injury is being kicked by a horse, which may cause skull fractures or severe trauma to the internal organs. Some possible injuries resulting from horse riding, with the percent indicating the amounts in relation to all injuries as reported by a New Zealand study, include: Arm fracture or dislocation (31%) Head injury (21%) Leg fracture or dislocation (15%) Chest injury (33%) Among 36 members and employees of the Hong Kong Jockey Club who were seen in a trauma center during a period of 5 years, 24 fell from horses and 11 were kicked by the horse. Injuries comprised: 18 torso; 11 head, face or neck; and 11 limb. The authors of this study recommend that helmets, face shields and body protectors be worn when riding or handling horses. In New South Wales, Australia, a study of equestrians seen at one hospital over a 6-year period found that 81% were wearing a helmet at the time of injury, and that helmet use both increased over time and was correlated with a lower rate of admission. In the second half of the study period, of the equestrians seen at a hospital, only 14% were admitted. In contrast, a study of child equestrians seen at a hospital emergency department in Adelaide reported that 60% were admitted. In the United States, an analysis of National Electronic Injury Surveillance System (NEISS) data performed by the Equestrian Medical Safety Association studied 78,279 horse-related injuries in 2007: "The most common injuries included fractures (28.5%); contusions/abrasions (28.3%); strain/sprain (14.5%); internal injury (8.1%); lacerations (5.7%); concussions (4.6%); dislocations (1.9%); and hematomas (1.2%). Most frequent injury sites are the lower trunk (19.6%); head (15.0%); upper trunk (13.4%); shoulder (8.2%); and wrist (6.8%). Within this study patients were treated and released (86.2%), were hospitalized (8.7%), were transferred (3.6%), left without being treated (0.8%), remained for observation (0.6%) and arrived at the hospital deceased (0.1%)." Head injuries Horseback riding is one of the most dangerous sports, especially in relation to head injury. Statistics from the United States, for example, indicate that about 30 million people ride horses annually. On average, about 67,000 people are admitted to the hospital each year from injuries sustained while working with horses. 15,000 of those admittances are from traumatic brain injuries. Of those, about 60 die each year from their brain injuries. Studies have found horseback riding to be more dangerous than several sports, including skiing, auto