MEDICAL STANDARDS FOR FITNESS TO RIDE

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NME33 MEICL STNS FO FITNESS TO IE These Standards apply to all applicants for amateur and professional jockeys licenses and permits (under the ules of acing) and iders Qualification Certificates (under the egulations for Point-to- Point Steeple Chases). PEFCE ace riding is an activity that requires each and every jockey to exercise physical skills and judgment of an extremely high order. ny failure in a jockey's performance may not only put his/her life in danger but may also put others at risk of injury, permanent disability or death. The British Horseracing uthority requires that all jockeys applying for a licence or permit to ride under ules or Point-to-Point egulations provide a eclaration of Health and appropriate medical evidence of his/her 'fitness to ride'. Each application is subject to scrutiny by our Chief Medical dviser who may request additional medical reports or specialist examination as appropriate. ll costs incurred in providing this information are the responsibility of the applicant. When sufficient information is available, a medical recommendation regarding each applicant is made to the Licensing Committee or the Point-to-Point epartment for their consideration. The final decision to grant or refuse a licence or permit rests solely with the Licensing Committee and such decisions may be subject to a Medical eview Procedure where appropriate. Existing licence or permit holders who, during the period of the licence or permit, suffer a significant injury (e.g. concussion, fracture) or significant illness (e.g. hepatitis) that could in any way affect their fitness to ride, must inform the Chief Medical dviser at the earliest opportunity. This applies to any significant illness or injury - regardless of whether or not it resulted from a racing incident (e.g. road traffic accident, hacking, eventing, on the gallops, winter sports, hang gliding, etc.). Chief Medical dviser INTOUCTION s a result of the regulator's extensive experience in the field of equestrian sport, it is the BH's longstanding practice to apply strict medical criteria for participation in race riding. These Medical Standards have been compiled to assist jockeys, and their medical advisers, in establishing which conditions are likely to affect the granting of a rider's licence or permit. MEICTION If an applicant requires, or has required, regular medication to maintain his/her physical or mental wellbeing, it must be declared as soon as possible ideally before commencing any medication. If any of the following statements apply, the licence / permit will invariably be declined or deferred - 1) The therapeutic effect of the medication may put a rider at risk when he/she rides or falls. 2) The side effects, actual or potential, of the medication are such that they could interfere with the rider's physical capability, judgment, co-ordination or alertness.

3) voluntary or involuntary adjustment of the dosage, administration or absorption of the medication may interfere with the rider s physical capability, judgement, co-ordination or alertness. These Medical Standards cover the areas of major concern to the British Horseracing uthority but, inevitably, cannot deal with every medical condition seen in practice. The Standards are not intended to restrict or limit in any way the discretion of the British Horseracing uthority to adopt a different approach in any case and to depart from these Standards where it considers it necessary or desirable to do so. Each application is considered individually on its merits and further clarification can be obtained by contacting - Chief Medical dviser The British Horseracing uthority 75 High Holborn London WC1V 6LS KEY TO CLSSIFICTION = Normally CCEPTBLE = EFEE - specialist opinion will normally be required prior to acceptance or refusal. Examination by the Chief Medical dviser may also be necessary. (ll costs involved in satisfying these criteria are the responsibility of the individual applicant.) = Normally EFUSE GE lthough no upper age limit exists for race riding, it is unusual for jockeys to continue racing after they reach the age of - 40 - Professional Jump jockeys 50 - mateur jockeys 50 - Professional Flat jockeys ny applicant for a Jump Licence whose age is 40, or above, will normally be required to undergo additional investigation, which may include an MI brain scan. medical examination by the Chief Medical dviser may be required. ny applicant for an mateur Permit, Flat Jockey's Licence or Point-to-Point Permit whose age is 50 or above, will normally be required to undergo additional investigation which may include Specialist ssessments (e.g. cardiology) and/or MI brain scan. medical examination by the Chief Medical dviser may be required.

CIOVSCUL ISOES Ischaemic heart disease/ngina Heart failure Myocardial infarction By-pass grafting ngioplasty Cardiac transplant ysrhythmias Pacemakers Cardiac valvular disease Hypertension Cardiomyopathies Congenital heart disease Marfan's Syndrome Treatment with anticoagulants Peripheral vascular disease ENOCINE N METBOLIC ISOES iabetes- Insulin ependent iabetes- equiring Oral Medication iabetes- Controlled by iet pplicants with iabetes will need to demonstrate evidence of good control of blood sugars at rest and with exercise and have clear protocols on how to react when blood sugars are outside of prescribed parameters. Uses of continuous blood sugar monitoring devices are preferred and the applicant must have the full support of their normal iabetic Consultant and be free of significant diabetic complications. n assessment by an independent iabetologist with specific experience in the management of athletes will be required to draw up a aceday iabetic Protocol. Periodic follow up may be required. If licenced the applicant must present to the on-site Medical Team at every race meeting and present their aceday iabetic Protocol plus emergency medical kit including oral glucose solution and glucagon injection. iabetes Insipidus Thyroid disease drenal disorders GSTO-INTESTINL N BOMINL ISOES cute gastric erosion Chronic gastritis Gall stones ctive peptic ulcer

Hiatus hernia Inguinal hernia Haemorrhoids, anal fissure, fistulae Cirrhosis Chronic pancreatitis Colostomy, ileostomy Colitis (ulcerative or Crohn s) GENITO-UINY N ENL ISOES Chronic enal Failure enal transplant Nephritis Kidney stones Prostatitis Single kidney or horseshoe kidney GYNECOLOGICL CONITIONS Pregnancy Caesarian section - (see Surgery below) Hysterectomy - (see Surgery below) HEING Hearing must be adequate for the jockey to hear instructions and to ensure that the safety of other riders is not put at risk. eafness- (hearing loss greater than 35dB in either ear over the normal vocal range 500-2000 c/sec) Perforated eardrum Chronic suppurating otitis media Otosclerosis INFECTIOUS ISESES The facilities in Jockeys changing rooms can be cramped and poorly ventilated. Jockeys should be advised to discontinue race riding whilst there is any risk of contagion. Tuberculosis (active)

MEICTION If an applicant requires, or has required, regular medication to maintain his/her physical or mental wellbeing, a licence may be declined. If any of the following statements applies, the licence will invariably be declined or deferred - 1. The therapeutic effect of the medication puts a rider at risk when he/she rides or falls. 2. The side effects, actual or potential, of the medication are such that they could interfere with the rider's physical capability, judgement, co-ordination or alertness. 3. voluntary or involuntary adjustment of the dosage, administration or absorption of the medication may interfere with the rider's physical capability, judgement, co-ordination or alertness. MUSCULO-SKELETL ISOES mputation of a limb or part of a limb Loss of digit(s) will be reviewed on an individual basis Fracture - (see below) Before applying to return to race riding, the jockey should have an appropriate range of pain-free movement, radiological evidence of a sound bony union, clearance from a Consultant Orthopaedic surgeon and be able to show that his/her ability to ride is unaffected as judged by an assessment by an experienced acing Physiotherapist. No jockey may race wearing a plaster cast, backslab, fibreglass support, or similar appliance. Fractures of the skull and spine are of particular concern and medical clearance by the Chief Medical dviser is required in every case. Clavicle Fracture islocated cromio-clavicular (/C) joint Before applying to return to race riding, the jockey should have an appropriate range of pain-free movement and be able to show that his/her ability to ride is unaffected. islocated or Subluxed Shoulder - First occasion Before applying to return to race riding, the jockey should have an appropriate range of pain-free movement and be able to show that his/her ability to ride is unaffected. islocated or Subluxed Shoulder - ecurrent Before returning to race riding, the jockey must have an appropriate surgical opinion. fter rehabilitation, the jockey should have an appropriate range of pain-free movement and be able to show that his/her ability to ride is unaffected. heumatoid rthritis Spondylolisthesis Slipped isc Joint replacement or internal metal fixation

NEOPLSI/CNCE NEUOLOGICL ISOES Chronic migraine Chronic neurological disorders (e.g. Parkinson's isease, Multiple Sclerosis etc.) Chronic Meniere s isease, vertigo or labyrinthitis which is not controlled Cerebrovascular disease Meningitis or encephalitis Intracranial tumour requiring craniotomy -V Malformation- symptomatic -V Malformation- fter a Bleed Intracranial aneurysm Pituitary tumour with no Visual Field efect Pituitary tumour with Visual Field efect Narcolepsy Unexplained loss of consciousness Subarachnoid haemorrhage- see epilepsy/single seizure Intracranial haematoma- see epilepsy/single seizure Serious Head Injury - see epilepsy/single seizure Craniotomy/Burr hole surgery see epilepsy/single seizure Epilepsy and other Seizures Unless the applicant can meet LL the following criteria - a) Complies with the current UK VL criteria for Group 1 drivers b) Is under regular medical review and on application has supporting evidence from the Consultant Neurologist responsible for their care c) Whose medication is stable and does not interfere with reaction time and other cognitive functioning which may be subject to periodic testing d) The applicant must declare any changes in medication or epileptic activity PLESE NOTE - following any cranial fracture or surgery, the integrity and/or strength of the skull must not be significantly compromised.

MENTL HELTH ISOES uring acute episodes of Mental Health Illness applicants will be stood down until their Consultant declares them to be fit for a return to race riding. Medication must be stable and not interfere with reaction time and other cognitive functioning which may be subject to periodic testing. The applicant must declare any changes in medication and may be stood down until settled on any new drug or dose increase for a minimum of two weeks. Neuroses (e.g. nxiety state, depression) Psychoses (e.g. Bipolar isorder, Schizophrenia) Schizo-affective disorders ementia (e.g. lzheimer's isease) Personality disorder (e.g. Post head injury syndrome, psychopathic disorders) ependence (or chronic abuse) - alcohol or drugs Chronic solvent misuse ESPITOY ISOES sthma Chronic obstructive airways disease Spontaneous pneumothorax- Single episode Spontaneous pneumothorax- ecurrent Emphysema Hay fever (until the condition has been stabilised by surgical intervention) SUGEY/OPETIONS Following any form of surgery, an applicant must obtain clearance from the specialist carrying out the procedure. The specialist will normally be required to provide a written report but, in certain circumstances, direct discussion with the Chief Medical dviser may be acceptable. VISUL CUITY Corrective lenses are acceptable provided that these are in the form of "soft contact lenses". MINIMUM requirements with or without corrective lenses istance Vision Monocular vision Visual field defect iplopia Colour Blindness etinal detachment "good" eye 6/9 "worse" eye 6/18