Page 53 - Journal of Special Operations Medicine - Fall 2017

Estimation of Dog-Bite Risk and Related Morbidity
Among Personnel Working With Military Dogs

H. Schermann, MD *; N. Eiges ; A. Sabag ;
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E. Kazum, MD ; A. Albagli, MD ; M. Salai, MD ; A. Shlaifer, MD 1
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ABSTRACT
Background: Soldiers serving in the Israel Defense Force Mili- dog bites in these units is scarce. The existing studies focus
tary Working Dogs (MWD) Unit spend many hours taming on victims who were intentionally injured by law-enforcement
dogs’ special skills, taking them on combat missions, and per- dogs, and do not discuss the occupational risk of uninten-
4–7
forming various dogkeeping activities. During this intensive tional bites of police officers or soldiers by MWDs.
work with the aggressive military dogs, bites are common,
and some of them result in permanent disability. However, this The Israeli Defense Forces MWD Unit is an elite unit, special-
phenomenon has not been quantified or reported as an oc- izing in taming dogs’ special skills and using them in various
cupational hazard. Methods: This was a retrospective cohort settings of limited conflict. The demand for MWDs is high;
study based on self-administered questionnaires. Information thus, training and work are extremely intense. Everyday activ-
was collected about soldiers’ baseline demographics, duration ities such as walking a dog, feeding it, and taking it to health
of the experience of working with dogs, total number of bites check-ups are combined with combat missions, Combat sol-
8,9
they had, circumstances of bite events, and complications and diers are responsible for their partner MWDs, whereas dog-
medical treatment of each bite. Bite risk was quantified by in- keepers care for temporarily unemployed MWDs. Dog bites
cidence, mean time to first bite, and a Cox proportional haz- are by far the most significant occupational hazard in this unit.
ards model. Rates of complications and the medical burden of A code of safety precautions exists but is violated often. The
bites were compared between combat soldiers and noncombat soldiers perceive bites as an inevitable outcome of work with
dogkeepers. Bite locations were presented graphically. Results: dogs (i.e., “part of the deal”). Obviously, for those who sus-
Seventy-eight soldiers participated and reported on 139 bites. tain more severe injuries and suffer from residual disability,
Mean time of working with dogs was 16 months (standard de- the price is too high.
viation, ±9.4 months). Overall bite incidence was 11 bites per
100 person-months; the mean time to first bite event was 6.3 This article focuses on soldiers who suffered bites while work-
months. The Cox proportional hazards model showed that ing with dogs. Its goals are to present dog bite–related mor-
none of baseline characteristics significantly increased bite bidity, including measures of risk, rates of complications, and
hazard. About 90% of bites occurred during routine activi- the distribution of bite locations, and to identify points for
ties, and 3.3% occurred on combat missions. Only in 9% of preventive intervention. Special attention is dedicated to com-
bite events did soldiers observed the safety precautions code. parison of the risk for bites and complication rates between
Bite complications included fractures, need for intravenous combat soldiers and dog keepers.
antibiotic treatment and surgical repair, prominent scarring,
diminished sensation, and stiffness of proximal joints. Bite Methods
complications were similar between combat soldiers and dog-
keepers. Most bites (57%) were located on hands and arms. A questionnaire-based retrospective cohort study was con-
Conclusion: MWD bites are an occupational hazard result- ducted in the MWD unit. Participating subjects were men and
ing in significant medical burden. Hands and arms were most women 18 to 21 years old, serving either as combat soldiers or
common bite locations. Observance of safety precautions may as noncombat dog keepers for at least 3 months. All soldiers
be the most appropriate first-line preventive intervention. Bar- visiting the unit clinic for any medical problem other than a
rier protection of upper extremities may reduce bite severity dog bite were offered the opportunity to participate. After
and complication rates. providing an informed consent, they completed a short base-
line characteristics’ questionnaire that requested information
Keywords: canine; combat; bites, dog; dogs, military work- on age, sex, type of service, height, weight, smoking status,
ing; Israeli Army; dog keepers number of bites, and total duration of working with dogs; and
a separate form for each bite they had received, which asked
about characteristics of the event and of the bite medical treat-
ment and complications. Event-specific information included
Introduction
time of the bite since the beginning of working with dogs, bite
Military working dogs (MWDs) are increasingly used in Army, location, whether it was a soldier’s own dog, the biting dog’s
1–3
police, and antidrug units. Scientific literature addressing breed (Belgian Malinois versus other types), whether safety
*Correspondence to sheralmi@gmail.com
1 Drs Schermann, Kazum, Albagli, Salai, and Shlaifer are affiliated with the Division of Orthopedic Surgery, Tel-Aviv Medical Center, Tel Aviv,
Israel. Drs Eiges and Sabag are affiliated with the Military Working Dogs Unit, Israeli Defense Force, Israel.
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