Background Headcollars (halters, US) are one of the most commonly used pieces of equestrian 'tack'. Despite this, there appears to be minimal information on their use, or more importantly, risk factors for injury of horses/handlers. Objective To explore headcollar use and safety in equestrians. Study design Quantitative cross-sectional survey. Methods An online survey (19 questions) exploring headcollar use and safety was disseminated through equestrian social media. Frequency analysis and multivariable modelling identified how headcollar type was linked to use and injury risk. Results Most respondents (88%; n = 4786) used headcollars multiple times daily but for short time periods (66%, n = 3388, <30 min). A horse being injured as a result of wearing a headcollar was reported by 1615 (31%) respondents with 15% of incidents also injuring a person. Fractures (horses) occurred in 134 incidents, and 167 equine fatalities were reported. Across all headcollar types, the odds of injury risk increased by 1.7 times (confidence intervals (CI): 1.07-2.41, P<0.02) using a headcollar when mucking out. During travelling, headcollar use reduced the odds of risk of injury by 0.7 times (CI: 0.43-0.98, P<0.04). The odds of injury risk reduced when using leather (Odds ratio (OR): 0.8, CI: 0.66-0.96, P<0.01) or synthetic (OR: 0.8, CI: 0.58-0.85, P<0.0001) safety headcollars compared with standard headcollars of the same material. Thematic analysis identified three key themes: (1) need for increased education: fit, safety features and basic horse handling, (2) 'safer' leather headcollars, and (3) increased safety focus required. Main limitations Data were self-reported and may be subject to memory recall errors; online surveys are subject to self-selection bias. Conclusions Increased user knowledge of risk factors for headcollar injury, combined with standardised guidance on how to correctly fit and use headcollars, would be beneficial to reduce injury risk.
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