Even in War Zones, Battle Doesn't Cause Most Injuries

THURSDAY, Jan. 21 (HealthDay News) -- Fractures, tendonitis and other musculoskeletal and connective tissue injuries are the most common reasons for medical evacuation of U.S. military personnel from Iraq and Afghanistan, a new study shows.

"Most people think that, in a war, getting shot is the leading cause of medical evacuation, but it almost never is," study leader Dr. Steven P. Cohen, an associate professor of anesthesiology at the Johns Hopkins University School of Medicine and a colonel in the U.S. Army Reserves, said in a Hopkins news release. "As in the past, disease and non-battle-related injuries continue to be the major sources of service-member attrition, and that's not likely to change. It's likely to get worse."

The reason there are so many injuries not related to battles, he explained, relates to the changing nature of warfare. "We have a lot of people in Afghanistan and Iraq, and their main job isn't fighting," Cohen said.

He and his colleagues analyzed the records of more than 34,000 military personnel sent to the U.S. military's medical center in Landstuhl, Germany, from 2004 through 2007. They found that the leading reasons for medical evacuation were musculoskeletal or connective tissue disorders (24 percent), combat injuries (14 percent) and neurological disorders (10 percent).

The percentages remained relatively stable over the four years. However, the percentage of military members leaving with psychiatric diagnoses rose each year, despite the introduction of mental health teams focused on treating combat stress on site, the study found.

As for the non-battle-related physical injuries, Cohen said the military needs to do more to prevent injuries and illness. He also said that military medical staff need to be trained to aggressively treat problems before they become more serious.

"For some of the musculoskeletal problems, you may not be able to prevent them," Cohen said. "Most people doing their jobs in heavy gear, like Kevlar, are going to get overuse injuries like knee pain, hip pain and bursitis. But you need to recognize and treat problems before they become severe."

The study is published Jan. 22 in The Lancet.

More information

The Henry J. Kaiser Family Foundation has more about military and veterans' health care.

SOURCE: Johns Hopkins Medicine, news release, Jan. 21, 2010

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