The Association between Sickle Cell Trait in U.S. Service Members with Deployment, Length of Service, and Mortality, 1992-2012

Darrell E. Singer, Ligong Chen, Stephanie Shao, Jonathan Goldsmith, Celia Byrne, David W. Niebuhr

Research output: Contribution to journalReview articlepeer-review

4 Scopus citations


Introduction: Sickle cell trait (SCT) affects an estimated 5.02% of non-Hispanic blacks, 1.08% of Hispanics, and 0.1% of Whites in the U.S. military. Policies for SCT screening and occupational restrictions vary by service. Population-based studies of SCT with quantification of military-relevant outcomes are lacking. Methods: The study design was a retrospective cohort of 15,081 SCT-positive versus 60,320 SCT-negative U.S. active duty personnel enlisted from 1992 to 2012 and followed through 2013. Military-relevant outcome included number and days of deployment, length of service, and cause of death. Results: SCT-positive versus SCT-negative service members experienced more deployments (p < 0.01) and longer number of days deployed for all services, especially the Army (p < 0.001). The median length of service was longer for SCT-positive service members stratified by service and by gender (p < 0.05). The adjusted risk of length of service greater than 5 yr by SCT status was 1.37 (95% confidence interval 1.31-1.43) with greater than a three-fold higher risk in the Navy and Air Force compared with the Army. Crude mortality rate was not significantly different by SCT status, although deaths due to suicide, self-directed violence, and other non-specific causes were more common in SCT-positive service members. Conclusion: We found that SCT-positive service members deployed more frequently, for greater lengths of time, and remained in service longer. No significant difference in crude mortality ratio was discovered. Additional research on military-relevant outcomes and a cost-effectiveness analysis of SCT screening practices are needed to inform evidence-based SCT enlistment policies.

Original languageEnglish
Pages (from-to)E213-E218
JournalMilitary Medicine
Issue number3-4
StatePublished - 1 Mar 2018
Externally publishedYes


  • Deployment
  • Length of Service, Military
  • Mortality
  • Retention
  • Sickle Cell Trait


Dive into the research topics of 'The Association between Sickle Cell Trait in U.S. Service Members with Deployment, Length of Service, and Mortality, 1992-2012'. Together they form a unique fingerprint.

Cite this