Hemoglobin S levels in sickle cell trait individuals.

Area of Science:

• Hematology
• Military Medicine
• Genetics

Background:

• Department of Defense regulations have been updated to permit individuals with sickle cell trait to serve in all military branches.
• A specific criterion defines sickle cell trait as having 41% or less S hemoglobin for regulatory purposes.

Purpose of the Study:

• To evaluate the impact of the new Department of Defense regulation's definition of sickle cell trait on service eligibility.
• To determine the percentage of individuals with sickle cell trait who would be excluded based on the 41% or less S hemoglobin criterion.

Main Methods:

• Analysis of screening data from 397 individuals diagnosed with sickle cell trait.
• Quantitative scanning of cellulose acetate electrophoretic sheets to determine S hemoglobin levels.

Main Results:

• The study screened 397 individuals with sickle cell trait.
• Based on quantitative analysis, 20-40% of individuals with sickle cell trait would be excluded by the 41% or less S hemoglobin criterion, depending on precise definitions used.

Conclusions:

• The current regulatory definition of sickle cell trait may disproportionately exclude eligible individuals from military service.
• Further review of the S hemoglobin threshold is recommended to ensure accurate and fair screening for military personnel with sickle cell trait.