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News & insight from Medi-K

Regular equestrian specific first aid news and insight from Medi-K, including updates to regulations and the latest safety equipment.

Accident reporting and investigation RIDDOR

First-aiders should be encouraged to keep a record of any treatment administered including the date, venue, person’s name and job, injury, treatment and/or advice, whether the person returned to work/went home/ went to hospital etc. It would not usually b…

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Accident reporting and investigation RIDDOR

First-aiders should be encouraged to keep a record of any treatment administered including the date, venue, person’s name and job, injury, treatment and/or advice, whether the person returned to work/went home/ went to hospital etc. It would not usually be necessary to have a specifically designated first aid room in premises of this nature

Accident reporting and investigation RIDDOR

  • Under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR), certain specified injuries /events have to be reported to the relevant enforcing authority;
  • fractures, other than to fingers, thumbs and toes
  • amputations
  • any injury likely to lead to permanent loss of sight or reduction in sight
  • any crush injury to the head or torso causing damage to the brain or internal organs serious burns (including scalding) which covers more than 10% of the body or causes significant damage to the eyes, respiratory system or other vital organs
  • any scalping requiring hospital treatment
  • any loss of consciousness caused by head injury or asphyxia
  • any other injury arising from working in an enclosed space which:
  • leads to hypothermia or heat-induced illness
  • requires resuscitation or admittance to hospital for more than 24 hours

Over-seven-day incapacitation of a worker

Accidents must be reported where they result in an employee or self-employed person being away from work, or unable to perform their normal work duties, for more than seven consecutive days as the result of their injury. This seven day period does not include the day of the accident, but does include weekends and rest days. The report must be made within 15 days of the accident.

Over-three-day incapacitation

Accidents must be recorded, but not reported where they result in a worker being incapacitated for more than three consecutive days. If you are an employer, who must keep an accident book under the Social Security (Claims and Payments) Regulations 1979, that record will be enough.

Non fatal accidents to non-workers (eg members of the public)

Accidents to members of the public or others who are not at work must be reported if they result in an injury and the person is taken directly from the scene of the accident to hospital for treatment to that injury. Examinations and diagnostic tests do not constitute ‘treatment’ in such circumstances. If the incident occurred as part of the normal riding activity and there was no failure in the management system, then it would not be RIDDOR reportable. If on the other hand, the accident was caused by a failure in the work of the riding establishment e.g. if faulty equipment/condition of the premises/riding surface, inadequate instruction contributed to an accident, then it would be reportable. A decision about whether a work related accident is reportable requires proprietors to make a reasonable judgement based on the information available to them. Further guidance on when, what and how to report an accident can be found on the HSE website at http://www.hse.gov.uk/riddor/index.htm.

There is no need to report incidents where people are taken to hospital purely as a precaution when no injury is apparent.

Reporting can be carried out via the HSE website form: https://extranet.hse.gov.uk/lfserver/external/F2508IE or by telephone at the Incident Contact Centre on 0345 300 9923 (opening hours Monday to Friday 8.30 am to 5 pm).

In addition to the requirements above, under the Social Security (Claims and Payment) Regulations 1979 there is an obligation to maintain an accident book where there are more than 10 employees. In practice however many premises will use the accident book as the method of recording both but there are conditions under the Data Protection Act 1998 and 2003.

The enforcing authority have a wide range of powers associated with accident investigation including interviewing witnesses, removing evidence from the scene. The proprietor may be advised to leave the scene intact and should co-operate with any investigation request.

It is also important to investigate properly accidents and ‘near miss incidents’. This is where an incident could have caused injury but did not. By monitoring these types of incident they help to better understand the things that can go wrong and thus preventative action can be taken.

None of these checks negate however the need for ongoing visual checks by all staff and appropriate methods for reporting. A staff member observing a significant area of stitching undone on a stirrup leather or a show jump in dangerous condition should take action e.g. take it for repair/cone off to prevent use/report the same day.

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Body Protectors

Body protectors are foam filled vests designed to reduce the risk of injury to the upper body of the rider. Testing procedures suggest that the force of impact transmitted to the body will be reduced from falls on flat surfaces as well as there being some…

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Body Protectors

Body protectors are foam filled vests designed to reduce the risk of injury to the upper body of the rider. Testing procedures suggest that the force of impact transmitted to the body will be reduced from falls on flat surfaces as well as there being some protection against sharper or angular objects including horse hoofs! Shoulder pads are a sensible optional addition to provide greater protection. The shoulder is a relatively common point of impact when riders fall.

BETA has produced a guide summarizing the standards involved in different levels of protection. BETA has also published a statement in 2012 on recent changes to the rules on body protector standards accepted in British Eventing and also Air Vests (Body Protectors for the Season Ahead).

Body protectors must be worn by all jockeys racing under BHA rules and all competitors riding cross country courses under BE rules. Similar rules are normally adopted by unaffiliated competitions such as Hunter Trials. Many riders wear them at other times such as when riding on the road and schooling young horses.

There is no guidance about whether body protectors should be worn out of competition.

Current body protectors are more comfortable and tend to mould to the rider more than earlier types. They can still feel hot and bulky. Many riders feel that their position and balance are compromised even by the best-fitting body protectors. This is why they are not always worn away from cross country or racing courses. It’s important to choose the body protector that suits you best. There are variations in style of manufacture which includes the foam protection being arranged in larger sheets or panels, small blocks or more recently hexagons! Most have front zips although there are foam panel types without zips. Weight, comfort, freedom of movement and length at the back are all important. Your body protector should be fitted by a trained retailer whilst you sit on a saddle. Does it push your arms out? Does the back catch on the saddle too much?

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Riding Establishment First aid needs assessment

In 2015, 2.7 million people in Great Britain rode horses and the equestrian sector contributed £4.3 billion to the economy, incorporating consumer spending across a wide range of goods and services each year.

Whilst horse riding is an established pastime…

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Riding Establishment First aid needs assessment

In 2015, 2.7 million people in Great Britain rode horses and the equestrian sector contributed £4.3 billion to the economy, incorporating consumer spending across a wide range of goods and services each year.

Whilst horse riding is an established pastime, there are risks involved. The environment can present hazards, such as falls from horses, fire, as well as potential injuries from being kicked when handling horses.

In theory any horse has the potential to cause harm or injury, simply through application of its weight or its hooves coming into contact at force with a person’s body. Horses are also animals that have their own idiosyncrasies, just like humans.

A horse riding establishment: A BUSINESS OF KEEPING HORSES FOR EITHER OR BOTH OF THE FOLLOWING; THE PURPOSE OF THEIR BEING LET OUT ON HIRE FOR RIDING THEIR USE IN PROVIDING INSTRUCTION IN RIDING’

Livery Yard: “THE BUSINESS OF PROVIDING A RANGE OF FACILITIES, SERVICE AND SUPERVISION INTENDED TO CARE FOR A HORSE IN RETURN FOR REWARD OR FINANCIAL GAIN”

Most riding school and livery yard premises will theoretically have some form of legal

obligations with regard to the management of safety risks to employees and others who

may be affected by work activities, notably children in many cases. But many of the livery yard proprietors may not be aware of their obligations with regard to health and safety legislation.

Whilst there is a significant amount of literature and assistance available with regard to

health and safety enforcement generally, very little is aimed specifically at the specialist

area of horse riding establishments/livery yards.

The HSE (Health & Safety Executive) cannot tell you what provision you should make for first aid. You, as an employer, are best placed to understand the exact nature of your workplace and decide what you need to provide.

First aid provision must be ‘adequate and appropriate in the circumstances’. This means that you must provide sufficient first aid equipment (first aid kit), facilities and personnel at all times.

In order to decide what provision you need to make you should undertake a first-aid needs assessment. This assessment should consider the circumstances of your workplace, workforce and the hazards and risks that may be present. The findings will help you decide what first-aid arrangements you need to put in place.

In assessing your first-aid needs, you should consider:

You may also need to consider:

  • the needs of travelling, remote and lone workers
  • the distribution of your workforce
  • the remoteness of any of your sites from emergency medical services
  • whether your employees work on shared or multi-occupancy sites
  • first-aid provision for non-employees (eg members of the public).

HSE has published further guidance on all the factors above that will help you carry out your first-aid needs assessment.

You may also wish to consider our suite of case studies PDF, containing scenario-based examples of first-aid needs assessments for a variety of workplaces. They demonstrate the general principles involved in deciding on the provision you should make for first aid, but you should not assume the outcomes shown are directly transferable to your workplace.

You do not need to record the findings of your needs assessment, but you may find it useful to do so, as it will demonstrate how you have decided on the first-aid provision that you make.

The minimum requirement in terms of personnel is to appoint a person to take charge of first-aid arrangements. The roles of this appointed person include looking after the first-aid equipment and facilities and calling the emergency services when required. The appointed person can also provide emergency cover, within their role and competence, where a first-aider is absent due to unforeseen circumstances. An appointed person is not required to have any formal training.

If your workplace has more significant health and safety risks, for example you use machinery or hazardous materials then you are more likely to need a trained first-aider.

There are no hard and fast rules on exact numbers, and you will need to take into account all the relevant circumstances of your particular workplace.

Where the work involves higher level hazards such riding establishments, firstaid requirements will be greater. Employers may then need to:

■ provide sufficient numbers of qualified first-aiders so that someone is always

available to give first aid immediately following an incident;

■ provide additional training for first-aiders to deal with injuries resulting from

special hazards;

■ consider additional first-aid equipment;

■ provide one or more first-aid rooms;

■ inform the local emergency services, in writing, of the site where high risk sport is taking place.

RESPONSIBILITIES TO EMPLOYEES

Within the riding environment there are some difficulties in the enforcement of Health and Safety legislation. The first question that should be asked is whether the Health and Safety at Work etc Act 1974 is applicable. Section 2 of the Act states,

‘IT SHALL BE THE DUTY OF EVERY EMPLOYER TO ENSURE, SO FAR AS IS REASONABLY

PRACTICABLE, THE HEALTH, SAFETY AND WELFARE AT WORK OF ALL HIS EMPLOYEES’

Where it is clear that there are employees, this requirement is absolute. For example riding establishments provide instruction to clients and usually employ riding instructors and other staff to assist. There is a clear employer/employee relationship. Some of the larger livery yards offering full or part livery will also employ a number of staff to assist with looking after the horses. Again the employer/employee relationship is evident and thus the health and safety legislative requirements clearly apply. The main groups of people exposed to hazards and consequent risks in and around riding establishments/livery yards are employees, riding school clients, contractors and members of the public. Staff roles vary considerably, from assistance with handling or riding horses, mucking out stables, grooming, preparing for lessons, to instructing and administration. Depending on the nature of their roles, staff are potentially likely to be exposed to the entire spectrum of hazards including kicks, falls, manual handling injuries, exposure to substances hazardous to health. However due to complacency and in some instances professional pride, many staff will not report accidents, even to their employers.

RIDING SCHOOL CLIENTS

Although they are in essence members of the public as opposed to staff, it is useful to illustrate these in a separate category. At riding schools where clients simply ‘turn up’ for a session, typically a one hour lesson or ride, where the horse is ready for them, they are potentially more likely to be exposed to hazards such as falls. At establishments where they assist with the horse care, attend residential courses or un-mounted training sessions, they may potentially be exposed to the same range of hazards as staff

MEMBERS OF THE PUBLIC

This may include people keeping their horses at livery, children and other people visiting livery yards/watching riding lessons etc. There is likely to be a vast array of experience, from competent riders to those completely unfamiliar with horses and the associated risks. Again they will be representative of all sectors of the community with regard to age, sex, disability.

Children and those unaccustomed to horses may need particular protection under the safety management system due to their lack of understanding/experience of the risks associated with horses and the riding school/livery yard environment. There is also an obligation to protect trespassers.

CONTRACTORS

There is a tendency for enforcement officers to think of those undertaking maintenance/cleaning as the main contractors with regard to all work environments and to focus on them with regard to health and safety enforcement. However in the context of riding establishments/livery yards, the contractors that are likely to visit on a far more frequent basis include vets, farriers or blacksmiths, feed and bedding delivery staff. Visits tend to be less frequent from maintenance contractors, field contractors (to cut hay, maintain hedges and ditches), or people to remove the muck heaps. Whilst vets and farriers would usually have some knowledge, training and awareness of the pertinent risks there are still steps that proprietors can take to control the risks. Other contractors may have no such awareness and need the same level of protection as general members of the public.

A common definition used in safety literature for a hazard is “something that has the potential to cause harm or injury”.  In considering the typical activities that will be undertaken in a riding establishment/livery yard it becomes apparent that there are many which will, if not controlled adequately, present a level of risk which is not acceptable or tolerable. Theoretically any horse has the potential to cause harm or injury, simply through application of its weight or its hooves coming into contact with a part of a person’s body. The riding environment typically includes uneven/cobbled floors, barbed wire fences, dark mornings/evenings as well as inclement weather, each of which presents its own hazards.

In addition the typical operations that are carried out in any establishment present hazards. These can include injuries arising from loading and unloading horses into horse boxes, catching horses from the field, moving parts of equipment, the use of machinery. The act of riding itself can present significant hazards. The riding a person may be involved in can range from simply walking or trotting within a purpose built area to galloping at 40 mph along road side verges in close proximity to moving vehicles.

The longer that people work with horses the more complacent they may become about the acceptability of the risk associated with any one hazard. Often falls from horses, particularly from very experienced riders, are deemed to be an intrinsic part of the job, as is being the recipient of the occasional bite or kick.

RISK ASSESSMENT

Once an assessment of the hazards associated with a typical riding school/livery yard has been made and the people at risk identified, a risk assessment has to be undertaken to determine which of the hazards are likely to be realised. As falls from height have been highlighted as a particular hazard from the data available, they will be used to illustrate the concept of assessing risk. In general terms, falls from horses are more likely to occur when riders are undertaking work at speed such as cantering and galloping or when riding over jumps, than at lower speed such as walk. Risks increase with turns, changes of direction etc which may affect the balance of horse and/or rider. The risks are also increased when external factors cause horses to react either by jumping, rearing or fleeing. These factors could include wind blown objects, flapping carrier bags, cars, lorries and motorbikes. Young or inexperienced horses are usually less predictable than mature older ones. Other factors likely to increase the risks are linked to the individual temperament of the horse. Some are more placid by nature while others are more likely to shy (jump away without warning), buck rear etc. The risk of a fall is greater for a beginner or novice rider than a more experienced one.

HANDLING HORSES

Although significant under reporting occurs, the data available and reports in equestrian journals show that many accidents involve un- mounted staff/riding school clients. The hazards arise from kicks, bites, being crushed or falling/being knocked to the ground. Whilst the majority of horses can be trained not to display such vices there is never room for complacency. In stressful situations, such as when in pain or frightened, even gentle horses can display uncharacteristic behaviour. Other horses, either through lack of training or other reasons, may be more prone to bad behaviour. Sometimes their temper is aimed primarily at other horses, but people in the vicinity can get hurt, while others will deliberately try to frighten or hurt people. To a large extent the overall assessment with regard to first aid provision will be dependent on the nature of the undertaking and the number of horses in addition to the number of employees. A large riding establishment/livery yard with horses used for most disciplines including cross country and show jumping would have a greater need for first aid provision than a small livery yard where staff had minimal direct contact with the horses. The assessment should take into account the previous accident history although it should be noted that many accidents, particularly to staff as opposed to the public, may not be recorded.

PROVISION OF FIRST AIDERS

The term ‘qualified first aider’ is applied to staff holding a current first aid at work qualification following attendance on a course/passing an examination in a Health and Safety Executive recognised qualification. The initial training course usually takes three days to complete and has to be renewed within three years, subsequent training courses usually lasting two days. If the assessment has shown there to be a need for first aiders on site these are the staff which fit the criteria. They must hold an up to date certificate. Some confusion occurs within the riding world as there are equine specific first aid training courses available facilitated by the BHS. These comprise an initial two day course followed by a one day refresher course every two years. They are very good in that they deal with the issues more likely to affect those working with horses than the generic first aider training courses, but attendance does not mean that a person is able to call themselves a qualified first aider. Instructors on the British Horse Society Register either have to be fully qualified first aiders or have to have attended regular equine specific first aid courses. Riding establishment Inspectors should ensure that proprietors do not mistakenly think the latter have the full HSE first aider qualification.

RATIOS OF FIRST AIDERS

There is no legislative requirement to provide a certain ratio of first aiders to employees although there is guidance available. Many yards will have small numbers of employees but still deem it necessary to have at least one first aider available at all times. Provision should be made to cover when first aiders are on leave or absent due to sickness, and so some yards will need at least two qualified first aiders. For establishments covering provision to the public it would be reasonable to expect to have a first aider present at all such times. The layout of the establishment can significantly affect the time for a first aider to reach an incident. In some yards staff will be working in fields/schooling areas/on tracks etc considerable distances away from the main office or yard. Staff will often work alone eg when catching horses from remote fields. Instructors may be required to teach/lead rides at some distance away.

REFERENCES

Association of British Riding Schools (ABRS), 2005,‘Risks’ aide memoir for the proprietor and other aspects of safety, (document for members),ABRS

ABRS, 2005,Safety guidelines for conducting a hack including road safety and procedures in the event of an accident, (document for members),ABRS

British Horse Industry Confederation/DEFRA, 2005,Draft strategy for the horse industry in England and Wales

British Horse Society (BHS), 2005,Approved livery yard scheme,BHS

HSE,Number of injuries enforced by local authorities allocated the code ‘horse’ in 2013/2014,HSE Statistics Unit

Royal College of Veterinary Surgeons (RCVS) /British Veterinary Association (BVA), January

2004,Guidelines for local authorities and their riding establishment inspectors, RCVS/BVA

Legislation

Health and Safety at Work etc Act 1974

Health and Safety (First Aid) Regulations 1981 as amended

Health and Safety Information for Employees Regulations 1989 (as amended)

Riding Establishments Act 1964

Riding Establishments Act 1970

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First Aid in the Field

Part of the joy of hunting is being given the chance to ride across beautiful countryside but in the case of an accident this can mean that medical assistance takes time to get to you. The big fences, tricky obstacles and speed you ride at all lend to the…

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First Aid in the Field

Part of the joy of hunting is being given the chance to ride across beautiful countryside but in the case of an accident this can mean that medical assistance takes time to get to you. The big fences, tricky obstacles and speed you ride at all lend to the exhilarating fun, but also add a level of risk, and it’s unavoidable that many people each year will take a tumble from their mount out hunting.

Would you know what to do if another rider suffered a nasty fall? The care a casualty receives in the first few minutes after an incident is critical and will affect their chances of recovery, and hunting in remote country may mean that you have anything from 10 minutes to half an hour before the first responders reach the casualty. Having a qualified first aider on the scene will prove invaluable in managing the accident scene, preserving life and promoting recovery until emergency services arrive or the injured rider is taken to a hospital.

Any rider who has had a fall on the hunting field may have sustained spinal injuries and should be treated with great care, however failure to breathe properly will kill someone faster than anything else, so the decision of whether to move the casualty should depend on signs of life. If the casualty is unconscious and breathing abnormally, they will require mouth-to-mouth resuscitation. Are you or anyone you hunt with capable of this? If they arent breathing normally, they will need CPR – do you know how to carry it out? Would you know what to do if someone on the ground was kicked? How to stop a bleed? If the answer is no to any of the above, it’s time to organize a first aid course.

Medi-K will provide you with the skills, knowledge and confidence to assess the situation, deal with resuscitation, fainting, bleeding control, shock, riding hat and body protector removal, recovery position, head injuries, foreign objects, seizures and legalities. We offer on-site training for all our courses at your yard, for a maximum of 12 people. Training is tailored to your group’s needs, so you can rest assured that any hunting field scenario will be covered. Would it not be reassuring for your members to know that there is someone present at all times who can provide immediate and critical first aid to a rider who’s fallen off or become unwell?

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Extreme Situations!

When working with horses everyone understands there is a certain risk involved, but few of us ever think about the risk associated with the lifestyle we all know and love. As equestrians we expose ourselves to the elements day in and day out, blistering h…

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Extreme Situations!

When working with horses everyone understands there is a certain risk involved, but few of us ever think about the risk associated with the lifestyle we all know and love. As equestrians we expose ourselves to the elements day in and day out, blistering heat in the summer and freezing temperatures in the winter. But how often do we stop and think of the consequences of this exposure? Would you know what to do if the elements took hold and got the better of you?

In the few summer months we get to enjoy in the UK we learn to deal with extremes, however on those few scorching hot days do you know the risks? Sunburn, dehydration and heat exhaustion are just a few things to consider, which must be treated quickly and correctly.

Although common and easily caused, sunburn can be exceptionally painful. Damage caused by UV rays, causes the skin to become painful, red, sore and hot, however in severe cases the skin can blister or swell, the sufferer may also experience chills, a fever, dizziness, sickness and other signs of heat exhaustion.

Sunburn is hard to spot while the damage is being caused as it can take hours for the skin to turn red, however the skin will feel warm to touch. If you get sun burnt you need to take action to cool the skin and limit damage. Get out of the sun; cool the skin by taking a cold shower/bath; take pain killers such as ibuprofen or paracetamol to relieve the pain; drink plenty of water to help keep you cool and to prevent dehydration. Severe cases of sunburn may also need medical attention.

Dehydration is a common problem in hot and humid weather and occurs when your body loses more fluid than you take in. Although not severe in it’s self, dehydration can make suffers lightheaded, dizzy and tired, which may have a knock on effect on the ability to function and reflexes which are vital when around horses. The best way to avoid dehydration is to ensure you drink plenty of water in hot conditions and when exercising. Always remember that mucking out a stable is classed as moderate physical exercise so take a bottle of water to the yard with you during the summer months.

If you are suffering from dehydration it is vital to try to rehydrate yourself quickly by drinking fluids such as water, diluted squash or fruit juice. Try to avoid tea, coffee and fizzy drinks as these are less effective and although contain sugar they are harder to drink in large amounts. A rehydration solution available from pharmacies are another great option as they replace the vital minerals, which become unbalanced when dehydrated.

Heat exhaustion and heatstroke are two potentially serious conditions that equestrians are vulnerable to, as they normally occur during heat waves, hotter than normal weather and during physical exercise. Both of these conditions are serious as the body is no longer able to cope with the heat and must be treated with urgent medical attention.

The signs are similar to dehydration however additional symptoms include intense thirst, muscle cramps, sickness, a fast pulse and low blood pressure. Quick first aid is vital. Get the sufferer to lie down in a cool place, make them drink water, wet their skin and remove any unnecessary clothing, however if the suffer does not respond within 30minutes you must ring 999/112.

We all know the summer is short and as the seasons change so does the weather. Most of us will experience snow and freezing temperatures during the winter months and as such we should all know how to spot and quickly treat the problems caused by extreme cold.

Due to prolonged time spent outside in cold conditions equestrians are vulnerable to hypothermia, a condition where someone’s body temperature drops below 35°C (normal body temperature is around 37°C). Hypothermia can quickly become life threatening and severe hypothermia is when the body temperature falls below 30°C, is often fatal.

Hypothermia is easy to spot with obvious symptoms including; shivering; cold, pale and dry skin; confusion; slow, shallow breathing; tiredness; irrational behaviour and a slow and weakening pulse. If you fear someone is becoming hypothermic it is vital to get them inside as quickly as possible. Warm them up using layers of blankets, hot drinks, heating the room to 25°C and high energy food like chocolate.

If the person is outside and you are unable to bring them in you must act fast, ring 999/112 and ask for an ambulance. While you wait, stay with the patient and get them off the cold floor anyway possible. Keep talking to your patient and monitor their pulse, breathing and responsiveness until medical help arrives.

Regardless of the season or the temperature equestrians are vulnerable and as such we should all be prepared with correct first aid. Medi-K offer a wide range of first aid courses designed especially for equestrians, yard owners and grooms of all levels which will ensure you are prepared for all weather related situations.

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