Epidemiology of U.S. Army cold weather injuries, 1980-1999.
BACKGROUND
Cold weather injuries (CWI) are of great military concern due to their wide-ranging impact on military readiness. Previous short-term studies have identified CWI to be more prevalent in African-Americans, infantrymen, and lower-ranking soldiers. The purpose of this cross-sectional study was to determine the occurrence of CWI hospitalizations in the U.S. Army from 1980 to 1999, and to identify possible trends, high-risk groups and/or activities.


METHODS
The U.S. Army Research Institute of Environmental Medicine Total Army Injury and Health Outcomes Database was searched for hospitalizations with ICD-9-CM codes for frostbite, hypothermia, immersion foot, chilblains, and other. Information concerning each soldier included: gender, age, ethnicity, rank, occupation, type of injury, home of record, duty station, principle diagnosis, trauma code, and cause of injury. Data was available on the demographic composition of the Army, by year, and was used as the denominator when calculating the frequency of occurrence.


RESULTS
During the study period there were 2143 hospitalizations due to CWI. African-American men and women were injured approximately 4 times and 2.2 times as often as their Caucasian counterparts, respectively. Trauma and cause of injury codes indicate that about 80% of all CWI hospitalizations result on-duty and during organized training. The yearly rate of CWI hospitalization has declined from 38.2/100,000 in 1985 to 0.2/100,000 in 1999.


CONCLUSIONS
Our data are consistent with previous research concerning the increased rate of CWI among African-Americans though further investigation appears warranted. The occurrence of most CWI during on-duty training suggests preventability. The decline in the overall rate of CWI hospitalizations is multifactorial.
U.S. Army Research Institute of Environmental Medicine, Thermal and Mountain Medicine Division, Natick, MA 01760-5007, USA. david.degroot@na.amedd.army.mil
David W
DW
DeGroot
John W
JW
Castellani
Jeffrey O
JO
Williams
Paul J
PJ
Amoroso
D003080:Cold Temperature / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D005260:Female; D005627:Frostbite / Q000453:epidemiology; D006801:Humans; D007035:Hypothermia / Q000453:epidemiology; D008297:Male; D008889:Military Personnel; D009784:Occupational Diseases / Q000453:epidemiology*; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology*