5.6 times higher for younger children, but that riding a horse was less risky than riding a moped. In Victoria, Australia, a search of state records found that equestrian sports had the third highest incidence of serious injury, after motor sports and power boating. In Greece, an analysis of a national registry estimated the incidence of equestrian injury to be 21 per 100,000 person-years for farming and equestrian sports combined, and 160 times higher for horse racing personnel. Other findings noted that helmets likely prevent traumatic brain injuries. In the United States each year an estimated 30 million people ride horses, resulting in 50,000 emergency department visits (1 visit per 600 riders per year). A survey of 679 equestrians in Oregon, Washington and Idaho estimated that at some time in their equestrian career one in five will be seriously injured, resulting in hospitalization, surgery or long-term disability. Among survey respondents, novice equestrians had an incidence of any injury that was threefold over intermediates, fivefold over advanced equestrians, and nearly eightfold over professionals. Approximately 100 hours of experience are required to achieve a substantial decline in the risk of injury. The survey authors conclude that efforts to prevent equestrian injury should focus on novice equestrians. Mechanisms of injury The most common injury is falling from the horse, followed by being kicked, trampled and bitten. About 3 out of 4 injuries are due to falling, broadly defined. A broad definition of falling often includes being crushed and being thrown from the horse, but when reported separately each of these mechanisms may be more common than being kicked. Types and severity of injury In Canada, a 10-year study of trauma center patients injured while riding reported that although 48% had suffered head injuries, only 9% of these riders had been wearing helmets at the time of their accident. Other injuries involved the chest (54%), abdomen (22%) and extremities (17%). A German study reported that injuries in horse riding are rare compared to other sports, but when they occur they are severe. Specifically, they found that 40% of horse riding injuries were fractures, and only 15% were sprains. Furthermore, the study noted that in Germany, one quarter of all sport related fatalities are caused by horse riding. Most horse related injuries are a result of falling from a horse, which is the cause of 60–80% of all such reported injuries. Another common cause of