Equestrians sports have a high injury rate and many athletes use chest protective equipment, i.e., the safety vest. Safety vest certification includes impact attenuation tests, but it is not known how relevant these tests are compared to real-world accidents. We categorised 902 equestrian accidents with suspected torso injury that occurred during competitions in the United States, 2020-2023. Falls from horses accounted for 68-92% of all cases with torso injury. The remaining cases were kicked, stepped on, or struck by a horse, and other scenarios. Most torso injuries were caused by forward or sideway falls from a horse in connection to a jump, with the first impact to the head or shoulder. We simulated two representative accident scenarios and compared to simulations of the impact tests in EN 13157 and ASTM F1937 standards. Simulations suggest that the impact tests defined in standards loaded the safety vest similar to hoof kicks but that they did not represent the slower loading seen in the simulated fall accidents. Hence, additional impact test methods are needed to assess safety vest performance in falls from horses.