The Burden of Deployment-Related Non-battle Injuries (NBIs) and Their Impact on the Musculoskeletal System

Abstract

Despite the large volume of news reports focused on battle-related injuries resulting from the recent conflicts in Iraq (Operation Iraqi Freedom, OIF) and Afghanistan (Operation Enduring Freedom, OEF), these injuries are only the tip of the iceberg. Soldiers have traditionally been two to five times as likely to be hospitalized or medically evacuated from combat zones due to disease and non-battle injuries (DNBIs) than for injuries directly related to combat, and trends in the distribution of DNBIs have significantly shifted over the last century. Recent data suggest that 83 % of medical evacuations from OIF and OEF were due to DNBIs and that 34.8 % of these were due to non-battle injuries (NBIs) compared with 48.2 % that were due to disease. When only examining medical evacuations due to DNBIs, 58 % were due to disease while the remaining 42 % were due to NBIs, with the majority of these injuries impacting the musculoskeletal system. The data also suggest that participation in sports and physical training are a leading cause for these NBIs. Those serving in the Army and Marine Corps, as well as younger soldiers and those in the junior and senior enlisted ranks, appear to be at the greatest risk for NBIs during deployment. Though many of these injuries are likely preventable, there is limited data available on the efficacy or effectiveness of injury prevention interventions among soldiers deployed in support of OIF or OEF. The purpose of this chapter is to provide an overview of the burden that NBIs pose during military operations and deployments. We will discuss historical trends in the distribution of NBIs and also review the most recent data on NBIs from the Gulf War and the conflicts in Iraq and Afghanistan. Finally, we will discuss the prevention of NBIs during military deployments.