Air Vests: Has any research been performed yet?

[KellyS]

The AiroWear Ayr vest thread brought this question to mind as I know this has been an ongoing conversation here. As far as I can find, there are no data or studies available to actually demonstrate that air vests provide superior protection compared with a regular approved safety vest.

I tried several keyword searches on PubMed, but the only study on vests was a 2012 study that looked at pediatric torso injuries and regular safety vests (see below).

Air vests have been out for several years now. I find it surprising that none of the companies has invested in actual research. Do they feel people will just continue to buy them if upper level riders wear them? Are the air vests gaining in popularity or is their use about the same or is it dwindling?

Klin Padiatr. 2012 Nov;224(7):443-7.

Effectiveness of safety vests in pediatric horseback riding.

Hessler C1, Eckert V, Vettorazzi E, Meenen N, Jürgens C, Schult M, Flamme C, Herberhold HJ, Madert J, Ekkernkamp A, Lockemann U, Püschel K, Pohlenz P.

Abstract
BACKGROUND:
Despite the benefit of safety vests to the reduction of torso injuries in children and adolescents is unclear, its’ use is recommended. The aim of the present study is to determine the effectiveness of safety vests actually used in pediatric equestrian activities.

PATIENTS AND METHOD:
In this case-control-study, we analyzed the accidents of 92 riders aged 18 or younger who fell off a horse onto his/her torso during a period of 18 months. Data were gathered from the clinical records. Additionally, a questionnaire was administered on the day of trauma by the patients and/or their parents.

RESULTS:
The cases comprised 31 patients who sustained torso injuries. The controls were 61 riders with injuries of other body parts than to the torso. Safety vest use was not associated with a lower risk of torso injuries (OR=1.18, 95% CI (0.50, 2.81), p=0.707). Post hoc power analysis revealed that within such a setting an odds ratio of 0.266 could be found with a power of 80%.

CONCLUSION:
This study is not able to show an association between wearing a torso protector and protection from torso injuries, probably due to confounding. We did not detect a high effect of safety vest usage in our study population. Whether the development of a new generation of safety vests might be more effective remains unclear. An effective vest should be adapted to the requirements of children and adolescents and should protect the thorax and abdomen, but also the cervical and the lumbar spine.

[Jealoushe]

Very very sad, that air vests have not been required to do testing, and yet are promoted by the National governing bodies, and also riders everywhere.

I asked the Hit Air sales rep if he could provide me with research, and sent me some motorcycle research. I requested actual research on their vest, with riders. Conclusion - there is none.

How a safety device company gets away with selling these legally is beyond me.

[KellyS]

@Jealoushe

Very very sad, that air vests have not been required to do testing, and yet are promoted by the National governing bodies, and also riders everywhere.

I asked the Hit Air sales rep if he could provide me with research, and sent me some motorcycle research. I requested actual research on their vest, with riders. Conclusion - there is none.

How a safety device company gets away with selling these legally is beyond me.

Yes, I did a keyword search on “Equestrian Helmets” on PubMed, and 3 pages of studies came up, with the latest being this year. Clearly the people are out there who evaluate this information and could do a study, but the air vest companies clearly have no interest.

It is so short-sighted because if they produced successful, peer-reviewed research, they would only increase their sales, However, if they are worried the research won’t support their claims, it explains why it has not been pursued.

Or, it’s simply a matter of money–if people will buy the vest without the research, why spend significant funds to pursue it?

The air vests seemed to be the big thing a few years ago, and I’m curious what the feeling is about them now.

[Guyot]

It’s been years now since I evented but I never wanted an air vest. I saw them and tried one on when they first came out, but the idea of adding one more thing to have to happen in the event of a fall across country seemed one extra thing to go wrong.

When I did some checking back then online and there were videos of people dangling off their horses attached by the vest. I know that the fail rate is low but it’s not gone 100%.

Eventers are often called, by others, crazy for galloping at speed at a large fence that doesn’t fall down. Call me crazy but the thought of then TYING myself to my horse, hoping the vest gets a clean break, seemed pretty much to fit the term of crazy! Of course I’ve never had any luck… other views may vary!

[CindyCRNA]

I love mine but no scientific evidence here. I tend to land on my back and the neck roll has kept the back of my head from hitting the ground. I saw an accident of someone who landed on their sacrum and their upper body continued the motion and impacted the back of her head, sustaining a concussion. I am 100% certain an air vest would have prevented that concussion just by the way she hit. But a lot of people fall different ways that it may not help. I wish the neck roll came up even further in the back and wrapped a little more around the ears.

[Winding_Down]

@KellyS

Yes, I did a keyword search on “Equestrian Helmets” on PubMed, and 3 pages of studies came up, with the latest being this year. Clearly the people are out there who evaluate this information and could do a study, but the air vest companies clearly have no interest.

It is so short-sighted because if they produced successful, peer-reviewed research, they would only increase their sales, However, if they are worried the research won’t support their claims, it explains why it has not been pursued.

Or, it’s simply a matter of money–if people will buy the vest without the research, why spend significant funds to pursue it?

The air vests seemed to be the big thing a few years ago, and I’m curious what the feeling is about them now.

I am not so sure that the air vest companies have no interest. I can only imagine how very expensive air vest research would be, especially in comparison to helmet testing. Of course, there is a plethora of research on air vests in the motocross industry but that research is supported by a much larger market.

I hesitate to infer that the companies are “short-sighted,” “worried the research won’t support their claims,” or “have no interest.”

On the face of it, I would guess that the research isn’t there simply because the companies cannot afford to do the research. So they rely on research from other disciplines in which people use air vests.

[Jersey_Fresh]

@Winding Down

I am not so sure that the air vest companies have no interest. I can only imagine how very expensive air vest research would be, especially in comparison to helmet testing. Of course, there is a plethora of research on air vests in the motocross industry but that research is supported by a much larger market.

I hesitate to infer that the companies are “worried the research won’t support their claims,” or that they “have no interest.” On the face of it, I would guess that the research isn’t there simply because the companies cannot afford to do the research. So they rely on research from other disciplines in which people use air vests.

This. Because of the factors that can influence injury rate with a fall from a horse, this could be a very large, very expensive study to conduct.

[Winding_Down]

@Jersey Fresh

This. Because of the factors that can influence injury rate with a fall from a horse, this could be a very large, very expensive study to conduct.

@Jersey Fresh I have always seen this as an obvious explanation, but I am not any sort of expert on these sorts of studies. It seems that drawing analogies with/to helmet studies is not accurate insofar as the latter probably do not require the expense to study; and the latter most likely have larger sales market, and resultant funds.

This could be an excellent grant proposal for researchers who have the expertise but thus far, I have not heard of interest. Of course, I suspect that the grant funds would have to be huge.

[Jealoushe]

Why are they not required to though, if they are marketed as a safety device? Are there not government guidelines that would require this?

From purely observation, rate of lung and collar injuries seem to increase with the use of an air vest. That is just anecdotal evidence I have seen.

[KellyS]

The thing is, there is funding available for research, if you’re willing to do a little research into it and write a grant proposal.

One place to start:

http://oedb.org/ilibrarian/100_place…your_research/

These air vests are supposed to save people from lethal injuries…I think the excuse that it’s too expensive to do research is not only a poor one, but also irresponsible.

How much money have the companies made selling the vests based on their assurances that the vests prevent certain injuries but with no proof at all other than anecdotal evidence?

The companies could even collaborate to fund a study together, if the best interests of the riders using their vests was at the forefront, but I don’t think this is going to happen.

[Jersey_Fresh]

@Winding Down

@Jersey Fresh I have always seen this as an obvious explanation, but I am not any sort of expert on these sorts of studies. It seems that drawing analogies with/to helmet studies is not accurate insofar as the latter probably do not require the expense to study; and the latter most likely have larger sales market, and resultant funds.

This could be an excellent grant proposal for researchers who have the expertise but thus far, I have not heard of interest. Of course, I suspect that the grant funds would have to be huge.

I think so too.

The problem is the more compounding factors and outside influences, the bigger the n per a treatment needs to be. In the case of an air vest study, those influences can be anything from the size of the horse, the pace before the fall, the type of fall, the weight of the rider,etc. By the time you narrow that down, you really don’t have that big of a population to study. And unfortunately, I am not sure a lab model would work. We are lucky that helmet safety research and testing is applicable to a much broader audience so there are funds for it. I would also think that helmet research models are a bit more generalized and the same tests can be used for motorcycle/biking/skiing/riding/etc with smaller modifications like force of impact. But with an air vest, a model used for say a motorcycle rider couldn’t be used for a rider because the motorcyclist doesn’t have to factor in say a 1200 lb horse flipping on top of him/her.

This is further complicated by the fact that studies funded by manufacturer’s are often viewed as biased by the general public so to truly get a study that people will accept the results of you need an outside agency like ASTM or a USEA to do it.

I do think the studies would answer a lot of questions and could help improve the safety and design of these vests. Anything that could help decrease the chances of injury or fatalities wold really help our sport.

[Jealoushe]

@Jersey Fresh

I do think the studies would answer a lot of questions and could help improve the safety and design of these vests. Anything that could help decrease the chances of injury or fatalities wold really help our sport.

Yes exactly. Perhaps some money from these research funds could go to vest studies…not just air vests. If there was a way to design one that prevented crushing, it would be well worth the money.

[KellyS]

@Jersey Fresh

This is further complicated by the fact that studies funded by manufacturer’s are often viewed as biased by the general public so to truly get a study that people will accept the results of you need an outside agency like ASTM or a USEA to do it.

I do think the studies would answer a lot of questions and could help improve the safety and design of these vests. Anything that could help decrease the chances of injury or fatalities wold really help our sport.

Thank you so much for your thoughtful commentary–it is really helpful, especially with regard to study design.

In medical research, we handle the ethics of company-sponsored research with very strict ethical and transparency guidelines, including peer review and author disclosures, and these papers are not considered biased when reviewed, accepted for publication, and published in a well-respected journal.

Thus, I see no reason why the companies themselves cannot pursue the research. However, it would be great to have ASTM do it (and develop baseline parameters for these vests as they’ve done for regular vests) and/or the USEA as part of their safety initiatives. It could actually be a group effort among the vest companies, USEA, and ASTM, and I bet there are some USEA members with the funds to consider significantly sponsoring such an effort.

The question is, would USEA ask their generous sponsors and donors to divert money into a safety study? Or is it more important to them to funnel these funds into competition sponsorship, etc?

[RAyers]

As a member of ASTM (F04 and F42), ASTM is a consensus standards organization. It can perform some testing, however, we rely on industry tests using the consensus standards developed. So, the airiest manufacturers would submit a standards protocol with testing methodologies to be voted upon by the members of the appropriate committee and then conduct said testing, if said standards are accepted by the general scientific/research/safety community.

[Jersey_Fresh]

@KellyS

Thank you so much for your thoughtful commentary–it is really helpful, especially with regard to study design.

In medical research, we handle the ethics of company-sponsored research with very strict ethical and transparency guidelines, including peer review and author disclosures, and these papers are not considered biased when reviewed, accepted for publication, and published in a well-respected journal.

Thus, I see no reason why the companies themselves cannot pursue the research. However, it would be great to have ASTM do it (and develop baseline parameters for these vests as they’ve done for regular vests) and/or the USEA as part of their safety initiatives. It could actually be a group effort among the vest companies, USEA, and ASTM, and I bet there are some USEA members with the funds to consider significantly sponsoring such an effort.

The question is, would USEA ask their generous sponsors and donors to divert money into a safety study? Or is it more important to them to funnel these funds into competition sponsorship, etc?

I completely agree with you on company-sponsored research, but I can say that even with all of that, the general public will doubt it. I know we face that with our sponsored research despite all of the things you mentioned. And if I had a dollar for every time someone told me they didn’t believe research (be it pet food, pharma, etc) because the company sponsored it or conducted it.

I think for the companies, it comes down to cost. I would bet the annual sales for air vests is still relatively small, and the ROI for investing in research is also small-people will purchase on the chance that it will help. I’m a scientist-I am trained in asking for data to back up claims, but I will admit I will be getting a vest because my family and husband feel that even if it only might help make my ride safer, that’s enough reason in their minds to ask me to wear one. They feel it won’t hurt and if it has a chance of making the sport safer they want to see me in one.

I think money allotted to USEA for safety studies would be better off used for safe course and jump design. Funds are limited and while you cant control what vest a rider wears on course, you can 100% control what fences they are asked to jump.

That all being said, I do wish they would do research on it. I just don’t know how it would be paid for.

[Jersey_Fresh]

@Jealoushe

Yes exactly. Perhaps some money from these research funds could go to vest studies…not just air vests. If there was a way to design one that prevented crushing, it would be well worth the money.

I really agree with this, mainly because everyone on XC has to wear a vest but air vests are optional. If we had research to improve regular vests or set a standard for impact, think of how much safer our sport could be.

[JER]

@Jealoushe

If there was a way to design one that prevented crushing, it would be well worth the money.

This was done already. It was called the EXO, first sold in 2005.

You can read more about that sad saga here: http://www.horseandhound.co.uk/news/exo-bodycage-body-protector-faces-an-uncertain-future-267628

Here’s a first-hand account by an owner/user (from http://www.woofwear.com/gallery/gallery_image.php?id=1085)

Uploaded by Jenny Booth

Tuesday 19th July 2016

Hey, I know it’s an old product but Neo fell at a jump and I was trapped under him! He was a star and stayed down until he was man handled off me. Through out I felt secure in the knowledge I had the Exo on and would not be crushed if he did get up

I have an EXO. It’s a great piece of equipment. But then I also have the only equestrian helmet ever made with the MIPS system, which meant going to the ends of the earth (Norway, actually) to find one.

I’ll happily pay for safety equipment that works.

[vineyridge]

Point Two had a British testing facility do tests. The results were, IIRC, published in H&H a couple of years ago. They did find a positive outcome in that injuries were not as severe as would be expected…

[Jealoushe]

@vineyridge

Point Two had a British testing facility do tests. The results were, IIRC, published in H&H a couple of years ago. They did find a positive outcome in that injuries were not as severe as would be expected…

We need to see this because I recall this, but it wasn’t actual testing if I remember correctly.

@JER yes the EXO, which no longer exists right?

[Winding_Down]

@vineyridge

Point Two had a British testing facility do tests. The results were, IIRC, published in H&H a couple of years ago. They did find a positive outcome in that injuries were not as severe as would be expected…

Here is the link if anyone is unable to find it via a web search:

http://www.horseandhound.co.uk/exclu…iveness-516934