Occupational and off-duty injuries among U.S. Army soldiers deployed for Operation Iraqi Freedom, 2003 – 2006

Background: Employment-related injuries negatively affect morale, motivation, and job performance in most occupational fields, including the military. For Army soldiers deployed for combat operations, occupational and off-duty non-battle injuries (NBIs) are especially critical if soldiers are unable to perform their military duties and require medical evacuation to receive specialized treatment or rehabilitation. In these cases, unit combat readiness is negatively impacted. Purpose: The objective of this investigation was to describe the incidence, types, anatomical locations, and causes of NBIs requiring medical evacuation of Army soldiers from Operation Iraqi Freedom. Methods: Air evacuation records were reviewed for all soldiers who sustained non-fatal NBIs requiring medical evacuation from Iraq between March 19, 2003 and December 31, 2006. Medical history and diagnosis were used to identify and classify the injury type, anatomical location, cause and intent for all non-fatal NBIs. Results: Of 27,563 soldiers medically evacuated from Iraq, 9,530 (35%) were for NBIs (NBI rate: 174/10,000 soldiers). Leading injury types were fractures (19%), inflammatory pain syndromes (18%), dislocations (12%), and sprains/strains (11%). Leading anatomical locations were the back (18%), knee (15%), wrist/hand (13%), ankle/foot (11%), and shoulder (9%). Only 139 injuries were intentional (assaults or self-inflicted). The top 3 unintentional injury causes were sports/exercise (19%), falls/jumps (18%), and motor vehicles-related accidents (15%). Conclusion: 9,530 soldiers assigned to Operation Iraqi Freedom sustained a serious non-fatal NBI requiring medical evacuation. These injuries negatively impact job performance and possibly soldier retention, just as occupational injuries in other fields negatively affect job performance and employability. See disclaimer.