crushings injuries Other Figure 11 Injury types expressed as a percentage of Vic rider fall claims in years prior to and following the introduction of the vests New South Wales Insurance Claim Data: Race day, track work and barrier trial data Rate of fall claims There has been no change in the rate of fall claims (expressed as a percentage of starters) in the years following the introduction of the vests (X2 = 0.087, P = 0.768) (Table 7). Table 7 Rate of fall claims prior to and following the introduction of the vests in NSW Total fall claims Starters Percentage Pre-vest 1120 335378 0.33% Post-vest 2065 611643 0.34% Time lost due to injury The average time lost due to injury was reduced in the years following the introduction of the vests however this did not reach statistical significance due in part to the large variation in annual average time lost (Table 8). Table 8 Average time lost (hours) due to injury prior to and following the introduction of the vests in NSW Average time lost (hours) Pre-vest 594 Post-vest 439 13 Change 142 P value 0.155 Gross value of claims and age of riders The NSW dataset contained additional fields allowing for the analysis of changes in the gross value of claims and average age of riders prior to and following the introduction of the vests. The data is presented in Table 9. Table 9 Average gross value of claims and age of riders in the pre- and post-vest periods Average gross value of claims Average age of riders Pre-vest $11872 29.7 years Post-vest $17672 30.6 years Change $3800 0.88 years P value 0.106 0.091 years There has been no significant change in the average gross value of claims or the average age of riders in the years prior to and following the introduction of the vests. Incidence of injury in specific bodily locations Figure 12 describes the frequency of injuries in each bodily location (expressed as a percentage of NSW rider fall claims) prior to and following the introduction of the vests (please refer Appendix 2a for raw data). The frequency distribution of injury location pre-vests was significantly different to that post-vests (X2 = 39.91, df = 6, P < 0.001). Examining the individual injury locations, there has been a significant increase in neck, and neck and other injuries in the years following the introduction of the vests (X2 = 21.62, df = 1, P < 0.001). There has also been a significant increase in the probability of “Multiple unspecified” injuries (X2 = 11.83, df = 1, P < 0.001). Head and face 9.0% PRE 9.6% POST ** Includes chest, ribs, pelvis, abdomen Neck injuries* 3.2% PRE 7.1% POST Back injuries 17.4% PRE 15.1% POST Trunk injuries** 6.0% PRE 7.5% POST Multiple unspecified other* 0.7% PRE 2.2% POST Upper limb injuries 32.4% PRE 28.9% POST Lower limb injuries 31.3% PRE 29.6% POST *P < 0.001 Figure 12 Frequency of injuries prior to and following the introduction of the vests in each bodily location analysed (NSW data). 14 Severity of injury in years pre- and post-introduction of the vests Figure 13 describes the percentages of injury types in years prior to and following the introduction of the vests (expressed as a percentage of NSW rider fall claims). The frequency distribution of injury type pre-vests was found to be significantly different to that post-vests (X2 = 48.95, df = 4, P < 0.001) due to a significant reduction (51% down to 39%) in “sprain and strain” injuries in the post-vest period. Please refer to Appendix 2b for raw data. 100.0 Types of injuries as % of fall claims 90.0 80.0 70.0 60.0 51.0 50.0 40.0 30.0 Pre-vest 39.3 26.1 Post-vest 29.4 20.0 11.3 15.8 10.0 2.9 2.3 8.8 13.1 0.0 Fracture Contusions and Sprains/strains crushings Intracranial injuries Other Figure 13 Injury types expressed as a percentage of Vic rider fall claims in years prior to and following the introduction of the vests “Sprains and strains” is clearly the dominant injury type effect accounting for 40.06 of the 48.95 X2 test value. If sprain and strain injuries are excluded, the remaining data shows a decrease in the percentage of fractures (4.7%) and intracranial injuries (2.0%) and an increase in the percentages of contusions and crushings (3.0%) and other injuries (3.7%) when calculated as percentages of all injuries excluding sprains and strains (Table 10). These differences do not reach statistical significance (X2 = 8.89, df = 3, P = 0.031). Table 10 Injury types in the pre- and post-vest period excluding sprains and strains Injury type Fractures Contusions and crushings Other Intracranial % pre-vest period 53.2 23.1 17.9 5.8 15 % post-vest period 48.5 26.1 21.5 3.8 Severity of injury at specific bodily locations in years pre- and post-introduction of the vests The severity of injuries at specific bodily locations (neck, back, ribs, chest and head/face) was further examined. The results are shown in Table 11 and expressed as a percentage of injury type for each bodily location. Table 11 Injury Type Severity of injuries at specific bodily locations Neck injuries Prevest (%) 0.01 80.6 5.6 Postvest (%) 12.41 67.6 15.2 Back injuries Prevest (%) 6.22 78.93 12.9 Fracture Sprains and strains Contusions and crushings 13.9 4.8 2.1 Other and multiple Intracranial including concussion 1,6 P = 0.004; 2,4,5 P < 0.001; 3 P = 0.008. Rib injuries Chest injuries Postvest (%) 16.12 61.73 19.3 Prevest (%) 1.8 0.8 0.9 Postvest (%) 2.7 0.5 0.8 Prevest (%) Postvest (%) 0.43 0.2 0.23 0.6 2.9 0.1 0.3 0.0 0.2 Head/facial injuries PrePostvest vest (%) (%) 6.95 21.35 5.9 1.5 6 4.0 12.26 31.7 51.5 Neck injuries The relative frequencies of neck injury types in the pre-vest period are significantly different than those during the post-vest period (X2 = 14.05, df = 3, P = 0.003). This was due to a significant increase in neck fracture percentages during the post-vest period (X2 = 8.46, df = 1, P = 0.004). The other injury types in the neck area vary comparing the pre- and post-vest period but none are significantly different. Back injuries The relative frequencies of back injury types in the pre-vest period are significantly different than those during the post-vest period (X2 = 18.91, df = 3, P <0.001). This was due to a significant increase in back fracture percentages during the post-vest period (X2 = 11.83, df = 1, P < 0.001) and a significant decrease in sprain and strain injuries (X2 = 7.07, df = 1, P = 0.008). There were no differences in the percentages of contusions and crushings or of other injuries (including dislocation). Rib injuries The relative frequencies of rib injury types in the pre-vest period are not significantly different than those during the post-vest period (X2 = 4.39, df = 3, P = 0.222). Chest injuries The relative frequencies of chest injury types in the pre-vest period are significantly different than those during the post-vest period (X2 = 7.91, df = 3, P = 0.048). This was due to a significant decrease the in number of sprains and strains in the years following the introduction of the vests. Head/facial injuries The relative frequencies of head and facial injury types in the pre-vest period are significantly different than those during the post-vest period (X2 = 22.23 df = 4, P < 0.001). This was due to a significant increase in fracture percentages (X2 = 11.35, df = 1, P < 0.001) and contusion and crushing percentages (X2 = 8.40, df = 1, P = 0.004) during the post-vest period. There were no differences among the remaining injury types, which all decrease during the post-vest period. 16 24.4 40.6 Discussion This part of the project involved the analysis of insurance claim data obtained from Racing NSW and Racing Victoria for the period 1986 – 2011. There were limitations to both the Victorian and NSW dataset. The data obtained for this study were retained for insurance purposes only and were not easily accessible for the purposes of this project. The system does not allow data to be sorted except in a limited number of standard formats and there may also be variation depending on the person entering the data. For these reasons there does exist the possibility of inaccuracies within the dataset. The Victorian dataset included race-day data only, allowing for a more focussed analysis compared to the NSW dataset. The analysis revealed a significant reduction in all fall claims during the post-vest period. However upon further analysis, the frequency distribution of injury location during the prevests period was not significantly different to that during the post-vest period indicating there has been no significant change in the frequency of injuries in specific bodily locations in the years following the introduction of the vests. The frequency distribution of injury type during the pre-vest period was also not significantly different to that during the post-vest period indicating there has been very little change in the types of injuries occurring since the introduction of the vests. This data suggests that the reduction in injury rates may have little to do with the introduction of the safety vests and instead may be due to other factors such as improvements in running rails and track conditions during race day. The NSW dataset contained race day, trackwork and barrier trial information which was unable to be reliably separated. Compared to the Victorian dataset, the rate of fall claims remained unchanged in the years following the introduction of the vests and was approximately three times higher than the race day only fall claim rate from Victoria, implying that injuries during trackwork and barrier trials are major contributors to the overall injury rate. This suggests that factors during out of competitive riding are having a significant impact on the incidence of injuries. Certain factors such as horse behaviour, experience and age; environmental conditions; track surface; and skill of riders may be contributing to the high rate of injuries during out of competition riding and require further investigation. While the NSW dataset had its limitations, the analysis did reveal some differences in the location and nature of injuries during the post vest period. The analysis identified an increase in neck injuries with a significant increase in neck fractures in the years following the introduction of the vests. There was no significant change in the incidence of back, rib or chest injuries, however when the nature of the injuries in these bodily locations was examined there was also a significant increase in back fractures. There was a significant reduction in less severe injuries (i.e. sprains and strains) in the back and chest regions and a non-significant decrease in sprains and strains in the rib region. Unlike the dataset obtained from Victoria, the NSW dataset suggests that it is possible that the vests are indeed offering some protection against less severe injuries. The main difference between NSW and Victoria is the type of vest being worn, with a preference for the Hows Racesafe vest in NSW and the Tipperary in Victoria. When tested (refer final chapter of this report) The Hows Racesafe vest was superior in terms of protective capabilities, which may be contributing to the significant reduction in sprains and strains in NSW but not in Victoria. In an attempt to determine the causation of the increased back and neck fractures in NSW, injuries in the head/facial area were also examined. While there was no change in the rate of head/facial injuries, there was a significant increase in fractures and contusions and crushings. As the increase in neck fractures was coupled with an increase in head/facial and back fractures, this suggests a change in the causation of injuries and may be due to the riders being “speared” into the ground (please refer to the next chapter of this report for an analysis of the biomechanical causation of injuries). Becker’s Principle (Byrd, 1993) states that the proportion of head injuries in a sport reflects the degree of headforward-stance adopted. In racing the rider leans forward over the shoulders of the horse and the head becomes the leading part of the body. In recent years some riders have been adopting a “toe-in-the 17 iron” riding style in an attempt to gain a performance advantage for the horse. It may be argued that the toe-in style only requires a slight deviation from the horse for the jockey to lose balance causing one or both feet to slip from the irons resulting in the jockey being “tipped” out of the saddle. While it is currently policy for trainee apprentices to ride with the stirrup iron on the ball of their foot, the increase in head fractures raises the question whether riding style may be impacting on injury type and severity. This part of the project also highlights the importance of ensuring a high (and possibly different) level of protection for riders involved in out of competition riding such as track work where weight restrictions are not as crucial. 18 Biomechanical review of the effectiveness of safety vests Method Individual cases where jockeys fell during a race meeting were investigated in detail. These cases occurred between 2002 and 2005 in NSW, VIC, ACT, QLD, TAS and Macau. Data collected for each incident included video footage, helmets where available and the injuries based on an interview with the jockey. The case was assessed and if a view of the incident was available in the video footage then the incident was digitised and still frames were captured from the video immediately surrounding the incident. These frames were analysed where possible to give estimates of the fall velocity, body region(s) involved and the object(s) struck during the fall. The characteristics of the fall were then combined with the injuries to the jockey to define the possible injury causation. Injuries were characterised as either direct (caused by a direct impact of that bodily location with an object) or indirect (due to an associated head or back impact by the track surface). Special attention was paid to the causation of any spinal injuries recorded. Finally, observations were made regarding the fall characteristics, the injury-causing impacts, the role of protective equipment and any apparent injury-avoiding actions of the jockey. The process was time consuming, hence only a limited number of cases was investigated. The cases investigated are a selection of incidents that were available and filled the following criteria: • Video footage of the incident was available; and • If the jockey survived the incident they were willing to discuss the injuries received. Results A total of 17 individual cases where jockeys fell during a race meeting were investigated in detail. The individual summaries of each case are included in Appendix 3. Of these cases, there were 39 individual injuries recorded. Of these, there were 7 head injuries (2 of which were fatal), 5 facial injuries, 6 injuries to the neck, 8 to the back or spine, 2 to the shoulder or clavicle, 3 chest injuries, 2 injuries to the upper limbs and 6 to the hip and lower limbs. The results of the case analyses are summarised in Table 12, in which the body region, injury and injury type and the region of injury-causing contact is summarised for each case. The injuries included 17 fractures and one dislocation. The remainder were soft tissue injuries or were unspecified. There were three main injury-producing fall modes observed: 1. Forward dive into the track as the horse stumbles 2. Fall off the side of the horse whilst holding onto the reins 3. Rider butted into the air or thrown from the horse In some cases the rider was trampled or crushed by a fallen horse after impacting the track. This mechanism of injury was typically unclear in the videos available and so difficult to interpret. The impact velocities observed were in the order of 30 to 50 kph, from heights of up to 3.5 metres. Although the video footage in most cases was unclear, there were observed to be very few active attempts at injury minimisation by riders, for example, taking a tucked position. In a tucked position the head and arms are “tucked” or pulled closely to the body and the spine flexed. The intent is to 19 minimise flail of the limbs and to reduce the exposure of the neck when the jockey tumbles as a result of the fall. The riders tend to hold onto the reins for as long as is possible and hence were poorly prepared for the eventual landing. When they tumbled, it was often uncontrolled with arms and legs flailing. Table 12 Results of the case analysis with the body region, the injury and the type and area of injury causing contact summarised for each case. Body Region Injury Type Head (7) Intracerebral bleeding Brain contusions Fracture Concussion (2) Unspecified (2) Direct Direct Direct Direct Direct Fracture (2) Direct Face (5) Neck (6) Spine (7) Back (1) Chest (3) Shoulder (1) Clavicle (1) Upper limb (2) Hip (1) Lower limb (5) Lacerations Bruising Unspecified Fracture (3) Dislocation Soft tissue injury (2) Cord injury Cord bruising Fracture Contacts Opponent Hoof Track Track Track Track Track Track Hoof Face Hoof Face Horse body or hooves Face Track Head Track Head Track Head/Back Track Head Track Head/Neck/Back Track or Horse Back Track Back Track Head Track Head/Back Track Back Track Back Track Chest Horse body or hooves Track Chest Track Shoulder Track Chest Hoof Upper limb Track Upper limb Track Hip Track Hip Horse body or hooves Lower limb Track or horse Lower limb Track or horse Lower limb Track Lower limb Track Body Region Head Head Head Head Head Head/Face Face Direct Direct Direct Indirect Indirect Indirect Direct/Indirect Direct Direct Indirect Soft tissue injury Bruising Fracture (2) Indirect Direct Direct Bruising Bruising Fracture Soft tissue injury Fractures Fracture Fracture (2) Direct Direct Direct Direct Direct Direct Direct Soft tissue injury Bruising/swelling Bruising Direct Direct Direct Case No. J12 J08 J04 J11, J15 J17 J09 J02 J12 J16 J05 J09 J05, J08, J14 J04 J01 J05 J07 J02 J10 J02, J03 J06 J13 J03 J02 J13 J01 J11 J01 J01 J13 J13 J05 J05 J05 J03 J11 Discussion The aim of this analysis of race falls was to present the various types of injury and their causation. When the causation of the specific injury is known, then it is possible to assess the effectiveness of the protective equipment used. While this information only represents a small percentage of injuries, based on this type of information, possible revisions to the standards defining the protective capabilities of the equipment may then be evaluated. If the injuries are studied by body region then it is possible to make an assessment of the adequacy of the current protective equipment and highlight those areas that can be improved in terms of protection offered. 20 Of the 17 cases studied, all seven head injuries observed were due to direct impacts by either the track surface (6) or by the hoof of a horse (1). This is a region already protected by the helmet. A helmet should be able to protect the wearer from skull fracture and brain injury in most impacts that occur in racing. Therefore these failures in protection are important and indicate that some improvement in the protective capability of the helmets may be able to reduce these injuries. A new standard for jockey helmets was issued by the Australian Racing Board (ARB HS 2012) in October, 2012 following 5 years of research and prototype testing. To date no manufacturer has complied with ARB HS 2012, but trials are currently being conducted by an Australian manufacturer that may result in ARB HS 2012 being met. Once a manufacturer has brought to market an ARB HS 2012 compliant helmet, all other helmets must meet the ARB HS 2012 within 9 months or be withdrawn from sale. A rider may only wear an ARB HS 2012 compliant helmet 9 months after the first compliant helmet becomes available for purchase. There were 5 facial injuries all due to direct impacts from the track surface (2), possibly the body of a horse (1) and the hooves (2). Improvements to the coverage area offered by the helmet by inclusion of a chin guard would offer protection to the face. A correctly designed chin guard has the potential to reduce the injuries to the face such as nose fractures, jaw fracture and bruising and laceration. However when surveyed (refer first chapter of this report), less than 10% of jockeys were in favour of additional protection in the facial region due to potential interference with sight and verbalisation during a race. There were 6 neck injuries ranging from soft tissue injury (2) to fracture (3) and dislocation (1). These injuries were all indirect and due to associated head impacts and possibly one impact to the back by the track surface. The mechanism of most of these injuries was not clear from the video footage. When surveyed many riders expressed concerns about an increase in neck fractures in recent years and attributed these injuries to wearing the vest. Based on these video footage analyses, it is evident that the majority of neck injuries are indirect and are a result of impact of the head to the track. There is no existing protective equipment available which is able to protect the neck from these injuries due to the neck being driven by impact to the head. There were 7 spine injuries ranging from soft tissue injury (2), fracture (3) and cord injury (3). These injuries can be divided into two types: direct injury (3) due to impacting the track surface directly with the back during the primary part of the fall; and indirect injury (4) which usually involved multi-axial loading of the back. There also was one that appeared to combine both loading mechanisms, Case J07 and a more general back injury that involved bruising. These injuries can be divided into two with regard to protection. The direct injuries due to direct contact with the track surface may be reduced by attention to the design of the vests in this region. A safety review conducted by the Irish Turf Club suggested that further improvements in the protection offered by the safety vest could be made if the panel covering the spinal column was strengthened, a point worth further investigation. It is less easy to effect injury reduction with the indirect and usually more serious injuries. There is no existing protective equipment available that is able to protect the spine from these indirect injuries, which are caused by multi-axial loading of the spine. The loading directions often consist of compression combined with flexion and possibly rotation; each motion of the spine being driven by a combination of direct body impacts and the inertia of the body. There were 5 torso injuries ranging from chest injuries (3), including fractures (2) and bruising (1), shoulder bruising (1) and a clavicle fracture (1). These injuries were all due to direct impact with the track (3) or horses hoofs (2). This is the area of the body that is protected by the vest and this offers the potential to reduce the injuries if improvements in design can be made. The other reported injuries were to the arms (2), hip (1) and legs (5). These injuries were all direct impact injuries from the track surface or the horses. The exact mechanisms of these injuries were not clear from the videos. 21 There appears to be potential for reducing injury by improving the design of the vests. The first step in assessing where this improvement might be achieved is by understanding the requirements of the current protective equipment standards. 22 Evaluation of Protective Equipment Standards Method Since 1998, it has been compulsory for jockeys and track work riders to wear a body protector. The current ARB Rules of Racing require the body protector to comply with one of three prescribed standards: • ARB Standard 1.1998; • SATRA Jockey Vest Standard; • European Standard EN 13158 Level 1 (currently the 2009 issue). Summaries were compiled of the major international standards for vests used by jockeys (refer Appendix 4). These were to assist in understanding the test requirements and also to indicate where improvements could possibly be made while still following accepted practice internationally. The aim of a standard for protective equipment is to ensure a baseline level of performance of the product under simplified test conditions. The test conditions are simplified to make the testing more repeatable and reliable. As a result the test requirements often seem to be different to the conditions of use in a particular sport. When evaluating a protective equipment standard it is important to keep in mind the purpose of the equipment, that is, to protect the wearer under the specific circumstances that occur in that sport. An item of protective equipment is effective if it fulfils the following requirements: 1. It is worn – in voluntary situations for this to occur, the equipment must be both comfortable to wear and accepted by the user as worthwhile (fit and ventilation for example); 2. It remains in place – the equipment must not be dislodged during an accident therefore the fit and retention must be suitable for the purpose to ensure that the equipment is not lost (retention system strength, stability for example); 3. It protects the wearer – the equipment must offer the correct level of protection of the correct type to reduce injury (impact energy absorption, resistance to penetrating impacts for example). Results and Discussion The following section provides discussion on each of the requirements for effective protective equipment. 1. It is worn For the jockeys it is compulsory that the vest be worn, however based on the number of complaints, the vests are neither comfortable nor have they been universally accepted as being worthwhile. There are also some concerns from racing regulatory authorities regarding the actual wearing of the vests on race days as some jockeys have been known to wear vests that do not conform to current standards for improved comfort. Some riders have also been found to alter the vests to obtain weight advantages. Once the vests are tampered with, their protective capabilities may be restricted. 23 2. It remains in place The vest must not be dislodged or displaced during a fall, and therefore the fit of the vest and the strength of the fastening system must be suitable for the purpose to ensure that the vest remains in place. The standards all have test requirements for the fastening system strength and fit testing. 3. It protects the wearer – The vest must offer the correct level of protection to the chest and spine and of the correct type to reduce injury. To protect the wearer requires that the vest have the correct energy absorption for distributed impacts with the track surface and also protect the wearer from smaller area harder impacts such as a kick from a horseshoe. The vest needs to cover a defined area on the body. The standards all have test requirements for the impact energy absorption, resistance to more penetrating type impacts and a gapping test to ensure that the padding components remain closely grouped. Each of the performance standards outline minimum requirements for the body protectors, such as padding coverage, gaps between padding, impact protection, strength of restraints, ergonomics etc. Both the SATRA Jockey Vest Standard and the ARB Standard 1.1998 are body protector standards specifically for jockeys. EN 13158 is a more comprehensive standard for body protectors and includes three performance levels. EN 13158 Level 1 is specifically for jockeys and is the lowest level of protection offered in the standard. The EN 13158 Level 1 test is the most recent standard and has the most comprehensive testing for impact performance. Two impact test configurations are required to be met: • Test 1 involves an impact using a flat circular impactor (80 mm diameter) onto the vest. The anvil used is a 150 mm radius dome with a surrounding guard ring level to the top surface. This test is performed at a drop energy of 25 J. • Test 2 involves an impact using a narrow bar impactor (80x20 mm). The 150 mm radius dome anvil is surrounded by a guard ring raised to 10 mm above the top surface. This test is performed at a drop energy of 20 J. The SATRA Standard (Figure 14) has different impact performance requirements to the European Standard EN 13158 Level 1. The SATRA Jockey Vest Standard M6 Issue 5 demands three impact test configurations to be met: • Test 1 involves an impact using a flat circular impactor (80 mm diameter) onto the vest. The anvil used is a 150 mm radius dome with a surrounding guard ring level to the top surface. This test is performed at a 25 J drop energy. • Test 2 is similar to Test 1 except the anvil has a domed top of 100 mm radius and the guard ring is set to 10 mm above the anvil. Test 2 is performed at a 30 J drop energy. • Test 3 involves an impact using a narrow bar impactor (80x20 mm). The 150 mm radius dome anvil of Test 1 is surrounded by a guard ring raised to 10 mm above the top surface. This test is performed at a 15 J drop energy. 24 Figure 14 SATRA Test Setup The European Standard EN 13158 specifies three performance levels for body protectors. Level 3 is considered to be the minimum requirement for Equestrian Sport activities (such as 3-day eventing). Two test configurations are required for the Level 3 standard: • Test 1 involves an impact using a flat circular impactor (80 mm diameter) onto the vest. The anvil used is a 150 mm radius dome with a surrounding guard ring level to the top surface. This test is performed at a drop energy of 35 J. • Test 2 involves an impact using a narrow bar impactor (80x20 mm). The 150 mm radius dome anvil is surrounded by a guard ring raised to 10 mm above the top surface. This test is performed at a drop energy of 45 J. For all tests, the average peak transmitted force should not exceed 4.0 kN, with no single force result exceeding 6.0 kN. For this report, the result was considered marginal if the transmitted force was close to or exceeded 4 kN. The ARB Standard.1998 was drawn up by Gibson for the Australian Racing Board. The ARB Standard is based on the SATRA Standard, with changes made to the impact attenuation requirements to allow for a more flexible vest; as well as the water retention requirement and the temperature specified for hot weather testing to ensure adequate performance in wet and hot conditions (Appendix 4). In a previous review of jockey injury data and vest standards, Gibson (1997) identified that temperatures of the Australian climate can have an effect on vest materials. Plastic materials become significantly softer at higher temperatures, typically over some transition temperature which depends on the specific material. In the EN 13158 standard, if the body protector is specified for use in high ambient temperatures (above 28°C), the vest must meet the impact performance criteria after being conditioned at 30°C. In the ARB Standard 1.1998, the vest must meet the impact performance criteria after being conditioned at 40°C, to be representative of body heat and sun load in Australia. In order to determine temperature sensitivity of the sample vests, the samples were also conditioned for at least 4 hours in a temperature chamber at 40°C and then retested according to the original procedure. The basis for testing the energy absorption of the padding is similar for all the vest standards. The vest is impact tested by dropping a mass onto the vest and measuring the transmitted impact force or acceleration of the impactor due to the sample vest being tested. The energy absorbed from the impact required varies according to the standard. The vest standards used in Australian racing have similar impact test methods, with similar anvils, the base test being a flat impactor on a domed rigid anvil (150mm radius) and measurement of the force transmitted through the vest in a test. The main differences are in the number of impactor types required and the test severity, measured in terms of 25 the drop energy, which is typically defined by the test velocity. The use of the ring surrounding the impact anvil is to assess the bending stiffness of the vest material, to control the vest response in the small area harder impacts. The velocity in a drop test rig is derived from the drop height. Of this group of standards, only the ARB Standard requires the vest to be tested at an elevated temperature, 40°C (near body temperature). These standards all require an average transmitted force for the tested vest of less than 4kN. The ASTM Standard uses a different test methodology, using a spherical impactor (of 150mm diameter) on a rigid anvil (based on the helmet test methods). It also requires testing at an elevated temperature of 40°C (near body temperature). This standard also requires the vest material to be tested on a deformable clay filled tray that is on a non rigid surface, to assess its bending stiffness as a guide for localised impacts. The aim of all the tests is similar: the domed/flat impact is designed to give a certain level of energy absorption for the vest material similar to an impact to the chest of the wearer. The domed/flat impact with guard ring is designed to give a certain level of energy absorption for the vest material similar to a more localised impact to the chest of the wearer. The 4kN requirement appears to be related to the compression stiffness of a tensed human cadaver chest when hit by a 150mm diameter 23kg impactor at a velocity of 6.7m/s (Kroell et al., 1974). The tests for all the standards give a combination of both energy absorption and bending strength for the vest material. The higher temperature test used for the ARB Standard is to ensure that the material used is suitable for use in warmer conditions. Most plastics used for the padding have a significantly reduced stiffness above 30°C. It is important to realise that body temperature is 38°. It is important to note that ARB Standard 1.1998 does not demand the narrow bar impactor test (Test 2) but only the flat impactor (Test 1) for the impact performance requirement. This removes the need for increased stiffness or thickness but the implications for injury are unknown. In reviewing NSW insurance claim data obtained previously, a minimum of 22.5% of rib claims were due to a direct impact by an object (either the horse kicking or stepping on the rider, the rider colliding with the running rail or the horse rolling on top of the rider). Rib claims accounted for approximately 4.3% of all claims, so these injuries are representative of approximately 1% of all rider fall claims. The narrow bar impactor test requirement is responsible for the “bending stiffness”. If this test were omitted from the requirements as is the case according to the ARB standard, it may be possible to produce a more flexible and potentially more comfortable vest for the wearer. As comfort and flexibility is a major consideration (and necessity) for riders, the necessity of this test deserves further investigation. 26 Safety Equipment Testing Method Samples of jockey and general equestrian body protectors were tested as part of the investigation into the effectiveness of vests in preventing injury to jockeys. These samples were tested at Human Impact Engineering to compare the performance of currently available jockey vests and to investigate whether other types of protectors have the potential to provide additional protective benefits. A number of vest samples were obtained and tested to the impact performance requirements of EN 13158 Level 1. This test protocol was chosen because it is the most recent standard and has the most comprehensive testing for impact performance. Following the results of the testing to EN 13158 Level 1, one of the vests was also tested to SATRA standard. The European Standard EN 13158 specifies three performance levels for body protectors. Level 1 is specifically for jockeys and is the lowest level of impact performance allowed. To illustrate the difference in impact performance, an EN 13158 Level 2 equestrian vest, Airowear Swift was also tested to this Level 1 standard. A number of higher protective level body protectors were also tested to investigate the impact properties of alternative materials. The samples were subjected to the impact test protocol of EN 13158 Level 3. The aim of this part of the product was to determine whether current vests are adequately protecting the jockeys and whether the currently prescribed standards are appropriate. The major concerns include: • The level of impact protection provided by the vests. • The extent of padding coverage provided by the vests. • The suitability of the current padding materials (including temperature sensitivity). 27 Results Comparison of Jockey vests Three jockey vests were supplied for testing, consisting of the two most common vests currently being worn by jockeys in Australia, the Hows Racesafe and Phoenix Tipperary, and the third a vest approved by the Japanese Racing Authority, the Descente. The Descente is currently not approved for use in Australia. In addition, a motorcycle vest/back protector to the EN1621-2 standard, the Komperdell Ballistic, was included for comparison with the jockey vests. Details of the samples tested are provided in Table 13 and pictured in Figure 15. Table 13 Jockey vest sample specifications. No. Type of protector Manufacturer & Model Size Phoenix Tipperary Standard Claimed EN13158:2000 Level 1 SATRA M6 1 Jockey vest Hows Racesafe 2 Jockey vest 3 4 Jockey vest Motorcycle back protector/vest Flat Padding thickness 20 mm Padding Stiffness Med Youth M 12 mm Large Small 12 mm 8 mm front 18 mm back Low with firm core Low & Med High JRA Descente Komperdell Ballistic JRA EN1621-2 Figure 15 The jockey vest samples (left to right) - Racesafe, Tipperary, Descente and Komperdell Ballistic 28 Impact performance The results of the EN 13158 Level 1 impact tests are presented in Table 14. Table 14 Vest Specimen Tipperary Tipperary Racesafe Racesafe Descente Descente Komperdell Ballistic Komperdell Ballistic Komperdell Ballistic (front) EN 13158 Level 1 impact performance testing results. TEST 1 (Flat Impactor) Peak force Pass / Fail Location (kN) Back, centre, 9.26 FAIL bottom Back, centre, 8.95 FAIL middle Back, centre, 1.77 PASS bottom Back, centre, top Back, centre, middle Back, right, top Back, centre, middle Back, centre, bottom Front, left, middle TEST 2 (Narrow Bar Impactor) Peak Location force Pass / Fail (kN) Back, centre, top 13.78 FAIL Back, left, bottom 9.63 FAIL 1.43 PASS 1.74 PASS 11.06 FAIL 18.27 FAIL 1.87 PASS 4.19 MARGINAL 3.78 MARGINAL Back, centre, bottom Back, centre, middle Back, centre, middle Back, left, middle 4.29 MARGINAL Back, centre, top 1.77 PASS 3.95 MARGINAL Back, left, middle 2.11 PASS 9.73 FAIL Front, centre, middle 26.71 FAIL Of the vests tested, the Hows Racesafe vest, which is BETA (British Equestrian Traders Association) certified to EN 13158 Level 1, had the best performance in both Tests 1 and 2, with peak force values well within the allowable threshold. The Racesafe also has the thickest padding material at 20 mm, (Table 14). The Tipperary vest performed the worst, failing both Tests 1 and 2 by a considerable margin. The Tipperary and the Descente had similar thickness material at 12 mm (Table 14). The Descente vest consists of foam pieces of variable density. The foam pieces around the arm and neck holes are considerably softer than the foam in the chest and back areas. As the soft foam pieces would allow a higher level of force to be transmitted, the Descente vest was only impact tested on the harder foam pieces, and so indicating the best possible performance. Nevertheless, the results show that the Descente vest has marginal performance in the flat impactor test. Considering the small padding thickness, the foam material had good impact performance. The Descente vest performed poorly in the narrow bar impactor test. The Komperdell Ballistic motorcycle vest/back protector consists of stiffer foam than the other samples. At the front, the vest was much too thin to provide adequate impact protection and failed both Tests 1 and 2. On the back, the vest had marginal performance in the flat impactor test but performed well in the narrow bar test. Testing the Tipperary vest to the SATRA Standard Due to the poor performance of the Tipperary Ride Lite vest, an additional Tipperary Ride Lite vest was obtained and tested to the requirements of the SATRA Jockey Vest Standard M6 Issue 5 (Table 16). The Tipperary Ride-Lite has a label affixed, which states “CE CERT. #617 Performance Test Level: SATRA Jockey Vest Standard Satra doc M6”. Details of the additional Tipperary vest are provided in Table 15. The vest is pictured in Figure 16. 29 Table 15 No. 9 Specifications of the additional Tipperary Ride-Lite sample. Type of protector Jockey vest Manufacturer & Model Tipperary Ride-Lite Standard Claimed Size SATRA Jockey Vest Standard doc M6 Small Padding thickness 12.5 mm Padding Stiffness Low with firm core Figure 16 Additional Tipperary Ride-Lite sample (size small) Table 16 Vest Specimen Tipperary Tipperary Tipperary Results of Tipperary Ride Lite when tested to SATRA Jockey Vest Standard M6 Issue 5. TEST 1 (Flat Impactor, 150 mm anvil, level, 25 J) Peak Pass / force Location Fail (kN) Front, 3.95 M Centre, Top Front, Left, 5.51 M Middle Front, Right, 5.75 M Middle TEST 2 (Flat Impactor, 100 mm anvil, raised, 30 J) Peak Pass / force Location Fail (kN) Back, Left, 14.84 FAIL Middle Back, Right, 23.51 FAIL Middle Back, Right, 25.49 FAIL Middle TEST 1 AVERAGE TEST 2 AVERAGE 5.07 FAIL 21.28 FAIL TEST 3 (Narrow Bar Impactor, 150 mm anvil, raised, 15 J) Peak Pass / force Location Fail (kN) Back, Centre, 5.72 M Middle Back, Centre, 8.23 FAIL Bottom Back, Centre, 4.56 M Bottom Back, Centre, 5.61 M Top TEST 3 6.03 FAIL AVERAGE The Tipperary Ride-Lite vest failed all three tests of the SATRA Jockey Vest Standard M6 Issue 5. Padding Coverage The SATRA and ARB standards have the same required minimum padding coverage area, which is different to that specified by the European Standard. The coverage templates are pictured in Figure 17. Figure 17 Coverage area templates for SATRA and ARB Standards (left) and EN 13158 (right) 30 The manufacturer must supply size ranges for the chest circumference (A), waist circumference (B) and over the shoulder (C) measurements. The supplied jockey vest samples were of different sizes but there is some overlap in the size ranges (Table 17). There was no sizing information evident on the Descente vest sample. The dimensions of each vest were measured and the results are displayed in Table 18. Table 17 Sizing dimensions supplied with the jockey vest samples Size Chest circumference size range (A) in mm Waist circumference size range (B) in mm Over the shoulder size range (C) in mm Table 18 Tipperary Youth Medium 750 – 850 Racesafe Flat 770 – 870 Descente Large Not Specified 700 – 800 670 – 770 Not Specified Not Specified 750 – 850 Not Specified Tipperary 230 260 425 425 525 420 965 Racesafe 180 260 365 400 590 435 915 Descente 240 310 390 390 620 455 805 965 855 725 145 80 65 115 55 45 105 55 25 Dimensions of the jockey vest samples Dimensions (in mm) Width across front at mid armhole Width across back at mid armhole Length at front centre Length at front edge Length at back centre Length at back edge Max chest circumference (no padding gaps) Max waist circumference (no padding gaps) Depth of neck hole front Depth of neck hole back Width of shoulder strap All three vests have similar dimensions. The major differences are the chest circumference, waist circumference and depth of the neck hole. The Tipperary and Racesafe vests have a considerably greater circumference at the chest and waist than the Descente vest when adjusted so that there are no padding gaps on the sides. It is most likely that the Descente vest is meant to be worn with gaps in the side regions to allow for chest and waist adjustability for the wearer. At the neck hole, the Tipperary vest has a much greater depth at the front and back compared to the other vest samples. The Descente uses much softer foam around the arm and neck holes, most likely to increase wearer comfort but this foam does not offer the same protection and compromises the energy absorption properties of the vest in these areas. The European standard allows for adjustable areas on the side regions and shoulders where the vest padding can consist of two layers of overlapping 50% thickness foam. Both the Tipperary and Racesafe vests use this allowance around the sides of the vests. 31 Padding separation (Gaps) A further requirement of all three current racing standards (ARB, SATRA and EN 13158) is that there cannot be gaps between padding pieces greater than 15 mm nor can the padding pieces be easily separated to create gaps of this size. The Tipperary and Racesafe vests satisfy the gap test requirements. The Descente vest does not satisfy the gap test requirements of the current standards because of large gaps between padding pieces and there is no padding on the shoulders or behind the front zipper. As a result, the vest is considerably more flexible and comfortable for the wearer but the flexibility and large gaps also contribute to the failure of the vest in the narrow bar impact tests. The extent to which the lack of gaps in the padding is important for the protection of the jockey in racing is a question yet to be determined. Comparison with an EN 13158 Level 2 Body Protector An Airowear Level 2 vest was subjected to the same impact test protocol as the jockey vests (EN 13158 Level 1). Table 19 No. 5 EN 13158 Level 2 body protector specifications. Type of protector Equestrian vest Manufacturer & Model Airowear Swift Standard Size EN13158:200 0 Level 2 5 Padding thickness 20 mm Padding Stiffness Med Figure 18 Airowear Swift EN 13158 Level 2 body protector. Table 20 Vest EN 13158 Level 1 impact performance. TEST 1 (Flat impactor) Peak Location force Pass / Fail (kN) Airowear Back, centre, top 1.46 PASS Airowear Back, centre, middle 1.50 PASS TEST 2 (Narrow bar impactor) Peak Pass / Location force Fail (kN) Back, centre, 0.68 PASS bottom Back, centre, 0.68 PASS bottom The Level 2 vest performed well when subjected to the Level 1 impact test protocol. The vest padding is the same thickness as that in the Racesafe vest, but the padding consists of a single sheet of foam rather than a number of smaller blocks. The one piece design of the Airowear padding allows it 32 to perform considerably better in the narrow bar impact test, however the flexibility of the body protector is decreased. Comparison of Higher Level Body Protectors A number of higher protective level body protectors were tested to investigate the impact properties of alternative materials. The details of the higher level protectors tested, two EN 13158 Level 3 equestrian vests and an EN1621-2:2003 motorcycle back protector, are summarised in Table 21 and shown in Figure 19. Table 21 No. 6 7 8 High level body protector specifications. Type of protector Equestrian vest Equestrian vest Manufacturer & Model Knox Kan Teq Komperdell Cross Protection Motorcycle back Komperdell Cross protector Standard Size 2 Small Padding thickness 28 mm 22.5 mm Padding Stiffness High Medium EN13158 EN13158:200 9 EN16212:2003 Small 23 mm High Figure 19 High level body protectors (from left to right) - Knox Kan Teq, Komperdell Cross Protection vest, Komperdell Cross body protector. As shown in Table 22, the Level 3 equestrian vests performed Tests 1 and 2 well, satisfying the requirements of the standard. The Komperdell Cross had marginal performance in the flat impactor test but performed well in the narrow bar test. Table 22 EN 13158 Level 3 impact performance results. Vest TEST 1 (Flat impactor) Peak force Location (kN) Pass / Fail TEST 2 (Narrow bar impactor) Peak force Location Pass / Fail (kN) Back, centre, 2.99 PASS bottom Back, centre, 1.87 PASS middle Knox Kan Teq Back, centre, bottom 1.97 PASS Knox Kan Teq Back, centre, top 2.04 PASS Back, centre, middle 2.35 PASS Back, centre, bottom 2.08 PASS Back, centre, top 2.59 PASS Back, centre, middle 1.57 PASS Back, centre, bottom 5.00 MARGINAL 1.80 PASS Back, centre, middle 4.25 MARGINAL 2.65 PASS Komperdell Cross Protection Equestrian Vest Komperdell Cross Protection Equestrian Vest Komperdell Cross MC Back Protector Komperdell Cross MC Back Protector 33 Back, centre, middle Back, centre, bottom Temperature Sensitivity Each vest sample was conditioned for at least 4 hours in a temperature chamber at 40°C and then retested according to the original procedure. Tables 23 and 24 compare the peak force transmitted through the vest for ambient and hot conditioning. Table 23 EN 13158 Test 1 (flat impactor) ambient v hot conditioning comparison. Improved responses are indicated by (+) deteriorated responses by (-). Vest Specimen Tipperary Tipperary Racesafe Racesafe Descente Descente Komperdell Ballistic Komperdell Ballistic Airowear Airowear Knox Kan Teq Knox Kan Teq Cross Protection Equestrian Vest Cross Protection Equestrian Vest Komperdell Cross Back Protector Komperdell Cross Back Protector EN Test Level Level 1 Level 1 Level 1 Level 1 Level 1 Level 1 Level 1 Level 1 Level 1 Level 1 Level 3 Level 3 Level 3 Level 3 Level 3 Level 3 Ambient Conditioning Peak Location force (kN) Hot (40°C) Conditioning Peak Location force (kN) Back, right, 8.40 bottom Back, right, 7.55 middle Back, right, 1.77 middle Back, right, 1.97 middle Back, left, top 6.13 Back, centre, top 3.98 Back, centre, 2.86(+) bottom % Change Back, centre, bottom 9.26 Back, centre, middle 8.95 Back, centre, bottom 1.77 Back, centre, top 1.87 Back, centre, middle Back, right, top 4.19 3.78 Back, centre, middle 4.29(+) Back, centre, bottom 3.95(+) Back, left, middle 2.72(+) -31.1(+) Back, centre, top 1.46 1.33 -8.9 Back, centre, middle 1.50 1.43 -4.7 Back, centre, bottom 1.97 0.92 -53.3 Back, centre, top 2.04 Back, left, middle Back, right, middle Back, right, middle Back, centre, top 2.08 2.0 Back, centre, middle 2.35 Back, left, top 1.70 -27.7 Back, centre, top 2.59 Back, right, middle 1.84 -29.0 Back, centre, bottom 5.00(+) Back, centre, top 2.82(+) -43.6(+) Back, centre, middle 4.25(+) Back, left, middle 2.82(+) -33.6(+) 34 -9.3 -15.6 0.0 5.3 46.3 5.3 -33.3(+) Table 24 EN 13158 Test 2 (narrow bar) ambient v hot conditioning comparison. Improved responses are indicated by (+) and deteriorated responses by (-). Ambient Conditioning Peak force Location (kN) Back, centre, top 13.78 Back, left, bottom 9.63 Back, centre, bottom 1.43 Back, centre, middle 1.74 Back, centre, middle 11.06 Hot (40°C) Conditioning Peak Location force (kN) Back, right, middle 17.08 Back, right, middle 13.10 Back, left, middle 1.57 Back, right, top 1.60 Back, right, top 13.48 Back, centre, 17.80 middle Vest Specimen EN Test Level Tipperary Tipperary Racesafe Racesafe Descente Level 1 Level 1 Level 1 Level 1 Level 1 Descente Level 1 Back, left, middle 18.27 Level 1 Back, centre, top 1.77 Back, right, top 1.40 -20.9 Level 1 Back, left, middle 2.11 Back, right, middle 1.43 -32.2 Level 1 Level 1 Back, centre, bottom Back, centre, bottom 0.68(-) 0.68(-) 1.77(-) 1.57(-) 160.3(-) 130.9(-) Knox Kan Teq Level 3 Back, centre, bottom 2.99 1.94 -35.1 Knox Kan Teq Level 3 Back, centre, middle 1.87 Back, right, bottom Back, left, bottom Back, centre, middle Front, right, middle 1.77 -5.3 Level 3 Back, centre, bottom 2.08(-) Back, right, middle 13.24(-) 536.5(-) Level 3 Back, centre, middle 1.57(-) Back, right, bottom 11.13(-) 608.9(-) Level 3 Back, centre, middle 1.80 Back, centre, top 1.80 0.0 Level 3 Back, centre, bottom 2.65 Back, centre, bottom 3.16 19.2 Komperdell Ballistic Komperdell Ballistic Airowear Airowear Cross Protection Equestrian Vest Cross Protection Equestrian Vest Komperdell Cross Back Protector Komperdell Cross Back Protector % Change 23.9 36.0 9.8 -8.0 21.9 -2.6 The high test temperature had some effect on the foam materials of the body protectors. The motorcycle back protectors, Komperdell Ballistic and Komperdell Cross, had improved performance in the flat impactor test (Test 1) at the higher temperature, as indicated in green in Table 23. In contrast, the Airowear and Komperdell Cross Protection vests had worse performance after high temperature conditioning in the narrow bar impact test (Test 2), see Table 24. The stiffer foam materials that are used in the motorcycle body protectors softened in the high heat, which resulted in improved performance in the flat impactor tests, as indicated in green in Table 23. In contrast, the more compliant foams in the Airowear and Komperdell Cross Protection vests became even softer and were adversely affected in the hot condition, as indicated in red in Table 24. Even at the raised test temperature, the Airowear vest does still pass the Level 1 requirements of the standard whereas the Komperdell Cross Protection fails the Level 3 requirements following hot conditioning. 35 Discussion This part of the project involved the testing of a number of samples of jockey and general equestrian body protectors in an attempt to further investigate the effectiveness of vests in preventing injury to jockeys. The two most popular vests in racing were chosen (refer Rider Survey results (Chapter 1)), the Hows Racesafe (over 50% of NSW riders) and Phoenix Tipperary (over 50% of Victorian riders). The Hows Racesafe claims to meet the EN13158:200 Level 1 Standard, while the Phoenix Tipperary Ride Lite vests claim SATRA Jockey Vest Standard on their labelling. Some additional vest types including the Japanese Descente vest and Level 2 Airowear vest were also tested to demonstrate their protective capacities against Level 1 standards. Vests manufactured from alternative materials (the Austrian Komperdell and UK KAN vests) were also tested. The impact performance of the vests is determined by the thickness and the type of padding material. Foam absorbs energy by being compressed. If foam becomes fully compressed in an impact, it has “bottomed out” and does not provide any further energy absorption. Foam padding in protective vests must be thick enough so that it does not bottom out and transmit high forcers onto the wearer. The level of energy absorption and amount of compression is determined by the stiffness of the foam. Soft foam will crush easily but not absorb as much energy as hard foam. However, if a foam is too hard, it may not compress at all in an impact, acting as if it were rigid and transmitting the energy through. Of the two currently used vests in Australia, the Hows Racesafe performed extremely well in the testing, and due to its thickness was of a similar standard to that defined by a “Level 2” vest. However, the Tipperary performed poorly, failing all tests by a considerable margin. The European Standard requires two distinct test configurations for impact performance to be satisfied. The thickness and type of padding material must be appropriate to pass both test configurations. For the flat impact test (Test 1), the vest will fail if the padding is too thin or too soft, such as the Tipperary and Descente vests. The vest cannot be too stiff either, as was the back of the Komperdell Ballistic. However, the stiffness of the Komperdell Ballistic meant that it was able to pass the narrow bar test (Test 2). The smaller surface area of the impactor requires the vest to have a certain level of bending stiffness (Komperdell Ballistic) or increased thickness (Hows Racesafe). Again, a vest that is too soft or too thin will not pass this requirement (Tipperary and Descente). It is important to note that ARB Standard 1.1998 does not demand the narrow bar impactor test (Test 2) but only the flat impactor (Test 1) for the impact performance requirement. This removes the need for increased stiffness or thickness but the implications for injury are unknown. The suitability of the narrow bar impact test should be further discussed. A higher level test (Level 2 Airowear) was also tested to demonstrate the difference in energy absorption compared to a Level 1 vest. When tested, the Level 2 vest performed well when subjected to the Level 1 impact test protocol. The vest padding is the same thickness as that in the Racesafe vest, but the padding consists of a single sheet of foam rather than a number of smaller blocks. The one piece design of the Airowear padding allows it to perform considerably better in the narrow bar impact test, however the flexibility of the body protector is decreased. As was the case with the Komperdell Ballistic motorcycle vest/back protector, the Komperdell Cross motorcycle back protector consists of stiffer foam than the other samples. As a result, the Komperdell Cross back protector was too stiff for the flat impactor (Test 1) but performed well under the narrow bar impactor (Test 2). The Komperdell Cross Protection equestrian vest uses a damped foam material, similar to the Level 2 Airowear vest. The Cross Protection is thicker so that it passes the more severe impact energy of the 36 Level 3 requirements. The results are well below the allowable peak force for EN 13158 in both tests 1 and 2. The Knox Kan Teq vest uses polyurethane foam which is moulded into panels (two front panels, one back panel and two shoulder panels). The polyurethane is formed so that there are open and closed cells in the padding layers. The resulting panels are firm but have more compressibility upon impact compared to the motorcycle back protector foam. The protector performed well in both Tests 1 and 2 however it was also the thickest body protector at up to 28 mm. It has previously been identified that temperatures of the Australian climate can have an effect on vest materials (Gibson, 1997). In order to determine temperature sensitivity of the sample vests, the samples were also conditioned for at least 4 hours in a temperature chamber at 40°C and then retested according to the original procedure. Temperature had a noticeable effect on some of the protective foam padding materials, in some cases softening the foam due to the heat load. The high stiffness motorcycle back protectors had improved performance in the flat impactor test due to the foam softening. The impact test results in both ambient and high temperatures indicate that the current padding in motorcycle back protectors is too stiff for use in jockey vests. A reduction in stiffness would improve the performance of these protectors in the impact attenuation requirement of the European Standard EN 13158. The Airowear jockey vest and Komperdell Cross Protection equestrian vest also exhibited softening of the foam materials when heated. These vests suffered deteriorated performance in the narrow bar impact test (Test 2). The peak force transmitted through the Airowear vest more than doubled after hot conditioning however the impact test requirement of the European Standard was still easily satisfied. The peak force transmitted through the Komperdell Cross Protection vest was more than five times greater after hot conditioning changing the result for the vest from a pass to a failure. The high peak force value indicates that the vest became much too soft and most likely bottomed out in the high temperature impact. As a result of this work, in September 2013, the Australian Racing Board suspended the use by licensed jockeys, track riders and stable hands of the Tipperary Ride Lite vest. The Australian Racing Board is continuing to work with the manufacturer of the Tipperary Ride Lite vest to address safety concerns. 37 Implications The primary aim of this project was to evaluate the effectiveness of currently used safety vests in Australian Racing. A number of studies were undertaken examining the suitability of the safety vests and their protective capabilities. The initial part of this work involved a survey of jockeys and apprentice riders. The survey suggests that generally speaking, riders prefer a flexible and comfortable vest, but often will sacrifice comfort (and potentially safety) for a lighter vest due to weight restrictions. Riders in Victoria choose a more flexible, heavier vest presumably due to the extra weight allowance available in that state. NSW riders opt for the lighter weight, less flexible vest. The majority of riders would like to see more vest choices available, with improved protection, while being comfortable enough to offer the riders the flexibility required during a race and ideally vests should be available in more customised sizes. When considering design of a new or alternative vest, riders considered vest comfort and protective capabilities of utmost importance and placed little emphasis on vest price and thermal qualities. While there appeared to be a more positive attitude towards the vests, some riders voiced concerns about a perceived increase in injuries (with particular reference to neck and back fractures) and many attributed these injuries to the wearing of the vests. The results of the insurance claim data analysis did indeed reveal an increase in neck and back fractures in the years following the introduction of the vests, however there was no evidence that these types of injuries were being caused by the vests. This was supported by a corresponding increase in head and facial fractures and the observation from a Biomechanical Engineer that most of these injuries were indirectly caused by the rider taking a forward dive into the track with the head hitting the turf. It will be important to assure the riders that the vests do not appear to be contributing to these injuries to alleviate their concerns. There is a suggestion that more riders are employing a more forward riding style which involves simply placing the toes in the stirrup irons as opposed to the ball of the foot. It may be worth investigating if this change in riding style is increasing the risk for the rider taking a forward dive off the horse and contributing to these more serious types of injuries, or if other factors are involved. The review of injury causation through the analysis of race day footage carried out by Human Impact Engineering identified two types of injuries: direct injury due to impacting the track surface directly and indirect injury which usually involved multi-axial loading of the back. The direct injuries due to direct contact with the track surface may be reduced by attention to the design of the vests in this region. It is less easy to effect injury reduction with the indirect and usually more serious injuries. There is no existing protective equipment available that is able to protect the spine from these indirect injuries, which are caused by multi-axial loading of the spine and due to the significant impact of fractures, alternative equipment (such as back protectors) may be worth further investigation. A safety review conducted by the Irish Turf Club suggested that further improvements in the protection offered by the safety vest could be made if the panel covering the spinal column was strengthened, a point worth further investigation (O’Sullivan, 2004). The review of insurance claim data obtained from NSW and Victoria was complex due to the nature of the original data received. Based on using race day data only, while there has been an overall reduction in the rate of fall claims, the data suggests that the reduction in injury rates may have little to do with the introduction of the safety vests and instead may be due to other factors such as improvements in running rails and track conditions. The NSW dataset contained both race day and trackwork claims and unlike the Victorian dataset revealed no change in claim rates in the years following the introduction of the vests. This suggests that factors during trackwork (such as horse behaviour, experience, age and skill of rider and environmental conditions) are having a significant impact on the incidence of injuries and require further investigation. It may be justifiable to investigate the implementation of a safety vest offering a higher level of protection (such as a Level 2 vest or equivalent) for track work riding, especially where weight limits are not as critical. 38 The insurance claim data analysis of the NSW dataset did reveal a significant reduction in less severe injuries (sprains and strains) in the region currently protected by the vests (chest, back, ribs). Interestingly this was not the case using the race day only dataset from Victoria. The jockey survey revealed that the majority of Victorian riders wear the Tipperary vest while the majority of NSW riders wear the Hows Racesafe vest. Both these vest types were tested at Human Impact Engineering, and despite the Tipperary Ride-Lite Vest having a label affixed stating “CE CERT. #617 Performance Test Level: SATRA Jockey Vest Standard Satra doc M6”, this vest failed all three tests of the SATRA Jockey Vest Standard. A second Tipperary vest was obtained which also failed testing requirements. The test failure of a popular vest is concerning and the Australian Racing Board took the action to recall all Tipperary Ride-Lite vests and is currently investigating the issue further. It is imperative that a quality assurance surveillance system be implemented to ensure vests are continuing to meet the safety standard. Vests are routinely inspected by stewards on race days and it is also crucial that this practice is continued to ensure riders are wearing an appropriate fitting vest correctly and not altering the vests in anyway which may result in reduced protective capabilities. In comparison to the Tipperary vest, the Hows Racesafe performed extremely well during the testing and despite its light weight, this vest was on par with a Level 2 vest due to the use of a thicker foam material. Following the implementation of routine surveillance and testing of commercially available vests claiming to meet the safety standard, the performance data information should be provided to the riders so they have the opportunity to select superior vests rather than simply relying on vest manufacturers. Moving forward, the review of safety standards and safety equipment testing carried out by Human Impact Engineering identified some key factors to consider for optimising vest impact performance while being mindful of comfort and weight issues. It was suggested that the padded foam must have adequate thickness and appropriate stiffness (not too soft or too firm) to achieve the allowable impact response in both a flat impact test and a narrow bar impactor test of the European Standard. Based on the testing conducted for this project, vests made of PVC nitrile appear to require a minimum padding thickness of approximately 20mm to be effective in meeting current standard requirements as is the case for the Hows Racesafe vest. Alternative foam materials, such as in motorcycle back protectors and moulded polyurethane, can offer a similar level of protection as the current vests and some may perform better at higher temperatures. The narrow bar impact test (EN 13158 Test 2) requires a certain level of stiffness for the body protector. The ARB standard does not demand this impact test and may allow for a more flexible vest. Further investigation is required to determine the suitability of the narrow bar impact test for realistic situations. Some changes to the test methods utilised by the safety standards may be required to make the material requirements clearer for the vest designer. Some of the vest materials are sensitive to temperature, softening under heat load. It is essential that the materials be tested at a higher temperature (40°C) to ensure that appropriate materials for use in Australian summer conditions are used. The impact performance must be ensured for all temperatures at which the vest is likely to be used. Furthermore, there may be some benefit from improving the protection capability to area of the vest covering the spine. 39 Recommendations Taken together there appears to be potential for reducing injury to riders by improving the design of the vests and reviewing current safety standards. In light of the results of the investigation into the effectiveness of safety vests in Australian racing, the following recommendations were presented to the Australian Racing Board: That the Australian Racing Board: 1. Establish a list of Approved Vests under the Australian Rules of Racing in addition to the standard defined by Australian Rule of Racing 87B as an added safeguard against substandard vests; 2. Institute a system of surveillance testing (i.e. batch testing) of certified vests so as to identify any manufacturer which fails to meet the ongoing obligation for all vests to meet the standard as defined by AR 87B; 3. Identify Approved Vests under AR 87B with a highly visible microchipped label providing easy identification so as to assist Stewards in the enforcement of compliance under AR 87B; 4. Develop a safety rating scale for vests based on the results of performance testing to enable riders to make more informed decisions on which vests to acquire; 5. Recommend the use of a vest providing a higher level of protection (such as the Hows Racesafe or a Level 2 vest (e.g. Airowear vest)) for trackwork riding; 6. Initiate discussions with the manufacturer of Hows Racesafe vest (Level 1), given its superior safety performance, so as to improve the comfort of the vest by increasing the depth at the neck hole now permitted under the most recent European standard; 7. Investigate the causation of the increasing incidence of head, neck and back fractures with particular attention paid to current riding styles or practices; 8. Review current safety standards under AR 87B and specifically the relevance of the narrow bar impactor component of testing requirements as this may be leading to unnecessarily inflexible and uncomfortable vests; 9. Investigate the degree of protection offered by back protectors and alternative materials with the aim of developing a form of hybrid vest offering superior protection and comfort for riders; 10. Consider the implementation of one uniform ARB standard to assist in the design of a superior vest with a higher impact performance and level of comfort with more simplified testing requirements better suited to Australian conditions; 11. Improve communication between racing authorities and jockeys and track riders to better inform riders of the protective capabilities of the vests. N.B. At the time of submission of this report, the Australian Racing Board had commenced acting on these recommendations and had completed the first round of surveillance testing on currently used vests in racing. 40 Appendices Appendix 1 Frequency of injuries in each bodily location and injury types (expressed as a % of rider fall claims) prior to and following the introduction of the vests: Vic Data (a) Body location Head & face Neck Back Trunk Upper limbs Lower limbs Unspecified Total Count of injuries at each bodily location pre post 40 61 21 39 44 62 34 41 120 164 78 105 30 30 367 502 Injuries at each bodily location expressed as a percentage of total injuries pre post 10.9 12.2 5.7 7.8 12.0 12.4 9.3 8.2 32.7 32.7 21.3 20.9 8.2 6.0 The frequency distribution pre-vests is not significantly different to that post-vests (X2=3.39, df=6, P=0.758). As can be seen, no individual body location pre-vests differs from that post-vests. (b) Injury type Fracture Contusions and crushings Sprains/strains Intracranial injuries Other* Total Injury types expressed as a percentage of total injuries pre post 46.3 46.0 10.6 13.5 25.9 22.1 5.4 5.4 11.7 12.9 Count of injury types pre post 170 231 39 68 95 111 20 27 43 65 367 502 The frequency distribution of injury type pre-vests is not significantly different to that post-vests (X2=3.02, df=4, P=0.554). 41 Appendix 2 Frequency of injuries in each bodily location and injury types (expressed as a % of rider fall claims) prior to and following the introduction of the vests: NSW Data (a) Body location Head and face Neck + Back + Trunk Upper Limbs Lower limbs Multiple other Total Injuries at each bodily location expressed as a percentage of total injuries pre post 9.0 9.6 3.2 7.1 17.4 15.1 6.0 7.5 32.4 28.9 31.3 29.6 0.7 2.2 Count of injuries at each bodily location pre post 101 197 36 145 194 311 67 155 362 593 350 609 8 45 1118 2055 The frequency distribution pre-vests is significantly different to that post-vests (X2=39.91, df=6, P<0.001). Examining the two sets of observed frequencies it can be seen that the differences are caused by: There is a significant increase in the probability of a neck+ injury post-vests (X2=21.62, df=1, P<0.001). There is a significant increase in the probability of a Multiple other injury post-vests (X2=11.83, df=1, P<0.001). There are no significant differences in the percentages across other body locations (X2=6.42, df=4, P=0.170). 42 (b) Injury type Fractures Sprains and strains Contusions and crushings Other Intracranial Total Injury types expressed as a percentage of total injuries pre post 26.1 29.4 51.0 39.3 11.3 15.8 8.8 13.1 2.9 2.3 Count of injury types pre post 292 608 571 812 127 327 98 270 32 48 1120 2065 There is a significant difference (X2=48.95, df=4, P<0.001) in the percentages pre- and post-vests across these injuries types. There is a significant relative decrease (51% down to 39%) in “sprain and strain” injuries post-vests (X2=40.06, df=1, P<0.001). This is clearly the dominant injury type effect accounting for 40.06 of the 48.95 X2 test value. The other four injury types are not consistent (X2=8.89, df=3, P=0.031). Indeed, once sprain and strain injuries are excluded we obtain the following: Injury type Fractures Contusions and crushings Other Intracranial Total Injury types expressed as a percentage of total injuries pre post 53.2 48.5 23.1 26.1 17.9 21.5 5.8 3.8 Count of injury types pre post 292 608 127 327 98 270 32 48 549 1253 There is a decrease in the percentage of fractures (4.7%) and intracranial injuries (2.0%) and an increase in the percentages of contusions and crushings (3.0%) and other injuries (3.7%) when calculated as percentages of all injuries excluding sprains and strains. 43 Appendix 3 Jockey Injury Case Studies CASE J-01 Accident description Horse stumbles and the rider slides forward over the horse’s head, landing on the right forearm and elbow, and then rolling on the right shoulder and head onto the back. Rider continues to roll onto his knees and again falls to his right side and onto his back. The horse gets up and steps over the rider, stepping on his upper right chest with the right back hoof. Rider’s actions The rider initial fends off the ground with his arms. He appears to tuck in his arms and legs in the latter stages of the fall. Rider’s injuries Fracture to the medial aspect of the right clavicle, right chest wall bruising, soft tissue injury to the right elbow and neck. Rider was off riding for 6 weeks. Injury mechanisms In the initial fall, the rider travelled from a height of approximately 2.5 metres at an average speed of approximately 14 m/s (or 50 kph), and landed on the right elbow and shoulder. The fracture to the right clavicle may be due to this initial impact alone, or a combination of this impact and subsequently being trodden on by the horse. Comments on Protective Equipment There were no reported head injuries. Increasing the protective capabilities of the vest in the shoulder region and extending this protection down to the elbows could prevent or reduce the injuries. CASE J-02 Accident description Horse stumbles and the Rider 1 slides forward over the horse’s head, landing on his face, right shoulder and then rolling onto his mid-back. Second horse clips the heels of the first horse and stumbles. The Rider 2 holds onto the reins but is thrown off the right side of the horse and lands on his buttocks. Riders’ actions Views are unclear or obscured, however Rider 1 appears to remain in a tucked position. Riders’ injuries Rider 1 suffered a fracture to the T5 thoracic vertebra, three rib fractures, bilateral pneumothoraces and a fractured nose. Rider 2 suffered bruising to the spine at coccyx level. 44 Injury mechanisms The initial impact of Rider 1 was to the face and occurred at approximately 10 m/s (36 kph). No direct chest impact with the track surface was observed. The chest injuries may have been caused by being trampled or crushed by the following horse. The fracture to the T5 vertebra was due to combined loading, which includes compression due to head impact, frontal flexion and some rotation. Rider 2’s injuries were from direct impact with the track surface. Comments on Protective Equipment The helmet of Rider 1 did not prevent the fracture to his nose. A full face helmet in this case may have prevented this injury. The vest of Rider 1 did not prevent the chest and spinal injuries. The combined loading to the spine and hence the spinal injury could not have been prevented by an improved vest. The cause of the loading to the chest is unclear. Rider 2’s vest was not effective in protecting him from the impact to the coccyx. CASE J-03 Accident description Horse stumbles and the Rider 1 slides forward over the horse’s head, landing on his head, then his right knee. Left leg appears to remain in the stirrup as horse continues to tumble and Rider 1’s body pivots horizontally to the left about his head, horizontal arrow in still photograph below. Rider 1 continues to tumble. Second horse clips the heels of the first horse and stumbles. The Rider 2 holds onto the reins but is thrown off the left side of the horse and lands on his buttocks and/or lower legs and continues to roll forward to land on the left leg and then continues tumbling. Riders’ actions Rider 1 appears to actively tumble out of the way of the falling horse. Rider 2 appears to tuck his head in but arms and legs continue to flail. Riders’ injuries Rider 1 received fractures of the 4th to 6th thoracic vertebra and some soft tissue bruising. Rider 2 suffered minor injuries including a sore leg and ankle and soft tissue swelling of the legs. Injury mechanisms Rider 1’s injuries were a result of multi-axial loading of the spine including: • Compression due to impact to the crown • Full forward flexion at the waist • Left lateral flexion of the torso • Some rotation of the spine Rider 2’s leg injuries appear to be due to direct impact with the track surface. Comments on Protective Equipment The helmet of Rider 1 was effective in this fall as it prevented any head injuries. The combined loading to the spine and hence the spinal injury could not have been prevented by an improved vest. There is no sign that the vest in this case contributed to the injuries suffered. Rider 2 had no major impacts to the head, chest or back. 45 CASE J-04 Accident description Rider is butted into the air by the horse as it falls forward. Rider lands and goes under horse. Views of landing are obscured. Rider’s actions Unknown Rider’s injuries Loss of consciousness with fractured skull and internal head trauma (bleeding), subluxation (partial dislocation) of cervical vertebra (C2 on C3). Injury mechanisms Rider was thrown to a height of at least 3.5 m and fell at a speed of approximately 50 kph. The injuries appear to be due to direct impact between the head and the track surface. Views of the actual impact are obscured. Comments on Protective Equipment It appears that the capabilities of the helmet in this case were exceeded due to the severity of the fall. If the injuries were in fact a fracture to the base of the skull, then it is unlikely that an improved helmet would have reduced the injuries. CASE J-05 Accident description Three falls: Rider 1 falls with his horse and continues rolling as the other horses appear to run over him. Second horse stumbles over first and Rider 2 holds onto reins, falling off the horse’s side onto his legs and left side, and then rolls onto his back. He continues to roll and appears to get his head momentarily caught under the rolling horse. Third horse falls over the second and Rider 3 also holds onto reins, falling onto his right hip and rolls onto his head. His left leg appears to be caught under the horse. Riders’ actions View of Rider 1 is obscured. Other two riders continue to hold onto reins until impact with the track. Riders’ injuries Rider 1 suffered a compound fracture to the tibia and soft tissue bruising to the legs and face. Rider 2 had ligament damage to the neck, an undisplaced fracture of the spinous process of the C7 cervical vertebra, and some shoulder bruising. Rider 3 suffered a fractured tibial plateau, bruising to the left leg and a soft tissue injury to the ankle. 46 Injury mechanisms Rider 1’s injuries are most likely due to being run over by the following horses. Rider 2’s injuries may have been caused by a forced extension to the neck. Rider 3’s leg injuries may be due to direct impact with the track surface, or from having his leg trapped under the horse. Comments on Protective Equipment Views of Rider 1 were obscured. Rider 2 may have been protected from crushing injuries to the head by the helmet. CASE J-06 Accident description Rider falls off side onto his legs and hands and is violently flipped, tumbling three times and twice landing on the upper back. Cap is lost during the tumbles but helmet remains in place. Rider’s actions Rider does not appear to actively tuck his body during the fall. Rider’s injuries The rider suffered a fractured vertebra. Injury mechanisms The fractured vertebra may be due to the full extension of the neck due to the initial impact with the ground, or subsequent impacts to the back in tumbling. Comments on Protective Equipment There appears to be no significant head impact or chest impacts in this fall. CASE J-07 Accident description Horse trips and rider is flipped forward off the back of horse onto his head and upper back and tumbles. Rider is crushed by the fallen horse. Views are obscured. Rider’s actions Unknown Rider’s injuries The rider is rendered an incomplete quadriplegic from his injuries. 47 Injury mechanisms The injuries are likely to have resulted from the initial fall and impact to the upper back, or from crushing. The initial impact on the head/neck was at a vertical velocity of approximately 5 m/s or 18 kph. Comments on the Protective Equipment There are no reported head or chest injuries, which could be related to the helmet or vest effectiveness. CASE J-08 Accident description Rider falls off side of horse onto his feet and knees and then continues forward to hit head on track. Rider’s actions The rider does not appear to actively tuck his body during the tumbles. Rider’s injuries The rider suffered brain contusions and fractured cervical vertebrae (unspecified). Injury mechanisms The rider hits the track surface with his head, after initially landing on feet and legs. The motion causing the neck injury is not clear. Comments on the Protective Equipment The impact between the head and the track caused brain contusion and possibly a fractured neck. An improved helmet (thicker and softer) may have been able to reduce the brain injury. There are no reported chest injuries, which could be related to the vest effectiveness. CASE J-09 Accident description Horse trips and rider continues forward to impact face first with the track. The rider then rolls onto his back and tumbles. Views are unclear and obscured. Rider’s actions View is unclear and obscured. Rider’s injuries The rider suffered fatal head and facial injuries from the fall. 48 Injury mechanisms The horse was initially travelling at approximately 36 kph. The rider fell from a height of approximately 2.4 metres. The injuries (although not specified) are likely to be as a result of direct impact to the face. Comments on the Protective Equipment The helmet failed to prevent head injuries. An improved helmet may have been able to reduce the head injury. A chin guard may also have reduced the head and facial injuries. No reported injury in the chest region. CASE J-10 Accident description Horse falters and rider loses balance. He holds onto the reins and falls down the right side of the horse, landing flat on his back. Rider’s actions View is unclear and obscured, but he attempts to hang onto the reins. Rider’s injuries The rider suffered fractured vertebrae (unspecified) from the fall. Injury mechanisms The injury is likely to be a result of a direct impact with the back from the fall. It is unclear whether there was further tumbling and/or whether the rider was trampled by the other horses. Comments on the Protective Equipment The vest does not appear to have been effective in preventing direct impact injury to the back. CASE J-11 Accident description Horse stumbles and rider holds onto reins as he is thrown initially upwards and lands head first, then upper back and shoulders. Rider’s actions The rider holds onto the reins until impact with the turf and does not appear to prepare for the landing. Rider’s injuries The rider suffered concussion and soft tissue bruising to the shoulders and legs 49 Injury mechanisms The head injuries are from direct impact with the track. The head impact was at a vertical velocity of approximately 10 m/s or 36 kph. Comments on the Protective Equipment An improved helmet could reduce the head injury. An improved vest could reduce the shoulder bruising. CASE J-12 Accident description Multiple fall accident in which one rider jumps from the side of his horse, lands on his left side and tumbles before apparently being kicked in the left jaw. His helmet was lost. Rider’s actions The rider appeared to try to land on his feet. Rider’s injuries Rider suffered a fractured jaw and intracerebral bleeding. Injury mechanisms The rider appears to have been kicked in the left jaw. Comments on the Protective Equipment Inspection of the helmet revealed a fractured retention strap clasp located on the left side. This is the reason the helmet came off. A chin guard may have been able to reduce the injuries to the head and jaw due to the kick. CASE J-13 Accident description Horse stumbled, rider was butted forward violently off the horse and is caught in a couple of flips, landing on his lower back and legs. Rider’s actions Rider does not appear to actively tuck his arms and legs in during the fall. Rider’s injuries Rider suffered a fracture to the hip, a right rib, suffered an aggravation of a previous lumbar L5 disc injury (from 5 years prior), and a fracture of the left wrist, thumb and 5th finger. 50 Injury mechanisms The lumbar disc injury is most likely compression and flexion related. Comments on the Protective Equipment The vest was not effective in preventing the rib fracture. CASE J-14 Accident description Rider holds onto reins as he falls from the left side of the horse and lands on his feet and knees and then tumbles, landing on his forehead and chest, and then rolling onto his back. Riders’ actions Rider tried to keep hold of the reins. No attempt to use a tuck position in the fall. Riders’ injuries Rider suffered a fracture through the body and lamina of the C2 cervical vertebra Injury mechanisms The impact to the forehead caused a hyperextension to the neck as the rest of the body fell, and is likely to have caused the fracture at C2. Comments on the Protective Equipment No head or chest injuries reported. CASE J-15 Accident description Horse stumbles and veers right, throwing rider off the left side. Rider holds onto reins, trying to step down, lands on his back, with heavy impact to the back of his head. Rider’s actions Rider attempts to hang onto the reins. No attempt to take a tuck position. Rider’s injuries The rider suffered a concussion with no loss of consciousness. Injury mechanisms Head injury due to the impact to the back of the head with the track surface. Comments on the Protective Equipment An improved helmet may have been able to reduce the likelihood of concussion. 51 CASE J-16 Accident description Horse pulls up, rider comes off the left side and tries to hold onto the reins. Lands on his feet and fell onto his back. He was then kicked or trampled by the hind legs of his own horse or by the following horse. Rider’s cap was lost but helmet remained in place. Rider’s actions The rider holds onto the reins and is not prepared for a fall. There is no evidence of tucking. Rider’s injuries The rider suffered a laceration to the forehead (eyebrow to hairline) and lips. Injury mechanisms Inspection of the helmet showed a crushed area of the liner in the region of the forehead. There was 60 mm vertical indentation in the shell at the back of the head (parietal area) with a matching fracture of the liner, indicating a kick. Inspection of the goggles worn shows an indentation in the right eye area. The laceration to the forehead indicates that the helmet was displaced during the impact. Comments on the Protective Equipment No chest injury reported. The helmet appears to have been effective in preventing head injury. The helmet was effective in two ways, with adequate energy absorption in the forehead area and sufficient shell stiffness and energy absorption in the rear. The provision of a chin guard may have been able to reduce the facial injury. The soft goggles received an impact, but no eye injury resulted. CASE J-17 Accident description Horse stumbles and rider moves forward over the head of the horse and appears to impact the track surface face and head first. Rider’s actions The rider has no time to react. Rider’s injuries The rider suffered fatal head injuries including massive intracerebral bleeding. Injury mechanisms The helmet appears to remain in place. More injury details are required before it is possible to comment regarding injury mechanisms. Comments on the Protective Equipment No reported chest injury. Insufficient detail in the head injuries to be able comment on the helmet effectiveness. 52 Appendix 4 Comparison of Jockey Vest Standards JOCKEY VEST STANDARDS SATRA M6 (1997) ARB Standard Issue 1, 1998 BETA 2000/ EN 13158:2000 100+/-1mm diam., 150+/5mm radius dome 100+/-1mm diam., 150+/5mm radius dome 100+/-1mm diam., 150+/5mm radius dome ID: 120+/-2mm, wall thickness 20+/-1mm ID: 120+/-2mm, wall thickness 20+/-1mm ID: 120+/-2mm, wall thickness 20+/-1mm 80+/-2mm diam., 5000+/50g (80+/-2)x(20+/-1) mm, 0.5mm radius corners, 2500+/-25g 80+/-2mm diam., 5000+/50g (80+/-2)x(20+/-1) mm, 0.5mm radius corners, 2500+/-25g 80+/-2mm diam., 0.5+/0.1mm radii, 2500+/-25g (80+/-2)x(20+/-1) mm, 0.5+/-0.1mm radius corners, 2500+/-25g Test 1 25 J, flat impactor on anvil, guard ring 0+/0.5mm above anvil 25 J, flat impactor on anvil, guard ring 0+/0.5mm above anvil Flat impactor on anvil, guard ring 0+/-0.2mm above anvil: Level 1- 25J, Level 2- 30J, Level 3- 35J Test 2 30 J, flat impactor on anvil, guard ring 10+/0.5mm above anvil Impact Test Equipment Anvil Guard ring Flat impactor Narrow bar impactor Impact Test Configuration Test 3 No. of impact points per sample Impact Test Criteria Max. average peak transmitted force (kN) Max. transmitted force (kN) Conditioning Padding Gap Test Lower bar Upper bar Fixings/Restraint Test Pull test Coverage – refer document page 36 Sizing Dimensions Narrow impactor on anvil, guard ring 10+/-0.2mm above anvil: Level 1- 20J, Level 2- 32.5J, Level 345J 15 J, narrow impactor on anvil, guard ring 10+/0.5mm above anvil 10 10 6 4 4 4 6 Samples washed as per instructions, conditioned @20+/-2 deg C, 65+/-5% RH for 24 hrs, tested within 10 minutes 6 Samples washed as per instructions, conditioned @ i) 20+/-2 deg C, 4hrs; ii) 40+/-2 deg C, 4hrs; Water immersion @ 10 to 30 deg C, 4hrs 6 Samples washed 5x as per instructions, conditioned @i) 20+/-2 deg C, 65+/5% RH for 48hrs; ii) 30+/2 deg C for 48hrs if specified for use under high ambient temps. W(15+/-1)xL(45+/2)xD(70+/-2) mm W(15+/-1)xL(45+/2)xD(70+/-2) mm W(15+/-1)xL(45+/2)xD(70+/-2) mm W(15+/-1)xL(45+/2)xD(55+/-2) mm, 2.55+/0.05kg W(15+/-1)xL(45+/2)xD(55+/-2) mm, 2.55+/0.05kg Similar to lower bar with mass 2.55+/-0.05kg Gradual 25N held for 10 seconds Gradual 25N held for 10 seconds i) 50N at midpoint of adjustment, ii) 10N at widest setting See diagram See diagram 53 See diagram See diagram See diagram See diagram References Byrd, J.W. (1993). Risk factors of head and neck injuries in equestrian activities. American Medical Equestrian Association News, 3. Edixhoven, P., Sinha, S. C. & Dandy, D. J. (1981). Horse Injuries. Injury 12, 279-282. Foote, C.E, McIntosh, A., V'Landys. P., Bulloch, K. (2011). Health and Safety in Australian Racing. RIRDC Publication No 10/067. Gibson, T. (1997). Protective vests for jockeys. Human Impact Engineering R97-01. Hitchens, P. L., Blizzard, C. L., Jones, G., Day, L. M. & Fell, J. (2009). The incidence of race-day jockey falls in Australia, 2002-2006. Medical Journal of Australia. 190, 83-86. Kroell, C.K., Schneider, D.C., Nahum, A.M. (1974). Impact tolerance and response to the human thorax II. Proceedings of the 18th Stapp Car Crash Conference, SAE 741187, pp 383-457. McLean, J. (2004). Assessment of protective jockey vests. RIRDC Publication No W04/190. O'Sullivan, D (2004). Turf Club Safety Review Group. Report and Recommendations. http://www.docstoc.com/docs/88327929/TURF-CLUB-SAFETY-REVIEW-GROUP-Reportand-Recommendations Press, J. M., Davis, P. D., Wiesner, S. L., Heinemann, A. & Semik, P. A., R.G. (1995). The national jockey injury study: an analysis of injuries to professional horse-racing jockeys. Clinical Journal of Sports Medicine 5, 236-240. Turner, M., McCrory, P. & Halley, W. (2002). Injuries in professional horse racing in Great Britain and the Republic of Ireland during 1992-2000. British Journal of Sports Medicine 36, 403409. Waller, A. E., Daniels, J. L., Weaver, N. L. & Robinson, P. (2000). Jockey injuries in the United States. Journal of American Medical Association 283, 1326-1328. Whitesel, J. (1976). How jockeys get hurt in thoroughbred racing. Physician and Sports Medicine 4, 67-69. 54 Evaluation of safety vests By Foote, C.E., Gibson, T.J. and McGauran, P.J. Pub. No. 14/037 Jockey safety is of paramount importance to the Australian horse racing industry and the equipment available to jockeys must find a balance between offering effective protection and being comfortable. Compulsory for jockeys and trackwork riders since 1998, safety vests are now an established part of the kit worn by jockeys. This study aimed to investigate the effectiveness of existing safety vests for jockeys and trackwork riders in Australia. The adoption of this report’s research findings will make longlasting improvements to the safety of jockeys and trackwork riders in Australia. RIRDC is a partnership between government and industry to invest in R&D for more productive and sustainable rural industries. We invest in new and emerging rural industries, a suite of established rural industries and national rural issues. Most of the information we produce can be downloaded for free or purchased from our website <www.rirdc.gov.au>. RIRDC books can also be purchased by phoning 1300 634 313 for a local call fee. Phone: 02 6271 4100 Fax: 02 6271 4199 Bookshop: 1300 634 313 Email: [email protected] Postal Address:PO Box 4776, Kingston ACT 2604 Street Address:Level 2, 15 National Circuit, Barton ACT 2600 www.rirdc.gov.au