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EQUINE VETERINARY EDUCATION / AE / APRIL 2018


reason, it is clear that greater awareness of injury risk, particularly early in one’s career, is important. Although this current study identified a list of procedures


most commonly associated with injury, it is important to recognise that this should not be taken to mean that other procedures are not risky. This list, at least to some extent, simply represents the common procedures undertaken by equine veterinary surgeons. A control population of uninjured veterinary surgeons was not available to enable an analysis of different procedures as risk factors for injury, so it would be unwise to only focus on the procedures listed as risky in this work. It is much more important that the message is reiterated that simply working as an equine veterinary surgeon, in close proximity to horses, is risky. It might be an obvious statement to make but given the severity of some injuries it is important to reiterate this fact. A common method of reporting accident risks by


occupational group is that of accident rates where the number of individuals injured per 100,000 employees per year is estimated. In this study, we have estimated that each veterinary surgeon in equine practice would sustain an injury every 3 years 7 months (0.27 injuries per year). This equates to approximately 27,000 injuries per 100,000 employees per annum. Even if we assume all nonrespondents to the survey had experienced no injuries, which is highly improbable, and that there are currently approximately 3000 veterinary surgeons engaged in equine practice in the UK, the accident rate is still approximately 5,400 per 100,000 per annum. Even at the lower estimate, comparison with the actively acquired annual Labour Force Survey data (http://www.hse.gov.uk/sta tistics/lfs/index.htm#allinjuries) indicates that equine veterinary practice is one of the most hazardous civilian occupations: equivalent figures for Prison Service personnel (below principal officer) – 10,760 per 100,000 pa; Police (Sergeant and below) – 8700; Welding and metal formers – 6980; Skilled construction workers – 4760 and Farm workers – 4620). The significant lack of reporting to the Health and Safety


Executive is of concern. However, it is now critical that a spotlight is shone on the risks associated with equine practice as the consequences for some are extremely serious. It is obvious that risk cannot be completely eliminated.


The work requires close handling of large, heavy animals, often behaving unpredictably, who may be distressed and in pain. Direct observation of the working environment, by the authors at the Weipers Centre Equine Hospital, confirms that animal handlers adopt a manner of easy confidence and intimacy with the horse, as a means of reassurance to the animal, but clearly more safeguards are required. Of concern is the incidence of serious injuries such as


fractures, head injury, unconsciousness, loss of vision, and the anecdotal accounts of veterinary surgeons who have had to give up practice, or move to less physically demanding work. This study confirms that equine veterinary work is inherently dangerous, is associated with an unacceptable risk of injury and that preventive measures are urgently required to improve the safety of the workforce. Equine practice requires adoption of the principles of health and safety management and risk minimisation to a much greater degree than is currently the case. While some procedures are less risky than others, in general most of the equine-related activities routinely undertaken by equine veterinary surgeons are associated with risk and generic health and safety measures are required.


© 2018 EVJ Ltd


Health and safety legislation requires employers to take


whatever steps are necessary to ensure the safety and health of workers and to have a health and safety management system that incorporates risk assessment, risk management and monitoring procedures. All practitioners and employers should consider the


following guiding principles throughout the risk assessment process:


Step 1. Identifying hazards and those at risk This study has identified high levels of risk of injury and some activities that may be associated with greater risk, and that equine veterinary surgeons, and most probably other equine handlers, are at risk.


Step 2. Evaluating and prioritising risks Estimating the existing risks (their severity and their probability) and prioritising them in order of importance. It is essential that the work required to eliminate or prevent risks is prioritised.


Step 3. Deciding on preventive action Identifying the appropriate measures to eliminate or control the risks. The issue of whether to sedate or not sedate horses undergoing procedures was one of the reasons for this study and the evidence would support the selective use of sedation. Workplace layout and organisation is important but may be a factor outside of the veterinary surgeon’s control when attending a distressed animal in a field or stables. A detailed analysis of high risk activities and the development of guidelines and standard operating procedures, based on best available knowledge and evidence, aimed at minimising risk are required. Personal protective equipment (PPE) may need to be


worn in some circumstances and could include safety footwear, gloves, protective helmets, eye protection and personal protective clothing. However, it is much more appropriate to avoid risky situations or modify a risky environment such that PPE is used as a last resort where risk cannot be minimised.


Step 4. Taking action All equine workers require training in safe handling of horses and injury prevention, risk assessment and the use of PPE. The implementation of preventive and protective measures through a prioritisation plan and specifying who does what and when, when a task is to be completed and the means allocated to implement the measures is a critical step in work aimed at minimising workplace injury.


Step 5. Monitoring and reviewing The impact of the preventive measures must be monitored to ensure compliance with safe working procedures, accurately recording and reporting of injuries and minor incidents and also importantly ‘near miss’ events. Training of students and all staff should occur regularly. Performance with regard to health and safety should be regularly reviewed and the philosophy should be that of continuous improvement.


Limitations of this work The study was not designed to identify risk factors for injury and this might be the next logical research direction for this work, but this would ideally require a reasonably large cohort


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