Copyright

Injury Vol. 27, No. 2, pp. 89-91,

1996
0 1996 Elsevier Science Ltd. All rights reserved
Printed in Great Britain.
0020-1383196
$15.00 + 0.00

ELSEVIER

Does the Dangerous

Dogs Act protect against
animal attacks: a prospective
study of mammalian
bites in the Accident
and Emergency
department
B. Klaassen,

J. R. Buckley

and A. Esmail

*Department of Accident and Emergency, Aberdeen Royal Infirmary, Aberdeen, ?Stracathro Hospital, Brechin, and
Dundee Royal Infirmary, Dundee, Scotland, UK

This comparative prospective study of mammalian bites attending one

urban Accident and Emergency department before the implementution
of the Dangerous Dogs Act 1991 andagain 2 years later, was to see the
effect offhe Act on the pattern of injury. The study comprised a simple
questionnaire detailing the injury, the implicated species, and the
treatment or referral if applicable. In both groups studied (before and
after implementation of the Act) 134 consecutive bites were recorded,
contributing 1.2 per cent and 1.23 per cent of total attendances during
these respective periods, Dogs were found to bite most commonly: in the
pre-legislution group 73.9 per cent were due to dog bites and in the
post-legislation group 73. I per cent. In both groups studied, human
bites occurred asthe second most common mammalian bite; I 7.9 per
cent in the pre-legislationgroup and 12.7per cent in the post-legislation
group. Human bites were as common as those from the most implicated
breed of dog. In general human bites were found to require more active
treatment and specialist referral. The study demonstrates the vast
majority of suck injuries are treated within Emergency departments.
This study also shows how dangerous breeds compare with others that
bite, demonstrating that these breeds contribute to only a small
proportion of these injuries. This comparative study clearly demonstrates little impact on rate of attendances for suck injuries since the
introduction of the 199~ Act. If legislation aims to reduce and prevent
injury from animal bites, in its present form it does little to protect the
public; this study suggests a wider control of the dog population may be

required.

Injury, Vol. 27, No. 2, 89-91,

1996

Introduction
Dog bites have recently stimulated interest in both the
popular press and medical journals. Recent reviews have
concentrated on those referred to Regional Plastic Surgery
Units1,2.In the light of recent legislation, the Dangerous
Dogs Act 1991, regarding certain dog breeds, we undertook a comparative study of patients with mammalian
bites attending an urban Accident and Emergency (A&E)
department (Dundee Royal Infirmary) over two 3-month
periods, one before the implementation of the Act, and 2
years later, to determine what effect, if any, the Act has had
on the frequency and severity of such injuries.

Methods
During both the 3 month periods before and after
implementation of the Dangerous Dogs Act (I October to
31 December 1991) and (1 November to 3 1 January 1994)
patients were askedto complete the samesimplequestionnaire on the circumstancesof their injuries. Medical and
nursing staff completed details of the treatment received.
The questions concerned the age and sex of patients, the
type of animal involved, whether it was known or
unknown to the victim and whether active treatment,
antibiotic prophylaxis or specialty referral was necessary.
In the 3 months in 1991 there were 10930 new
attendances,of which 134 (1.2 per cent) were for mammalian bites. In the 3 months of 1993/1994 there were 10 810
new attendances of which 134 (1.23 per cent) were for
mammalianbites.

Results
Before the Dangerous Dogs Act
Of the 134 consecutive mammalian bites seen over this
period 99 (73.9 per cent) were causedby dogs. There were
24 (17.9 per cent) human bites, and three (2.25 per cent)
each by horses and cats. The remainder were of mixed
rodent origin, two (1.5 per cent) hamstersand one (0.75 per
cent) eachby a rabbit, rat and chinchilla. The age range was
from 2 months to 84 years.
Of the dog bites 30 per cent were of patients younger
than 15 years old, the male to female ratio in this group
being 3 : 1 (23 : 7). In adults the male to female ratio was
2 : 1 (47 : 22). Fifty-four patients (54.5 per cent) were bitten
by dogs known to them, 45 (45.5 per cent) by unfamiliar
dogs - of which three were police dogs (the samedog was
implicated in two such injuries, one requiring specialist
referral for skin grafting).
The breed of dog responsible was also identified
(FigureI). Alsatians were the most common breed with 24
(24.2 per cent) cases,closely followed by mongrels with 18
(18.2 per cent). Of the so-called dangerous breeds, only
six (6.1 per cent) caseswere attributed to Pit Bull Terriers,
Rottweilers and Dobermans.
Of patients sustaining human bites, none were younger
than 15 years old and only seven were over 40 years old.

90

Injury:

International

AlsatiCNl
Mongrel
Labrador
Highland
Terrier
ChiiUahUa
Jack Russell
York Terrier
Collie
Boxer
Poillter
lx4Jerman
setter
Pit Bull Terrier
Poodle
Lhso Apso
Springer Spaniel
scottie
Terrier
Lurcber
Cocker Spaniel
Rottweiler
Labrador Cross Collie
Golden Retriever
Cairn Terrier

Journal

of the Care of the Injured

Vol. 27, No. 2, 1996

AlSatioll
Mongrel
Labmior
Jack Russell
York Tenier
Collie
Boxer
Short Haired Hound
poberman
Borzoi
-0
Pit Bull Terrier
8
Poodle
!s
Lham Apse
Spaniel
Sccuie
Terrier
Greyhound
Border Collie
Rottweiler
Old English Sheepdog
Golden Reliever
Basset Hound

west
-2
s

10 12 14 16
Number
of bites

18

20

22

24

10 12 14 16
Number
of bites

18

20

22

24

Human
Horse
Cat
HalllSter
Rabbit
Rat
Chinchila

Figure 1. Animal bites experiencedbefore implementationof

the DangerousDogs Act 1991.

Most (70.8 per cent) occurred in young adults with a male

to female ratio of 1.4: 1. Two (8.3 per cent) required
specialistreferral, one to plastic surgery for re-implantation
of the pinna, and the other presenting with an old bite
complicated by osteomyelitis. In this group, 21 (87.5 per
cent) required or received prophylactic antibiotics. One
patient also required hepatitis B immunoglobin after being
bitten by a foster child, a known hepatitis B carrier.
In the group bitten by dogs only one patient (1 per cent)
required referral to plastic surgeons for skin grafting.
Thirty-three (33 per cent) required prophylactic antibitotic
cover, and 14 (14.1 per cent) required wound dressing
including sterile adhesive tape steristrips.
After the Dangerous Dogs Act
In this period the number of consecutive animal bites seen
was 134, of which 99 (73.1 per cent) were causedby dogs.
Of bites seen 17 (12.7 per cent) were by humans, 10 (7.5
per cent) by cats, three (2.2 per cent) by hamsters,and one
(0.75 per cent) eachby a rabbit, horse, squirrel, pig, fox and
field-mouse.Patients agesranged from 1 to 87 years old.
In the dog-bite group, 38 (38 per cent) were younger
than 15 years old, the maleto femaleratio being 1: 5, while
in the adult population the male to female ratio was 2 : 1.
Fifty (51 per cent) were attacked by animals known to
them, 48 (49 per cent) were bitten by unfamiliar dogs.
Again the pattern of dog breeds implicated was identified (Figure2). Mongrels were most commonly implicated
with 30 (30.6 per cent) bites. Alsatians were the next most
common with 17 (17.4 per cent). The dangerousPit Bull
Terriers, Rottweilers and Dobermansaccount for ll(ll.25
per cent) bites in this period.
Of patients bitten by humans,none were younger than
15 years old, and only six were over 40 years old. Most
(64.7 per cent) human bites occurred in young adults, the

IO I2
Number

I4 16 I8
of bites

20

22

24

IO I2
Number

I4 I6 18
of bites

20

22

24-30

30

HUeWI
Horse
Cat
HaIlXter
Rabbit
Squirrel
fig
Fox
Fieldmouse

Figure 2. Animal bitesexperiencedafter implementationof the

DangerousDogs Act 1991.

male to female ratio being 1.75 : 1. In this period none of

the human bites required specialistreferral and 15 (88.2 per
cent) required or received prophylactic antibiotics. In the
dog-bite group two (2 per cent) required referral for
specialist treatment (plastic surgery); 32 (32.7 per cent)
required prophylactic antibiotic cover and 13 (13.3 per
cent) required a wound dressing.

Discussion
Recent reviews of animal bites, particularly by dogs, have
been selective in their study of patient referralsto specialist
units?. Our study demonstratesthat out of 134 consecutive mammalianbites attending an urban A&E department
only three (2.1 per cent) in 1991 and two (1.5 per cent) in
1993/1994 required referral for specialist management.
The vast majority, it would seem,are treated within the
confines of the A&E department. Thus a study of this
group of patients should be more comprehensive and
meaningful.
Mammalian bites account for l-2 per cent of new
attendancesat this department. The implementation of the
Dangerous Dogs Act 1991 hasmadelittle impact upon the
attendance rate: in 1991 it was 1.2 per cent and in
1993/1994 1.23 per cent. Dogs are the animalsthat offend
most frequently, accounting for 73.9 per cent of bites seen
in 1991 and 73.1 per cent in 1993/1994. In both groups
just over half of the patients were bitten by their own dogs
or one well known to them.
In the pre-legislation group, Alsatians followed by
mongrels were the most implicated breeds; and in the
post-legislation group these breeds remain the most
frequent, albeit in reverse order. Before the Dangerous
Dogs Act the dangerous breeds as defined by the Act
were collectively responsible for 6.1 per cent of injuries

Klaassen

et al.: Dangerous

91

dogs act

seen - some 2 years after implementation they are

implicated in I 1.25 per cent of recorded injuries.
During both studies in 1991 and 1993/1994 only one
dog-bite patient required specialistreferral. This injury was
caused by an Alsatian police dog which maintained a
prolonged hold on its victim.
Surprisingly, humans were found to inflict bites as
commonly asthe most implicated breed, Alsatian, in 1991,
and as commonly as the second most implicated breed,
again Alsatian, in 1993/x994.
Of the human bites seen a greater number required
referral for specialist in-patient management, and in
general human bites required more active treatment
(antibiotics, formal dressings and in one case immunoglobin) than dog bites.
It would seemtherefore that the Dangerous Dogs Act
1991 doeslittle to protect the public from mammalianbites
as it fails to addressthe most commonly implicated breeds
and, in this particular urban setting, has failed to show any
reduction in injuries caused by the so-called dangerous
breeds.The Act has singled out certain dangerousbreeds
without, it would seem,any substantive data to support it.
We believe this paper is the first suchstudy to demonstrate
how the dangerous breeds rank amongst other dog
breeds and other mammals that bite (including Homo

seenin the A&E departments. If legislation is to reduceand

prevent injury from dog bites, this study suggests there
should be much wider control of the dog population in
general, and not one that simply addressedthe dangerous
breeds, referred to in the Dangerous Dogs Act 1991.

sapiens).

Requests for reprints should be addressed to: Mr 0. Klaassen,

It appears that the Act in its present form will fail to

prevent or reduce all but a tiny proportion of such injuries

Accident & EmergencyDepartment,AberdeenRoyal Infirmary,

AberdeenAB9 2ZD, Scotland,UK.

Acknowledgements
We thank Mr H. Cuthbert (now retired) and the nursing
and medical staff of Dundee Royal Infirmary A&E Department for their help with data collection and Mrs
E. M. Bridson for typing this paper.

References
I PalmerJ andReesM. Dog bitesof the face;a 15year review.
Br ] East Surg 1983; 36: 315.

2 ShewellPCandNancarrowJD. Dogsthat bite. Br Med] 1991;

303: 15120.

Paper accepted 24 October 1995.