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1.
Aviat Space Environ Med ; 72(12): 1086-95, 2001 Dec.
Article in English | MEDLINE | ID: mdl-11763109

ABSTRACT

BACKGROUND: Risk factors for drowning are largely undocumented among military populations. HYPOTHESIS: Accident report narratives will provide important information about the role of alcohol use and other behaviors in drownings among active duty male U.S. Army soldiers. METHODS: Using a case series design, we describe drowning deaths reported to the U.S. Army Safety Center (1980-1997), documenting associated demographic factors, alcohol use, and other risk-taking behaviors. RESULTS: Drowning victims (n = 352) were disproportionately young, black, and single, with less time-in-service, and no college experience. Most drownings occurred off-duty (89%). Alcohol use was involved in at least 31% of the cases overall. Alcohol use was also associated with a 10-fold increase in reckless behavior (OR 9.6, 95% Cl 4.5-20.7) and was most common among drownings in Europe (OR = 4.3, 95% Cl 1.5-13.4). Most drownings occurred where no lifeguard was present (68%), but almost two-thirds occurred in the presence of others, with CPR initiated in less than one-third of these cases. Drownings involving minority victims were less likely to involve alcohol, but more likely to occur in unauthorized swimming areas. While most drownings did not involve violations of safety rules, over one-third of the cases involved some form of reckless behavior, particularly for those under age 21. CONCLUSIONS: Intervention programs should be tailored to meet the needs of the demographic subgroups at highest risk since behavioral risk factors vary by race and age. CPR training and skills maintenance can improve survival rates. Narrative data are important for developing hypotheses and understanding risk factors for injuries.


Subject(s)
Alcohol Drinking , Drowning/epidemiology , Military Personnel , Adolescent , Adult , Humans , Male , Risk Factors , Risk-Taking , United States/epidemiology
2.
Mil Med ; 165(10): 762-72, 2000 Oct.
Article in English | MEDLINE | ID: mdl-11050874

ABSTRACT

A total of 675,626 active duty Army soldiers who were known to be at risk for deployment to the Persian Gulf were followed from 1980 through the Persian Gulf War. Hospitalization histories for the entire cohort and Health Risk Appraisal surveys for a subset of 374 soldiers were used to evaluate prewar distress, health, and behaviors. Deployers were less likely to have had any prewar hospitalizations or hospitalization for a condition commonly reported among Gulf War veterans or to report experiences of depression/suicidal ideation. Deployers reported greater satisfaction with life and relationships but displayed greater tendencies toward risk-taking, such as drunk driving, speeding, and failure to wear safety belts. Deployed veterans were more likely to receive hazardous duty pay and to be hospitalized for an injury than nondeployed Gulf War-era veterans. If distress is a predictor of postwar morbidity, it is likely attributable to experiences occurring during or after the war and not related to prewar exposures or health status. Postwar excess injury risk may be explained in part by a propensity for greater risk-taking, which was evident before and persisted throughout the war.


Subject(s)
Health Status Indicators , Health Status , Mental Health , Military Personnel/psychology , Military Personnel/statistics & numerical data , Adolescent , Adult , Female , Health Behavior , Humans , Indian Ocean , Male , Morbidity , Risk-Taking , Stress, Psychological/epidemiology , Stress, Psychological/psychology , United States/epidemiology
3.
Am J Prev Med ; 19(2): 87-93, 2000 Aug.
Article in English | MEDLINE | ID: mdl-10913897

ABSTRACT

BACKGROUND: Healthy People 2000 (HP2000) is a national agenda of health promotion and disease prevention objectives, with specific health behavior goals in 22 priority areas. The U.S. Army Health Risk Appraisal (HRA) is a self-administered health-habits survey, inquiring about tobacco and alcohol use, physical activity, nutrition, and safety-related practices, given to more than 400,000 active-duty U.S. Army soldiers in the 1990s. This article compares the health behaviors of U.S. Army soldiers, as measured by the HRA, with the HP2000 objectives. METHODS: We compared cross-sectional analyses of self-reported health behaviors of active-duty Army personnel responding to HRA questionnaires in 1991 (n=78,256) and in 1997-1998 (n=59,771) with corresponding HP2000 objectives. We also calculated longitudinal changes for personnel who took more than one HRA (n=86,393). RESULTS: By 1997-1998, the Army exceeded HP2000 physical fitness goals by at least 50% and also exceeded goals for eating high-fiber foods and using bicycle helmets. The Army did not meet goals for nutrition, tobacco use, and seat-belt use. CONCLUSIONS: The Army has made good progress toward the HP2000 goals. However, improvement is needed to meet the tobacco, nutrition, and safety goals.


Subject(s)
Health Behavior , Health Promotion , Adolescent , Adult , Alcohol Drinking , Cross-Sectional Studies , Diet , Female , Humans , Longitudinal Studies , Male , Military Personnel/statistics & numerical data , Nutrition Surveys , Organizational Objectives , Risk Factors , Smoking , Surveys and Questionnaires , United States
4.
Am J Epidemiol ; 151(11): 1060-3, 2000 Jun 01.
Article in English | MEDLINE | ID: mdl-10873129

ABSTRACT

The authors examined the relation between cigarette smoking and suicide by conducting a cohort study of 300,000 male US Army personnel followed prospectively from January 1987 through December 1996 for 961,657 person-years. They found that the risk of suicide increased significantly with the number of cigarettes smoked daily (p for trend < 0.001). In multivariable-adjusted analyses, smokers of more than 20 cigarettes a day, compared with never smokers, were more than twice as likely to commit suicide. For male active-duty army personnel, the dose-related association between smoking and suicide was not entirely explained by the greater tendency of smokers to be White, drink heavily, have less education, and exercise less often.


Subject(s)
Military Personnel/statistics & numerical data , Smoking/adverse effects , Smoking/epidemiology , Suicide/statistics & numerical data , Adult , Cohort Studies , Educational Status , Humans , Male , Prospective Studies , Risk Factors , Surveys and Questionnaires , United States/epidemiology
5.
Am J Prev Med ; 18(3 Suppl): 85-95, 2000 Apr.
Article in English | MEDLINE | ID: mdl-10736544

ABSTRACT

BACKGROUND: Motor vehicle crashes are a leading cause of injury in the Army. Behaviors increasing risk for motor vehicle crashes are also prevalent, but research has not linked these behaviors directly to injury outcomes (e.g., hospitalizations). METHODS: To evaluate the relationship between behavior and motor vehicle crash injuries, 99, 981 Army personnel who completed Health Risk Appraisal surveys in 1992 were followed for up to 6 years. Cox proportional hazards modeling was used to evaluate speeding, seat belt use, drinking patterns, and demographics. RESULTS: A total of 429 soldiers were hospitalized for motor vehicle injury. Unadjusted analyses revealed that heavy drinking, drinking and driving, speeding, low seat belt use, younger age, minority race/ethnicity, and enlisted rank were significantly associated with motor vehicle injury, but neither smoking nor gender was. Multivariate models showed a significant trend of increasing injury risk with younger ages. Soldiers under age 21 were injured almost five times more often than those over age 40 (HR 4.89, 2.56-9.33). Also associated with risk for hospitalizations were minority race (HR 1.78, 1.46-2.18), heaviest drinkers versus abstainers (HR 1.81, 1.11-2.94), and seat belt use of 50% or less versus 100% (HR 1.40, 1.07-1.85). Although nonsignificant, there was evidence of an age-drinking interaction where the difference in injury risk between those older and those younger than 21 was greatest at low alcohol consumption levels. CONCLUSIONS: Modifiable risk factors associated with motor vehicle injuries include heavy drinking and low seat belt use. Programs targeting these behaviors that meet the needs of young and minority soldiers are needed. The high density of young, at-risk soldiers residing in base housing may provide a unique opportunity for a residential intervention program.


Subject(s)
Accidents, Traffic/statistics & numerical data , Hospitalization/statistics & numerical data , Military Personnel/statistics & numerical data , Risk-Taking , Wounds and Injuries/epidemiology , Accidents, Traffic/prevention & control , Adolescent , Adult , Alcoholic Intoxication/epidemiology , Alcoholic Intoxication/prevention & control , Causality , Female , Health Education , Humans , Male , United States , Wounds and Injuries/prevention & control
7.
Occup Med (Lond) ; 49(3): 139-45, 1999 Apr.
Article in English | MEDLINE | ID: mdl-10451594

ABSTRACT

Military parachuting has been recognized as a hazardous activity since it was first introduced in World War II. Other risks associated with military service include actual war-fighting, training with weapons and explosives, operating with armoured vehicles or deployment to climatic extremes. These other hazards should be considered in any assessment of the additional risk associated with military parachuting. The aim of this study was to identify the risk attributable to parachuting amongst US Army enlisted soldiers. This study identified a cohort of infantry soldiers who served between 1990-94. They were separated by receipt of parachute hazardous duty pay. There was a total of 329,794 person-years (PY) available for study of which 18% were in the exposed group. The rate of hospitalization was very similar in both groups [123.9 per 1,000 PYs for the exposed group, 127 in the non-exposed group: relative risk (RR) = 0.98, 95% confidence interval (CI) = 0.96-1.00). The exposed group was 1.49 times (CI = 1.42-1.57) more likely to be admitted as a result of an injury as compared with the non-exposed group. Military parachuting was 20 times (CI = 16.6-24.3) more likely to be the cause of an injury. This study has shown that receipt of hazardous duty pay for military parachuting can be used as a marker in identifying significant additional risks to the health of infantry soldiers associated with military parachuting. This was reflected in an increased incidence of admission for acute injury and musculoskeletal trauma (particularly a trauma pattern associated with parachuting) as a result of military parachuting. Other risks, which are associated with parachute pay, are admission for the effects of heat, battle injury and helicopter accidents.


Subject(s)
Aviation/statistics & numerical data , Hospitalization/statistics & numerical data , Military Personnel/statistics & numerical data , Occupational Health , Adolescent , Adult , Cohort Studies , Humans , Middle Aged , Occupations , Risk Assessment , United States/epidemiology
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