Female army injuries soar with sex equality

LONDON (Reuters Health) – The number of female British army recruits injured in training has more than doubled since "gender-free" policies were introduced in 1998, according to a study published on Thursday.

The same physical tests are now applied to male and female army applicants, both sexes undergo identical training, and the women are expected to reach the same fitness levels as the men.

But army researchers who compared the new and old policies say that female army recruits face a "substantially greater risk" to their health than men do with the changes.

To determine the effects of the new policy, they examined the number of medical discharges among 5697 men and 791 women recruited before the changes and 6228 men and 592 women afterwards.

The findings, published in the current issue of the Journal of the Royal Society of Medicine, show that for the men, the proportion of medical discharges due to injuries such as stress fractures, tendonitis and back pain remained below 1.5%

But for women, it rose from 4.6% to 11.1% under the new training regimen. The researchers said this means that women are now eight times more likely than male recruits to be discharged with this type of "overuse" injury.

Lt. Col. Ian Gemmell, the army occupational physician who co-authored the study, said differences in women's bone size and muscle mass mean that there is 33% to 39% more stress on the female skeleton than on the male skeleton during training.

In a mixed platoon of recruits, the women tended to march at the men's longer stride, putting their bones and muscles under even more stress, he added.

The data also suggest that although women's muscles can "mimic" male muscle, women need a 6-month training period rather than the standard 12 weeks.

"It is clear that there are differences in muscle physiology, bone architecture and body composition that interact to place women at a substantial disadvantage when training," Dr. Gemmell concludes.

"This study confirms and quantifies the excess risk for women when they undertake the same arduous training as male recruits, and highlights the conflict between health and safety legislation and equal opportunities legislation," he adds.

"There are a lot of women who come into the army and are subsequently injured," Dr. Gemmell told Reuters Health. "I don't think it is right to sit back and watch that happen."

He said experience in the US marines showed that many more females succeed when the training period is extended. However, this costs more and it would be "a braver man than me" who determines the maximum training period that should be allowed.

J R Soc Med 2002;95:23-27.

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