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Update: Cold weather injuries, active and reserve components, U.S. Armed Forces, July 2014-June 2019
Insights
Cold injury rates, including frostbite, were highest in active component service members during 2018-2019. Risk factors included being male, younger, enlisted, and non-Hispanic black, with notable exceptions in female soldiers.
Area of Science:
- Military medicine
- Environmental health
- Epidemiology
Background:
- Cold injuries pose a significant health risk to military personnel.
- Previous surveillance has identified trends in cold injury incidence.
Purpose of the Study:
- To report the incidence and characteristics of cold injuries among active and reserve component service members.
- To identify trends and high-risk demographics for cold injuries.
Main Methods:
- Retrospective analysis of medical encounter data from July 2018 to June 2019.
- Calculation of incidence rates per 100,000 person-years.
- Stratification of data by service component, demographics, and injury type.
Main Results:
- The 2018-2019 incidence rate of 36.5 per 100,000 person-years was the highest in a 5-year period.
- Frostbite was the most common cold injury across all services.
- Higher incidence rates were observed in males, non-Hispanic black, younger (<20), and enlisted service members.
- Female Army members had a higher cold injury rate than males due to frostbite.
- Cold injuries associated with overseas deployments reached a 5-year high in 2018-2019.
Conclusions:
- Cold injury incidence is increasing, reaching a peak in 2018-2019.
- Targeted prevention strategies are needed for identified high-risk groups.
- The rise in deployment-related cold injuries warrants further investigation and intervention.
Abstract:
From July 2018 through June 2019, a total of 513 members of the active (n=446) and reserve (n=67) components had at least 1 medical encounter with a primary diagnosis of cold injury. The crude overall incidence rate of cold injury for all active component service members in 2018-2019 (36.5 per 100,000 person-years [p-yrs]) was slightly higher than the rate for the 2017-2018 cold season (35.8 per 100,000 p-yrs) and was the highest rate during the 5-year surveillance period. In 2018-2019, frostbite was the most common type of cold injury among active component service members in all 4 services. Among active component members during the 2014-2019 cold seasons, overall rates of cold injuries were generally highest among males, non-Hispanic black service members, the youngest (less than 20 years old), and those who were enlisted. As noted in prior MSMR updates, the rate of all cold injuries among active component Army members was higher in women than in men because of a much higher rate of frostbite among female soldiers. The number of cold injuries associated with overseas deployments during the 2018-2019 cold season (n=24) was the highest count during the 5-year surveillance period.