title: Blisters on the battlefield: the prevalence of and factors associated with foot friction blisters during Operation Iraqi Freedom I.
abstract: BACKGROUND
  Foot friction blisters in military personnel lessen a soldier's mobility, concentration, and critical decision-making skills.
  
  
  OBJECTIVE
  To determine the prevalence of and factors associated with friction blisters during deployment in all military personnel who nonurgently presented to the 28th Combat Support Hospital.
  
  
  METHODS
  A cross-sectional survey was performed at the 28th Combat Support Hospital. Statistical tests used included descriptive statistics, chi-square tests, and logistic regression for nominal data.
  
  
  RESULTS
  The response rate was 97% with 872 surveys completed. Blister prevalence was 33% (95% confidence interval [CI] = 30.0-36.4). Eleven percent of these sought treatment (p < 0.001). Factors increasing the risk of developing blisters include female sex (prevalence ratio [PR] = 1.55, 95% CI = 1.27-1.91), wearing boots not broken in (PR = 1.52, CI = 1.26-1.85), longer than 6 months in theater (PR = 1.33, CI = 1.09-1.63), and history of prior blisters (PR = 2.08, CI = 1.69-2.56).
  
  
  CONCLUSIONS
  The prevalence of foot friction blisters was 33% during a 12-month block of Operation Iraqi Freedom I. Of these, 11% required medical care. The group most likely to develop blisters is women, ages 26 to 34, who are unable to break in their boots and have a past history of blisters.
authors.affiliation: Seacoast Orthopedics & Sports Medicine, 7 Marsh Brook Drive, Somersworth, NH 03878, USA.
authors.forename: Fred H
authors.initials: FH
authors.lastname: Brennan
authors.forename: Cody R
authors.initials: CR
authors.lastname: Jackson
authors.forename: Cara
authors.initials: C
authors.lastname: Olsen
authors.forename: Cindy
authors.initials: C
authors.lastname: Wilson
mesh_terms: D000293:Adolescent; D000328:Adult; D001768:Blister / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D003430:Cross-Sectional Studies; D005260:Female; D018409:Foot Injuries / Q000453:epidemiology* / Q000209:etiology; D017276:Friction; D006801:Humans; D007493:Iraq / Q000453:epidemiology; D054542:Iraq War, 2003-2011; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D015995:Prevalence; D011481:Protective Clothing / Q000009:adverse effects*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D055815:Young Adult