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 Researchers examined data on almost 30,000 casualties from 2003 to
2014 in the Department of Defense Trauma Registry, including cases
that happened both on and off the battlefield. Overall, roughly half
of these injuries were caused by explosives, and another 15 percent
were from gunshot wounds.
But overall, about 34 percent of injuries were not sustained in
battle. Injuries off the battlefield often involved motor vehicle
crashes; other incidents involved operating machinery or playing
sports, the study also found.
"It was clear from my own experience as a physician deployed to
Afghanistan in 2011 that the deployed environment presents a
significant risk of injury due to accidents and mishaps," said
senior study author Dr. Kevin Akers, a lieutenant colonel at the
U.S. Army Institute of Surgical Research at Fort Sam Houston in
Texas.
"There is a lot of heavy machinery which may be operating day and
night, in all weather conditions, and during periods of intense
stress and distraction," Akers said by email. "Even so, I was
surprised by the proportion of casualties in the DOD Trauma Registry
attributed to non-battle injury, which seemed higher than what I
would have expected."
Non-battle injuries were most common in the Air Force, accounting
for 67 percent of cases, followed by the Navy at 48 percent, the
Army at 35 percent, and the Marine Corps at 26 percent, researchers
report in JAMA Surgery.
Falls were the most common cause of non-battle injuries, accounting
for 21 percent of cases, followed by car crashes at 19 percent and
heavy machinery or equipment accidents at 13 percent, researchers
report in JAMA Surgery.
Another 11 percent of injuries off the battlefield were from blunt
trauma, and sports and gunshot wounds each accounted for another 7
percent of cases.
These injuries are also becoming more common. Researchers estimate
that 41 percent of injuries between 2015 and 2022 will occur off the
battlefield.
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Many of these accidents may be preventable, lead study author Dr.
Tuan D. Le of the U.S. Army Institute of Surgical Research said by
email.
One limitation of the study is that it included people seriously
injured enough to be sent to the hospital, and excluded more minor
cases as well as fatalities that happened before service members
could reach a hospital, the authors note.
Dr. Todd Rasmussen, author of an accompanying editorial and a
surgeon at Walter Reed Medical Center in Bethesda, Maryland, told
Reuters Health by email that deployment conditions often make
everyday tasks more dangerous than they would be in civilian life,
and this contributes to injuries off the battlefield, Rasmussen, a
colonel in the U.S. Air Force, said by email.
"In the deployed environment, even basic activities such as driving
a vehicle, working on a logistics or maintenance mission, or even
working out are not routine," said Rasmussen, who is a colonel in
the U.S. Air Force.
He added, "Mission-critical activities need to be accomplished in
adverse environmental conditions (e.g., heat, dust storms, snow and
ice) and in areas with little if any normal infrastructure (e.g.,
safe roads, utility and electric grids or communication systems)."
"These mission-critical activities are often completed by relatively
young troops facing fatigue and possibly even psychological
stressors," Rasmussen added. "Couple this with the urgency of the
mission, and it's not surprising that unintended situations account
for a good portion of injured service members."
SOURCE: http://bit.ly/2M2vOBC JAMA Surgery, online May 30, 2018.
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