Sickle cell trait and military service

Abstract

In the community great efforts have been made to educate those with sickle cell trait that their condition is not a handicap and that they are fit to lead a normal life. It would be seen as a retrograde step for the Armed Forces to imply that they are in some way unfit for normal duties. The evidence presented demonstrates that with the exception of a small excess risk of sudden unexplained death during training there is no objection to recruiting those with sickle cell trait into the Royal Navy. At present those with sickle cell disorders are barred from service in the Royal Marine Commandos and from diving, submarine and aircrew service. On the basis of the evidence presented in this review a case can be made for allowing those with sickle cell trait to enter as aircrew in helicopters but not as pilots. In view of the requirements for military divers to operate in cold water under stressful conditions the exclusion of those with sickle cell trait is entirely justified. The overriding requirement must be the safety of both the affected individual and of others and the current regulations reflect this. Screening of all recruits and officer entrants in appropriate racial groups is not performed at present but would allow counselling and advice to be given to those affected by sickle cell trait at an early stage of their careers and the reasons for their exclusion from certain branches fully explained either by establishment Medical Officers or by the haematologist.(ABSTRACT TRUNCATED AT 250 WORDS)