title: Medical Redeployment in Soldiers With and Without Medical Deployment Waivers.
abstract: Historically, disease and nonbattle injuries (DNBI) have caused more casualties during military operations than enemy combatants. Recent deployments to U.S. Central Commands (USCENTCOM) area of operation (AOR) have demonstrated similar outcomes. Intuitively, appropriate medical standards for our deploying Soldiers should result in no greater redeployments rates for those Soldiers who are waived for various medical conditions. However, no formal study has been published on redeployment rates of Soldiers with medical deployment waivers. The objective of this report was to evaluate the redeployment rates of Soldiers with and without medical waivers.
  
  
  
  A matched retrospective cohort study design was used in this study. Data were obtained from USCENTCOM, Army Central Command, Transportation Command, and the Armed Forces Health Surveillance Center. All U.S. Soldiers deploying to USCENTCOM's AOR with a medical deployment waiver during the calendar years of 2008-2013 were eligible for inclusion into the exposure group of this study. Soldiers with a medical deployment waiver were matched 1:5 to Soldiers without a medical deployment waiver. The Soldiers with a medical deployment waiver and their matched counterparts were then subdivided into 5 strata on the basis of their diagnosis. A McNemar's χ2test was performed to calculate risk ratios (RRs) per strata and for the group as a whole.
  
  
  
  The overall risk of being medically evacuated because of DNBI for all medical deployment waivers was an RR of 2.03 (CI: 1.74, 2.36). The greatest risk of being medically evacuated because of DNBI was from the group of Soldiers on a waiver for neurological conditions with an RR of 3.81 (CI: 1.99, 7.30). The RR of medical evacuation because of DNBI was increased and statistically significant for all strata (p < 0.05).
  
  
  
  There is a statistically significant increased RR of Soldiers with a Modification of the Operational Order waiver being medically redeployed for a DNBI reason from USCENTCOM's AOR from 2008 to 2013 compared with their matched peers without a waiver. The results of this study provide Commanders with additional information when making decisions regarding Soldier deployment.
authors.affiliation: Department of Occupational Medicine, United States Army School of Aviation Medicine, 540 Hulse Road, NAS Pensacola, FL 32504.
authors.forename: Corey M
authors.initials: CM
authors.lastname: Cronrath
authors.affiliation: Department of Soldier Research Development and Engineering Center, Natick Soldier System Center, 15 Kansas Street, Natick, MA 01760.
authors.forename: Joseph
authors.initials: J
authors.lastname: Venezia
authors.affiliation: Department of Occupational Medicine, United States Army School of Aviation Medicine, 540 Hulse Road, NAS Pensacola, FL 32504.
authors.forename: Titus J
authors.initials: TJ
authors.lastname: Rund
authors.affiliation: Department of Occupational Medicine, United States Army School of Aviation Medicine, 540 Hulse Road, NAS Pensacola, FL 32504.
authors.forename: Timothy H
authors.initials: TH
authors.lastname: Cho
authors.affiliation: Department of Occupational Medicine, United States Army School of Aviation Medicine, 540 Hulse Road, NAS Pensacola, FL 32504.
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Solana
authors.affiliation: Department of Occupational Medicine, United States Army School of Aviation Medicine, 540 Hulse Road, NAS Pensacola, FL 32504.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Benincasa
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D054542:Iraq War, 2003-2011; D008297:Male; D008889:Military Personnel / Q000706:statistics & numerical data*; D016017:Odds Ratio; D010560:Personnel Selection / Q000379:methods / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D000068436:Surgical Clearance / Q000379:methods / Q000706:statistics & numerical data*; D014195:Travel / Q000706:statistics & numerical data; D014857:Warfare