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Throughout the history of war, there have been many instances when the cold has ravaged armies more effectively than their enemies. Delineated risk factors are restricted to negro origins, previous cold injury, moderate but not heavy smoking and the possession of blood group O. No attention has been directed to the possibility that abnormal blood constituents could feasibly predispose to the development of local cold injury. This study considers this possibility and investigates the potential contribution of certain components of the circulating blood which might do so. Three groups of soldiers from two of the battalions who served during the war in the Falklands Islands in 1982 were investigated. The risk factors which were sought included the presence or absence of asymptomatic cryoglobulinaemia, abnormal total protein, albumin, individual gamma globulin or complement C3 or C4 levels, plasma hyperviscosity or evidence of chronic alcoholism manifesting as high haemoglobin, PCV, RBC, MCV or gamma glutamyl transpeptidase (GGT). No cases of cryoglobulinaemia were isolated and there was no haematological evidence to suggest that any of those men who had developed cold injury, one year before this study was performed, had abnormal circulating proteins, plasma hyperviscosity or indicators of alcohol abuse. Individual blood groups were not incriminated as a predisposing factor although the small numbers of negroes in this series fared badly. Although this investigation has excluded a range of potential risk factors which could contribute to the development of cold injury, the problem persists. Two areas of further study are needed: the first involves research into the production of better protective clothing in the form of effective cold weather boots and gloves and the second requires the delineation of those dietary and ethnic factors which allow certain communities to adapt successfully to the cold. A review of the literature in this latter area is presented.
There is a long recorded history of Trench Foot from the Napoleonic Wars onwards and we can assume it existed before this time. Prolonged exposure to cold and damp has been cited as the exciting factors and it would seem logical to consider internal predispositions as a qualifying factor. Experiences of the First and Second World War combatants living through these conditions would support Trenchfoot was in epidemic proportions. The atrocious conditions in the 14-18 trenches would certainly claim many victims who were incapable of keeping their feet warm and dry but statistics also show more Allied forces suffered casualties in the Second World War (European Theatre) from Trench Foot than from German machine gun fire. Many soldiers aware of the dangers would deliberately expose their feet to the elements and this situation became so critical the US military dealt with proven cases of deliberate incapacitation as cowardice in the field and some were even shot. In Asia Immersion Foot was a similar condition which arose after prolonged exposure to warm and wet conditions.
In more recent times the ever changing theatre of war has put tremendous pressure on Governments to provide suitable footwear for their soldiers. The resurgence of Trench Foot was reported in the Falklands War and many Argentinean personnel were killed maimed or captured because the UK troops wanted to take their boots which were of superior quality to the UK issue.
More recently claims that insufficient supplies of adequate footwear have seriously handicapped the troops in Iraq and Afghanistan. The hotspots of Iraq and Afghanistan have necessitated developments in military footwear which can cope with the territory as well as challenges in making sure the fighting force have the appropriate supplies for combat. Having comfortable feet is a priority for the modern soldier with comfort, robustness plus the capability of dealing with temperature extremes and ground conditions all paramount. Military boots need to weather temperatures as high as 50C by day and often below 0, at night and on manovers, troops have often to cross sand and mountainous terrain. Boots need to give support a fully kitted soldier as well as withstand the rigours of conditions ranging from sandy desert to stony ground. During a series of trials conducted in Iraq, Afghanistan and Cyprus, on behalf of the Ministry of Defence (MoD) the German Meindl (general issue) and the US Lowa heavy-duty desert boots (in combat roles) came tops. In a very sensible move non combatant serving personnel will be issued with light weight patrol boots based on these styles and women soldiers will be issued with specialist female footwear appropriate to their role. In addition, troops involved in winter tours of Iraq and Afghanistan will be offered two different types of specialist boots for the cold weather. The latest Prabos footwear (Czech) is available for anyone unable to wear the standard issue Iturri product. Both boots have insulation to protect against extreme conditions.