Gender differences in load carriage injuries of Australian army soldiers

Abstract

Background: With the removal of gender restrictions and the changing nature of warfare potentially increasing female soldier exposure to heavy military load carriage, the aim of this research was to determine relative risks and patterns of load carriage related injuries in female compared to male soldiers. Methods: The Australian Defence Force Occupational Health, Safety and Compensation Analysis and Reporting workplace injury database was searched to identify all reported load carriage injuries. Using key search terms, the narrative description fields were used as the search medium to identify records of interest. Population estimates of the female: male incident rate ratio (IRR) were calculated with ninety-five percent confidence interval (95% CI) around the population estimate of each IRR determined. Results: Female soldiers sustained 10% (n = 40) of the 401 reported injuries, with a female to male IRR of 1.02 (95% CI 0.74 to 1.41). The most common site of injury for both genders was the back (F: n = 11, 27%; M: n = 80, 22%), followed by the foot in female soldiers (n = 8, 20%) and the ankle (n = 60, 17%) in male soldiers. Fifteen percent (n = 6) of injuries in female soldiers and 6% (n = 23) of injuries in males were classified as Serious Personal Injuries (SPI) with the lower back the leading site for both genders (F: n = 3, 43%: M: n = 8, 29%). The injury risk ratio of SPI for female compared to male soldiers was 2.40 (95% CI 0.98 to 5.88). Conclusions: While both genders similarly have the lower back as the leading site of injury while carrying load, female soldiers have more injuries to the foot as the second leading site of injury, as opposed to ankle injuries in males. The typically smaller statures of female soldiers may have predisposed them to their observed higher risk of suffering SPI while carrying loads.

Profiling lower extremity injuries sustained in a state police population: a retrospective cohort study

“…Of note, no differences in the severity of injuries between the genders were reported. This contrasts the findings of Orr et al [35], who found that while male and female soldiers suffered similar levels of injuries due to occupational load carriage, female personnel were 2.4 times more likely to suffer a 'serious personal injury' than male personnel. Noting that the research by Orr et al [35], was of a single task (load carriage) in a military population, potential differences in severity are reported by Hua et al [77], who found that female police officers, in general, attended a greater number of inhouse physiotherapy treatments than male officers (8.25 ± 5.12 vs. 6.57 ± 4.03 treatments respectively).…”

“…This contrasts the findings of Orr et al [35], who found that while male and female soldiers suffered similar levels of injuries due to occupational load carriage, female personnel were 2.4 times more likely to suffer a 'serious personal injury' than male personnel. Noting that the research by Orr et al [35], was of a single task (load carriage) in a military population, potential differences in severity are reported by Hua et al [77], who found that female police officers, in general, attended a greater number of inhouse physiotherapy treatments than male officers (8.25 ± 5.12 vs. 6.57 ± 4.03 treatments respectively). Differences in these findings may be explained by several factors including, a lack of detail in regard to rating the severity of the injuries entered into the database, differences in reporting processes (e.g., self-reported, as was the case in this study) versus point-of-care (i.e.…”

“…'Motorcycle pursuits' and 'parking control' were found to be the least common activities, associated with only three injuries in total (< 0.1%). When comparing between genders, there was a statistically significant, albeit weak [39] association (Cramer's V = 0.236) between gender and the activity being undertaken at the time of injury (χ2 [35] = 692.201, p < .001). The most common activity being performed at the time an injury occurred was 'arresting an offender' (n = 2450, 27%), followed by 'walking/running' (n = 838, 9%), and 'foot pursuit' (n = 837, 9%) for male officers and 'walking/running' (n = 608, 18%), followed by 'arresting an offender' (n = 562, 17%), and 'general duties' (n = 382, 11%) for female officers.…”

“…A recent review by Lyons, et al [34] found that the majority of studies in law enforcement contexts that have investigated injuries included only male participants. Understanding differences in injury presentations between male and female officers is of importance as research has shown that, for examples, male and female tactical personnel can suffer from different lower limb musculoskeletal injuries [35] and that lower limb interventions to address genderspecific injuries are effective [36]. Furthermore, the review found that there were no standard injury definitions, with many of the included studies failing to include any definition at all [34].…”

1.5 mile run time and body mass predict 8 mile loaded march performance, irrespective of sex

“…[1][2][3] Repetitive and prolonged load carriage can place significant strain on the musculoskeletal system, increasing the risk of acute and chronic overuse injuries, in particular for untrained soldiers. 3,4 In an attempt to reduce this risk, Representative Military Tasks (RMTs) have been developed to assess a soldier's physical status and combat readiness which replicate the physical demands of specific military tasks, but in a more practical and safe manner. 5,6 A prerequisite for applicants wishing to join the Infantry in the British Army is to complete and pass three RMTs to a required standard before basic training, namely a 1.5 mile run (to best effort), a Single Lift (SL; capped at 40 kg; Powerbag TM from the floor onto a 1.45 m platform), and a bilateral Water Can Carry (WCC; 20 kg on each hand, capped at a distance of 150 m).…”