PT  - JOURNAL ARTICLE
AU  - Daniel R Clifton
AU  - D A Nelson
AU  - Y S Choi
AU  - D B Edgeworth
AU  - K J Nelson
AU  - D Shell
AU  - P A Deuster
TI  - Risk factors for musculoskeletal-related occupational disability among US Army soldiers
AID  - 10.1136/bmjmilitary-2021-001900
DP  - 2021 Aug 08
TA  - BMJ Military Health
PG  - bmjmilitary-2021-001900
4099  - http://militaryhealth.bmj.com/content/early/2021/08/08/bmjmilitary-2021-001900.short
4100  - http://militaryhealth.bmj.com/content/early/2021/08/08/bmjmilitary-2021-001900.full
AB  - Introduction Minimising temporary and permanent disability associated with musculoskeletal conditions (MSK-D) is critical to the mission of the US Army. Prior research has identified potentially actionable risk factors for overall military disability and its MSK-D subset, including elevated body mass index, tobacco use and physical fitness. However, prior work does not appear to have addressed the impact of these factors on MSK-D when controlling for a full range of factors that may affect health behaviours, including aptitude scores that may serve as a proxy for health literacy. Identifying risk factors for MSK-D when providing control for all such factors may inform efforts to improve military readiness.Methods We studied 494 757 enlisted Army soldiers from 2014 to 2017 using a combined medical and administrative database. Leveraging data from the Army’s digital ‘eProfile’ system of duty restriction records, we defined MSK-D as the first restriction associated with musculoskeletal conditions and resulting in the inability to deploy or train. We used multivariable Cox proportional hazards regression to assess the associations between incident MSK-D and selected risk factors including aptitude scores, physical fitness test scores, body mass index and tobacco use.Results Among the subjects, 281 278 (45.14%) experienced MSK-D. In the MSK-D hazards model, the highest effect size was for failing the physical fitness test (adjusted HR=1.63, 95% CI 1.58 to 1.67, p<0.001) compared with scoring ≥290 points.Conclusions The analysis revealed the strongest associations between physical fitness and MSK-D. Additional efforts are warranted to determine potential mechanisms for the observed associations between selected factors and MSK-D.No data are available.