174632 Impact of Military Deployment on Soldiers with Pre-Deployment Chronic and Recurrent Injuries

Sunday, October 26, 2008

Suzanne R. Block, MPH , Injury Prevention Program, US Army Center for Health Promotion and Preventive Medicine, Aberdeen Proving Ground, MD
Keith G. Hauret, MSPH, MPT , Injury Prevention Program, US Army Center for Health Promotion and Preventive Medicine, Aberdeen Proving Ground, MD
Nakia S. Clemmons, MPH , Injury Prevention Program, US Army Center for Health Promotion and Preventive Medicine, Aberdeen Proving Ground, MD
Bonnie Taylor, PhD , Injury Prevention Program, US Army Center for Health Promotion and Preventive Medicine, Aberdeen Proving Ground, MD
Bruce H. Jones, MD, MPH , Injury Prevention Program, US Army Public Health Command (Provisional), Aberdeen Proving Ground, MD
Introduction: Employment-related exacerbations of chronic or recurrent (C-R) injuries are recognized concerns in many occupational fields, including the military. Even though pre-deployment screening prevents soldiers with job-limiting C-R injuries from deploying to Operation Iraqi Freedom (OIF), many injuries are exacerbated by deployment-related duties and eventually require medical evacuation to seek medical care and rehabilitation.

Purpose: The objective of this investigation was to describe the incidence, anatomical location, type, and exacerbating causes of C-R injuries requiring medical evacuation from OIF.

Methods: Air evacuation records for U.S. Army soldiers medically evacuated from OIF for non-battle injuries (NBIs) between March 19, 2003 and December 31, 2006 were reviewed. Patient medical history and diagnosis were used to identify soldiers requiring evacuation for exacerbated pre-deployment C-R injuries along with the anatomical location, type and exacerbating causes of these injuries.

Results: 9530 soldiers were evacuated for NBIs. Of these, 1509 (15.8%) were for worsening of pre-deployment C-R injuries. The leading anatomical locations were the back (33%), knee (19%), and shoulder (15%). 521 patients were diagnosed with inflammation/pain syndromes and 231 with dislocations. Exacerbating causes were identified in 29% of these cases. The top three causes were 1) wear of boots and personal protective equipment (PPE) (20%), 2) falls/jumps (16%), and 3) lifting/pushing/pulling activities (16%).

Conclusion: 16% of NBI evacuations were for pre-deployment C-R injuries. 33% occurred in the back, and 20% were exacerbated by wear of boots and PPE. Similar to many civilian occupations, military deployment can result in job-limiting worsening of C-R injuries.

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Learning Objectives:
Recognize the methodological issues that occur in chronic and recurrent injury surveillance Describe the incidence of job-limiting chronic and recurrent injury among soldiers deployed for Operation Iraqi Freedom Describe the injury type, anatomical location, and exacerbating causes for chronic and recurrent injuries that require air evacuation of deployed soldiers Compare and contrast military and civilian occupational chronic and recurrent injuries

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: “The views expressed in this presentation are those of the author and do not reflect the official policy or position of the Department of Army, Department of Defense, or the U.S. Government” The injury prevention program has demostrated expertise in this area through multiple presentations, abstracts, and journal articles on this topic. I, as a member of this program, am qualified as an author on this topic, in addition to having an MPH in epidemiology.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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