Freezing cold injuries among soldiers in the Norwegian Armed Forces – A cross sectional study

ABSTRACT

Introduction: Freezing cold injuries (FCI) are a common risk in extreme cold weather warfare operations. The Norwegian Armed Forces (NAF) have the expertise and capabilities in education and training for warfighting capabilities in the Arctic. Nevertheless, a substantial number of Norwegian soldiers sustain freezing cold injuries annually. The aim of this study was to describe the FCI in the NAF, the associated risk factors and clinical associations.

Methodology: The subjects for the study were soldiers registered with FCI in the Norwegian Armed Forces Health Registry (NAFHR) between January 1st 2004–July1st 2021. The soldiers answered a questionnaire regarding background, activities at the time of injury, description of the FCI, risk factors, medical treatment and any sequelae from their FCI.

Results: FCI in the NAF were most frequently reported among young conscripts (mean20.5 years). Hands and feet are most often injured (90.9%). Only a minority (10.4%) received medical treatment. The majority (72.2%) report sequelae. Extreme weather conditions was the most important risk factor (62.5%).

Conclusions: Most soldiers had the knowledge to avoid FCI, but they were injured anyway. It is concerning that only one in 10 injured soldiers received medical treatment after diagnosed with FCI, increasing the risk of FCI sequelae.

KEYWORDS:

• Cold weather injuries
• Arctic
• freezing cold injury
• frostbite
• risk factor
• soldier
• military
• conscript
• sequelae
• grading

Acknowledgments

The authors wish to thank the Norwegian Armed Forces Health Registry and the Armed Forces HR and Conscription Centre for contributing to the data for the study. We also appreciate all valuable input and discussions with our colleagues at the Joint Medical Services and at the UiT – The Arctic University of Norway.

Disclosure statement

No potential conflict of interest was reported by the authors.

Authors’ contributions

TS and AJN conceived the study, and AEK and TS conducted the initial and final analyses. TS and AJN drafted the initial version of the paper. All authors gave input into how to interpret and structure the findings and reviewed subsequent versions. All authors have read and approved the final manuscript.

Ethics approval and consent to participate

The study was approved by the Regional Committee for Medical and Health Research Ethics (REK 278,429). Informed consent was obtained from all participants.

Availability of data and materials

The raw dataset is not available due to Norwegian privacy regulations. Applicants for any data must be prepared to conform to Norwegian privacy regulations.

Additional information

Funding

The cost of the publication and charges for this article have been funded by a grant from the North Atlantic Treaty Organization (NATO). No further funding was received.