Defining the magnitude of the problem: U.S. military injury surveillance| Volume 38, ISSUE 1, SUPPLEMENT , S94-S107, January 2010

Frequency and Causes of Nonbattle Injuries Air Evacuated from Operations Iraqi Freedom and Enduring Freedom, U.S. Army, 2001–2006


      Medical information systems during past military deployments had limited injury surveillance capability as data were not accessible during deployments and did not capture causes of injury. This paper describes nonbattle injury (NBI) results from an ongoing surveillance program that identifies injury occurrences and causes during deployments for Operations Iraqi Freedom (Iraq) and Enduring Freedom (Afghanistan).


      U.S. Army soldiers medically air evacuated from Iraq (March 2003–December 2006) or Afghanistan (October 2001–December 2006) were identified from air evacuation records that provided demographics, casualty type, diagnosis, and patient history. For NBI cases, the patient history was used to identify and code injury cause, incident circumstances, and body region. Descriptive statistics were used to describe and compare NBIs evacuated from Iraq and Afghanistan.


      In all, 27,563 soldiers in Iraq and 4165 in Afghanistan were air evacuated. NBIs accounted for 35% and 36% of cases, respectively, and were the largest single category of evacuations for both operations. Distributions for leading categories of NBI diagnosis (fracture, inflammation/pain, and dislocation) and body region (back, knee, and wrist/hand) were similar for both operations. Leading NBI causes were the same for both operations—sports/physical training (19%–21%), falls/jumps (18%), and motor vehicle–related incidents (12%–16%)—but the proportion of motor vehicle incidents was higher in Iraq (p<0.001).


      Routinely collected air evacuation records provided the basis for ongoing injury surveillance for Iraq and Afghanistan. NBI was the largest category of evacuations from both operations. Leading NBI causes were similar to those identified for previous deployments and many should be preventable.
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