Elsevier

Public Health

Volume 129, Issue 5, May 2015, Pages 531-538
Public Health

Original Research
Occupation and other risk factors for injury among enlisted U.S. Army Soldiers

https://doi.org/10.1016/j.puhe.2015.02.003Get rights and content

Highlights

  • Injury incidence for the prior 12 months was 43%.

  • Soldiers who were older, had higher BMI's, smoked cigarettes, and less aerobically fit were at higher risk of injury.

  • Armor and Chemical, Explosives, & Ammunition occupational groups had higher injury risk when compared to Infantry Soldiers.

Abstract

Objective

To investigate injury risk associated with occupation and occupational physical demand levels among U.S. Army Soldiers.

Methods

Personal characteristics, physical fitness, military occupational specialty (MOS), and injury data were obtained by survey from Soldiers in an Army light infantry brigade (n = 2101). Odds ratios (OR) and 95% confidence intervals (95% CI) from a multivariate analysis assessing injury risk were calculated.

Results

Injury incidence for the prior 12 months was 43%. Physical fitness and behavioral factors associated with injury risk included age 21–29 (OR [age 21–29/age ≤ 20] = 1.37, 95% CI 1.00–1.90), BMI 27.5–29.9 (high-overweight) (OR high-overweight/normal = 1.62, 95% CI 1.20–2.18); BMI >29.9 (obese) (OR obese/normal = 1.73, 95% CI 1.23–2.44), cigarette smoking (OR Smoker/Nonsmoker = 1.34, 95% CI 1.11–1.63), and poor APFT two mile run performance (OR (Q4/Q1) = 1.61, 95% CI 1.19–2.19). Higher risk of injury was associated with some MOSs (OR (Chemical, Explosives & Ammunition/Infantry) = 2.82, 95% CI 1.19–6.68; OR (Armor/Infantry) = 1.53, 95% CI 1.13–2.07).

Conclusion

This study identified a number of potentially modifiable risk factors for injuries including: maintenance of healthy weight, improved aerobic endurance, and reduction in smoking. Results also indicate certain Army occupations may be at higher risk of injury. Further investigation into reasons for their higher risk is warranted.

Introduction

Unintentional occupational injuries result in substantial lost work time and productivity in the U.S. In 2009, unintentional occupational injuries affected 141 million U.S. workers at an estimated cost of $168.9 billion.1 Unintentional injury rates have been shown to vary across industries and occupational groups. In industries with high physical demands such as construction, non-fatal injury rates are as high as 12.4 per 100 full time workers per year compared to less physically active sectors such as financial services with rates of 1.4 injuries per 100 full time workers per year.2

Injuries are also a concern for the military. Historically, injuries have been the leading cause of medical encounters, disability and death.3, 4 Musculoskeletal injuries result in work restrictions and time away from work in order to recover, ultimately limiting mission effectiveness.5 Injuries are also a financial burden due to lost duty time, medical costs and, in some cases, medical discharge of seriously injured Soldiers.5, 6, 7, 8 In 2004, the top ten unintentional injuries for all U.S. Armed Forces resulted in an estimated 25 million limited duty days.5

Within the U.S. Army there are a various occupations with unique physical demands and skills needed to successfully accomplish their mission. These occupations have been classified into Military Occupational Specialties (MOS). Each MOS has a specific job description and estimated physical demand level.9 For example, Army regulation 611-21 describes the duties of an infantryman as follows: “supervises, leads, or serves as a member of an infantry activity that employs individual small arms weapons or heavy anti-armor crew served weapons, either vehicle or dismounted in support of offensive and defensive combat operations.” The Infantryman occupation is classified as an MOS of 11B, and the physical demand level is classified as “very heavy”.9

Very few studies have investigated the association of occupation, occupational physical demands, and injury risk in military populations. Prior studies have indicated that Army Soldiers assigned to physically demanding jobs are at increased risk of injury, hospitalization, and disability.10, 11 The purpose of this project was to describe the association of MOS and physical demand levels with injury risk among U.S. Army Soldiers controlling for potential confounders such as age, body composition and physical fitness levels.

Section snippets

Data collected

Subjects for this retrospective cohort study were Soldiers from a single light infantry Army brigade. Baseline demographic information on participating Soldiers (age, ethnicity, education, and marital status) and MOS were obtained from the Defense Medical Surveillance System, a data system maintained by the Armed Forces Health Surveillance Center.12 Surveys were also completed by Soldiers as part of an ongoing evaluation of a physical training program. The survey obtained self-reported data on

Descriptive statistics

Surveys was voluntarily completed by 2101 enlisted male Soldiers (60% of brigade), with a mean (±SD) age of 26.5 ± 6.0 years. A majority of Soldiers were Caucasian (72%), high school graduates (87%), married (61%), of lower rank (E1-E4) (63%), were classified as overweight or obese (61%), and cigarette smokers (52%).

Table 3 compares age, BMI, sit-ups, push-ups, two-mile run time, percentage cigarette smokers, and injury incidence by MOS groups in the thirteen MOSs observed. As shown in Table 3,

Discussion

This investigation described injuries and injury risk factors for enlisted male Soldiers in a U.S. Army light infantry brigade with a focus on occupations. The self-reported injury incidence over the year was 43%, with an injury rate of 35.7 per 1000 person-months. Only a few other studies have investigated injury risk in operational Army units. One study used medical treatment records and showed 51% of 298 male Soldiers in a U.S. Army infantry unit had sustained an injury over a six month time

Contributors

All authors have contributed significantly to the preparation of this manuscript, including participation in designing the study, analyzing and interpreting the data, drafting the manuscript and approving the final draft being submitted. The views and opinions expressed in this article are those of the authors and should not be construed to represent the views of the sponsoring agency or the Federal Government.

Ethical approval

This project used a previously anonymized database and the project was determined to

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