RISK FACTORS FOR MUSCULOSKELETAL INJURIES IN DEPLOYED FEMALE SOLDIERS

Each year musculoskeletal injuries (MSI) result in thousands of lost duty days per unit as well as thousands of medical discharges resulting in billions of dollars in disability costs. Approximately 15% of the U.S. Army is made up of women and no studies have identified risk factors for MSIs while deployed despite the fact that female soldiers have higher incidence rates of MSIs than male soldiers. The purpose of this prospective cohort study was to investigate occupational, physical, and psychosocial risk factors for musculoskeletal injury in female soldiers. \ud Female participants were recruited from three Brigade Combat Teams deploying during 2012. They underwent performance testing and completed surveys on demographics, sleep, coping, and job stress prior to deployment. Upon completion of the deployment, soldiers completed the surveys again plus an additional survey on occupational demands and MIs. \ud Of the 160 women, 57 (36%) suffered 78 resulting in 1642 days of limited duty. Most injuries were to the knee (24%) or low back (18%). Soldiers identified physical training as the self-reported cause for most injuries (27%). In univariate analysis, injured soldiers had significantly higher average load worn and more time wearing it; higher heaviest load worn and more time wearing it; more time spent wearing body armor or a back pack; higher average weight of lifted objects, more repetitions of lifting it, and carrying it further; higher Y Balance composite score; and more family members. In multivariate analysis of physical and occupational variables, the average load and heaviest load worn, the average number of times an object was lifted, and the number of sit ups performed were predictors of MSI. None of the psychosocial variables predicted MSI. In the combined multivariate model, the most parsimonious set of risk factors was, average load worn (OR=1.04), heaviest load worn (OR=1.03), average number of times an object was lifted (OR=1.07), and number of sit ups performed on the Army Physical Fitness Test (OR=0.96). \ud These results suggest that injury prevention programs designed to improve load bearing ability, lifting endurance, and core strength should be considered to decrease MSIs in deployed female soldiers.\u