Fall-related injuries as a leading cause of injury among deployed Army soldiers

Introduction: Falls are the leading cause of nonfatal injuries in the United States (U.S.). For the U.S. Army in 2008, falls (including near-falls) were the leading cause of unintentional injury hospitalizations (18%). During the Persian Gulf War (1990-91), falls were the 2nd leading cause of non-battle injury (NBI) hospitalizations (19%) among deployed Army soldiers. Purpose: The objective of this investigation was to describe the incidence of serious fall-related NBIs requiring medical air evacuation of soldiers deployed to Iraq or Afghanistan. Methods: Air evacuation records were reviewed for soldiers medically evacuated from Iraq or Afghanistan for NBIs (January 2001–December 2008). Narrative case history and diagnosis were used to classify cause of injury, fall type, and injury type. Descriptive statistics were used to report incidence of fall-related injuries (including near-falls), fall types, and injury types. Results: Overall 15,739 soldiers were air evacuated for an NBI. Of injuries with an identifiable cause (n=10,265), falls were the leading injury cause comprising 25% of NBIs (n=2,617; rate: 3 /1,000 person-years). Fall types included falls from one level to another (30%), on a single level (30%), alighting vehicles (10%), from stairs/ladder (6%), and near-falls (24%). Leading fall injury types were fractures (36%), dislocations (19%) and sprains (13%). Conclusion: Falls were the leading cause (25%) of serious NBIs air evacuated from Iraq and Afghanistan. These injuries, many of which are preventable, negatively impact soldier work performance and unit readiness during deployments. Development of prevention strategies targeted at specific fall types is required to lessen this impact.