Etiology of Fall-Related Injuries in the Army: Review of Narrative Incident Reports, January to December 2011

Abstract : Background: Though falls are consistently a leading cause of injuries in U.S. civilian and military populations, injury prevention can be hindered without adequate details regarding target populations and activities. Objective: This project identified activities and hazards most frequently associated with fall-related injuries among deployed and non-deployed Active Duty Army Soldiers to help determine injury reduction strategies. Methods: Narrative data collected from calendar year 2011 Army safety, medical evacuation, and casualty reporting systems was independently reviewed by investigators to ensure incidents met inclusion criteria and to assign a priori determined codes. Calculation provided injury rates and descriptive frequencies for various activities and hazards. Results: A total of 988 non-deployed and 254 deployed fall-related injury incidents were identified. Rates were not statistically different (2.20 per 1000 non-deployed person-years and 2.21 per 1000 deployed person-years). Most injuries (75%) in both settings were temporarily disabling especially fractures, sprains and sprains. Lower extremities (ankle, foot, knee) were most frequently injured. Leading non-deployed activities included sports (22%) especially snowboarding and basketball, parachuting (20%), and walking or marching (19%); ice and snow hazards were a leading hazard (43%). In deployed settings, occupational tasks (53%) , walking or patrolling (24%) , and climbing (23%) especially in and out of vehicles were highlighted. Conclusions: Fall-related injuries have substantial impacts to military readiness. Over 40,000 duty days are lost each year due to fall-related fractures, sprains, and sprains alone. This Army-wide assessment highlights priorities for fall prevention, but improved documentation and local installation and unit level assessments are needed to identify and track these injuries.