Public health surveillance of trends in non-battle injury rates among army soldiers deployed to operations iraqi freedom/new dawn (OIF/OND) and enduring freedom (OEF), 2001-2011

Background/Purpose: The U.S. Army Institute of Public Health maintains a surveillance system for non-battle injuries (NBIs) of soldiers who have been deployed for OIF and OEF. The Barell injury matrix displays frequencies of injury diagnoses based on the nature of injury and body region. This study evaluates the functionality of a public health surveillance system by assessing trends in Army soldier NBI rates based on Barell injury categories and their leading causes for deployed soldiers. Methods: Records of NBIs that required medical air evacuation of Army soldiers from OIF/OND and OEF (2001-2011) were identified. Monthly troop strength information was used to calculate rates. Annual rates for leading categories of NBIs and their related causes were evaluated for significant linear trends over time. Results: From 2001 through 2011, 15,946 (OIF/OND ) and 4,382 (OEF) NBIs were air evacuated from theater. Fracture, dislocation, open wound, and crush NBI rates decreased over time (p<.05). Decreases in these NBI rates were related to decreases in the rates for motor vehicle accident, crush/blunt trauma, fall/jump, slip/trip, and cut/pierce injuries (p<.05). The only NBI rate to increase over time was internal injury. Injury rates for the upper and lower extremity, torso, and head/face/neck decreased (p<.05). These decreases in the lower extremity NBI rates were related to decreases in fall/jump and slip/trip NBI rates (p<.05). Conclusions: Maintaining a public health surveillance database and examining NBI trends over time provides important information for identifying intervention needs to maintain Army soldier health and readiness even in deployed situations.