The aim of the study was to determine the seasonal influence of vitamin D status on bone metabolism in French submariners over a 2-mo patrol. Blood samples were collected as follows: prepatrol and patrol days 20, 41, and 58 on crewmembers from both a winter (WP; n = 20) and a summer patrol (SP; n = 20), respectively. Vitamin D status was evaluated for WP and SP. Moreover, extended parameters for acid-base balance (Pco(2), pH, and bicarbonate), bone metabolism (bone alkaline phosphatase and COOH-terminal telopeptide of type I collagen), and mineral homeostasis (parathyroid hormone, ionized calcium and phosphorus) were scrutinized. As expected, SP vitamin D status was higher than WP vitamin D status, regardless of the considered experimental time. A mild chronic respiratory acidosis (CRA) was identified in both SP and WP submariners, up to patrol day 41. Such an occurrence paired up with an altered bone remodeling coupling (decreased bone alkaline phosphatase-to-COOH-terminal telopeptide of type I collagen ratio). At the end of the patrol (day 58), a partial compensation of CRA episode, combined with a recovered normal bone remodeling coupling, was observed in SP, not, however, in WP submariners. The mild CRA episode displayed over the initial 41-day submersion period was mainly induced by a hypercapnia resulting from the submarine-enriched CO(2) level. The correlated impaired bone remodeling may imply a physiological attempt to compensate this acidosis via bone buffering. On patrol day 58, the discrepancy observed in terms of CRA compensation between SP and WP may result from the seasonal influence on vitamin D status.

Le Service de protection radiologique des Armées est le « bras armé » du SSA pour toutes les questions liées au nucléaire et notamment pour le suivi du personnel affecté à l’ensemble des composantes de la dissuasion. Le SPRA constitue, de ce fait, un outil essentiel pour le bon fonctionnement des opérations.

French military Search and Rescue (SAR) is primarily for the recovery of downed aircrew in an operational environment but has traditionally also played an important civilian role. Military doctors and nurses with competence in this area frequently form part of civilian teams, their experience being transferable between operational and civilian spheres. A recent re-organisation of French Medical Aid at Sea (MAS) has seen greater involvement of civilian medical services in this sector with consequent potential for negative impact on future military involvement.The French Military Medical Service / Service de Santé des Armées (SSA) 2020 plan provides opportunities for mutually advantageous, deeper engagement and joint working between the SSA and the French National Health Service / Service Public de Santé (SPS).This article describes the current structure for MAS and the involvement of SSA therein before considering some of the challenges and potential solutions with respect to deeper civilian-military engagement in this domain in future.

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