Equine vets in danger [H&H VIP]

  • Vet students have been warned by the equine veterinary professional body to think seriously before specialising in horses, now that equine practice is officially labelled the most injurious civilian profession.

    This pessimistic recommendation came from British Equine Veterinary Association (BEVA) former president Keith Chandler, after an extensive study published last week (11 September) showed that horse vets are substantially more likely to sustain injury at work than firefighters, policemen, shipbuilders or members of the prison service —and are notably lacking in health and safety awareness.

    In 2013, before the study, BEVA wrote to veterinary schools highlighting the worrying restriction in employment opportunities in equine practice. Now BEVA is further underlining the downside.

    This week Mr Chandler told H&H: “Last year, we identified there were very few jobs compared with the numbers of graduates who expressed an interest. We are proud that so many young people want to work in equine practice, but they need to be aware of the restricted employment opportunities and the risk of injury.”

    BEVA commissioned the study from the Institute of Health and Wellbeing and the University of Glasgow’s veterinary school, whose lead researcher Tim Parkin described it as a “wake-up call”.

    Hind legs do the most damage

    Anecdotal information had long suggested that horse vets are frequently hurt and occasionally killed. But the prevalence and type of injury had never been documented, so 25% of BEVA members completed an extensive questionnaire.

    An estimated 164 of the 620 respondents were hurt per year. Even if the remaining 75% of BEVA members had “improbably” never been hurt, the study extrapolated a pro-rata equivalent to more than 5,400 injuries per 100,000 persons per year.

    In a 30-year career, horse vets can expect seven to eight injuries serious enough to lose working days.

    A horse’s hind limbs are the most lethal, accounting for 49% of reported injuries. Vets’ legs (29%) and heads (23%) were the most common targets.

    Mr Chandler said: “Of greatest concern is the number who suffered head injuries and unconsciousness. These injuries appeared more common during certain procedures, such as endoscopy of the upper respiratory tract, when vets are often only partly sighted while using examination equipment, or during wound management and bandage changes, where vets are often crouching for long periods.”

    Many of the most severe injuries occurred when the vet was treating a pleasure horse handled by the owner or client.

    BEVA compared its findings with data for other professions, held by the Health and Safety Executive (HSE), with whom BEVA is now working to mitigate risk.

    Only 37% of respondents had ever completed an accident report form and only 14% reported injuries to the HSE, even though 44% had been unable to return to work promptly.

    The study also noted: “In this industry, where it would appear that there was a relative lack of health and safety awareness, it is possible that there was considerable under-reporting and it is noteworthy that 23% of injuries required hospital treatment.”

    Personal health insurance and income protection policies tailored to vets is a new concept.

    “There is no requirement to take out personal insurance, but practices have to take out public liability insurance, as all businesses do. The question is less about insurance and more about raising awareness as a first step,” Mr Chandler told H&H.

    A sometimes fatal profession

    BEVA’s 44-page report mentions no victims by name, although accidents often make the news.

    Irish vet Gerard Long died after being kicked in the head in May this year. He is one of nine vets now identified by their still active colleagues to have died in work-related accidents.

    In 2008, former British eventing team vet Bob Baskerville needed facial reconstructive surgery after being kicked when preparing to treat the hind fetlock of a sedated two-year-old in the relative safety of his clinic.

    Racing and eventing vet Mark Lucey still has an impaired kidney, ruptured 25 years ago when kicked while pregnancy-testing a docile mare known to his practice.

    One Newmarket vet, who preferred not to be named, said: “My most dangerous daily encounter is dealing with foot lameness in foals, weanlings and yearlings. Apart from being trodden on, the greatest risks are potentially lethal or disfiguring kicks to the face and upper body. In some practices, vets now wear helmets when digging pus out of feet or doing nerve or joint-blocks.

    “Prevention is the best cure: experienced handlers, sedation and suitable facilities — examination stocks etc — are essential, although obviously not always possible.

    Other restraining methods such as twitching are very useful but must be used judiciously. A horse exploding off a twitch is very dangerous.”

    Mr Lucey thinks owners misunderstand the purpose and efficacy of sedation.

    “I went to take stitches out of an eventer sutured 10 days before for a small laceration inside the stifle area,” he said. “I did dope it, as it was known to be a bit difficult. It looked very sleepy. The horse woke up suddenly and exploded and I ended up in the straw with the scissors embedded in my arm.

    “Sedated horses can still react to painful stimuli and, because they are sedated, seem to summon up more power to overcome the sedation — hence they move very quickly. Sedatives are not painkillers.

    “Also we vets — possibly because we think we have sedated them satisfactorily — tend to take more risks or stand in more dangerous positions. Sedation affects some horses more than others, so it’s very difficult to give average dose rates.”

    Most risky professions *

    • Equine vet 5,467 injurious accidents per 100,000 persons
    • Prison service 3,576
    • Fireman 2,379
    • Police officer 1,583
    • Forestry worker 1,490
    • Construction 995
    • Farm worker 432
    • Non equine-specialist vet 215

    *all figures adjusted pro rata

    Most risky procedures

    • Foot lameness 11.3% of reported accidents
    • Dental exam 6.8%
    • Female reproductive exam 6%
    • Distal limb nerve block 5.3%
    • Minor surgery 5.3%
    • Bandage or wound dressing 4.9%
    • IV injection or blood sampling 4.1%
    • Standing castration 4.1%
    This news story was first published in H&H magazine on 18 September 2014