Objectives This study aimed to: 1) examine fall and injury incidence in Irish horseracing between 2016 and 2024, 2) establish injury characteristics, 3) compare incidence rates between professional and amateur racing and 4) investigate changes in incidence rates over time. Design Descriptive epidemiology study. Methods Fall and injury data was recorded by Irish Horseracing Regulatory Board (IHRB)-appointed medical doctors using a standardised injury report form at every Irish race meeting between 2016 and 2024. Fall and injury incidence, injury location and type of injury were reported with 95% Confidence Intervals (CIs) between 2016 and 2024. Incidence Rate Ratios (IRRs) and 95% CIs were calculated 1) between jump, flat and amateur racing, 2) over the course of the study (2016-2024), and 3) between the previous (2007-2016) and current (2016-2024) study. Results Amateurs had the highest fall incidence across Irish horseracing (110/1000 rides), whilst jump jockeys had the highest total injury incidence (8/1000 rides), and flat jockeys had the highest injury incidence per fall (294/1000 falls). Amateurs had the highest fracture (3/1000 rides) and concussion (1/1000 rides) rates, whilst flat jockeys had the highest fracture (67/1000 falls) and concussion (59/1000 falls) rates per fall. Over the course of the study (2016-2024), there was a 7% decrease in injuries/1000 falls in jump (IRR 0.93, p<0.001) and a 10% decrease in flat (IRR 0.89, p=0.003) racing. Falls and injuries decreased across all Irish horseracing since the previous study (7-28%). The upper limb was most commonly injured in jump (34%) and amateur (57%) racing, and the lower limb (30%) in flat racing. Contusions were most common in jump (33%) and flat (32%) racing, whilst fractures were most common in amateur (49%) racing. Conclusions Fall and injury risk varies between types of horseracing, with amateurs at a higher risk of falling, jump jockeys at a higher risk of injury, and flat jockeys at a higher risk of becoming injured as a result of a fall. Injury rates have decreased in professional racing over the course of the study, which could be a result of new safety interventions. However, more targeted approaches may be needed to address persistent injury risk in amateur racing. Amateurs also had the highest proportion of serious injuries such as fractures and concussions, highlighting the need for greater attention towards amateurs. Practical implications • There have been minimal changes in fall incidence over the course of this study, indicating that current fall prevention strategies may no longer yield additional reductions. This highlights the need for the development and implementation of new fall prevention strategies to reduce the risk of falls and subsequently, reduce injury risk. • Total injury incidence decreased in professional racing from 2016 to 2024, however more emphasis should be focused towards reducing injuries in amateur racing in order to see the same results. • The reduction in injuries in professional racing may suggest that new safety measures have been successful, highlighting the importance of monitoring incidence rates to inform future injury prevention strategies. • The majority of injuries reported in amateur racing were fractures, highlighting a potential issue with underreporting of minor injuries, or simply that amateur jockeys are more susceptible to fractures due to their levels of physical conditioning.
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