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This study examined risk factors for self-reported injury incurred before arrival at the U.S. Army Ordnance School for advanced individual training (AIT). During AIT in-processing, soldiers (n = 27,289 men and 3,856 women) completed a questionnaire that collected demographic and lifestyle information, and asked if the soldier currently had an injury that would affect his or her AIT performance. Potential risk factors for self-reported injury were explored using logistic regression. For men, self-reported injury was associated with older age [odds ratio (OR) greater than or equal to 30 years/17-19 years = 1.9], race (OR Black/Caucasian = 1.2), basic combat training (BCT) site (OR Fort Benning/Fort Jackson = 1.7, OR Fort Leonard Wood/Fort Jackson = 1.6, OR Fort Knox/Fort Jackson = 1.3), smoking on 20 or more days in the 30 days prior to BCT (OR smoker/non-smoker = 1.2), and current illness (OR ill/not ill = 6.2). For women, increased self-reported injury was associated with older age (OR greater than or equal to 30 years/17-19 years = 2.0), BCT site (OR Fort Leonard Wood/Fort Jackson = 1.5), and current illness (OR ill/not ill = 5.8). The authors conclude that certain demographic characteristics and lifestyle behaviors may be identified as injury risk factors on arrival at Ordnance AIT., Accepted for publication in Public Health on 17 March 2010.

In May 2005, the U.S. Army Center for Health Promotion and Preventive Medicine was tasked by the Deputy Assistant Secretary of the Army for Environment, Safety and Occupational Health to develop an injury surveillance system for deployed Army Soldiers. A primary objective was to develop a system capable of identifying types and potentially preventable causes of injuries requiring medical air evacuation. The primary data source for air evacuated injured Soldiers was the U.S. Transportation Command Regulating and Command and Control Evacuation System (TRAC2ES) which included standardized diagnosis codes and a free-text patient history from which details for injury causes could be obtained. TRAC2ES data were linked to data from the Defense Casualty Reporting System (DCIPS) and the Army Safety Management Information System (ASMIS) to obtain additional details for the injury causes and circumstances. Since information on injury causes was in free-text fields, coders reviewed each air evacuation case and applied a standardized coding scheme (STANAG) to classify causes of injury. The final enhanced air evacuation data system included 1) linked data from TRAC2ES, DCIPS and ASMIS and 2) coded causes and types of injuries. This system provided high quality, analysis-ready data and is well suited for deployment injury surveillance.

This paper summarizes hospitalization rates and trends, injury hospitalizations relative to other diagnoses, and injury hospitalizations by external cause of injury. Hospitalization rates in the Army increased 8% between 1981 and 1994, to a rate of 153/1,000 personnel/year. For the years 1989-1994, both the Navy and Marine Corps saw declines in hospitalization rates; the Navy rate declined 24% to 71/1,000 personnel/year, whereas the Marine Corps rate fell 27% to 61/1,000 personnel/year. Between 1980 and 1994, the Air Force hospitalization rate declined 35% to 100/1,000 personnel/year. Musculoskeletal conditions, which are frequently the result of injuries, were the leading cause of hospitalizations in the Army (18%), Navy (22%), and Marine Corps (28%) in 1994. Digestive conditions constituted the largest proportion of hospitalizations in the Air Force in 1994; however, musculoskeletal conditions and injury together accounted for 22% of hospitalizations that year.

The Total Army Injury and Health Outcomes Database (TAIHOD) comprises data on active duty Army soldiers from six Department of Defense (DoD) agencies. The TAIHOD is used for epidemiologic research and has three general types of data: demographics, health outcomes, and self-reported health habits. Demographic data include personal characteristics such as rank, age, and occupation; health outcome data such as hospitalizations, lost-time injuries, permanent disabilities, and fatalities; and self-reported health habit data such as diet, tobacco, and alcohol use. Data are linked by encrypted social security number. Linking these disparate databases is a good example of using administrative data for epidemiologic research. Researchers use structured data queries of the TAIHOD to investigate health problems and make recommendations about policy and the design and implementation of intervention. To date, the TAIHOD has been used to document the risk of hospitalization in certain Army occupations and to evaluate the association between seat belt use and hospitalization for motor vehicle crashes. The TAIHOD is regularly updated and expanded, by updating the present data sets and by incorporating new data sets. The TAIHOD is a valuable tool that enables researchers to improve the Army's health through epidemiologic research, and is a model comprehensive research database., Chapter 8 of Atlas of Injuries in the U. S. Armed Forces.

This paper outlines the five steps in the public health prevention model and applies them to the problem of injury morbidity and mortality in the U.S. Armed Forces. The five steps are (1) determine the existence and magnitude of the problem, (2) identify the causes of and risk factors for the problem, (3) determine what prevents the problem, (4) implement prevention strategies and programs, and (5) monitor and evaluate the effectiveness of prevention efforts. The paper applies these five steps to the problem of injuries in the military., Chapter 9 of Atlas of Injuries in the U.S. Armed Forces.

The Department of Defense (DoD) Injury Surveillance and Prevention Work Group, chartered under the DoD Safety and Occupational Health Committee and Defense Environment Security Council, was tasked to: Determine the size of the problem of injuries in the military. Document rates and trends of injury fatalities, disabilities, and hospitalizations. This Identify information sources with potential for use in conducting injury surveillance and prevention programs. Atlas of Injuries in the U.S. Armed Forces is the result of their work. Information provided here was collected from DoD, Army, Navy, Marine Corps, and Air Force databases that document the occurrence of injuries in military personnel. The data presented in this atlas are intended to serve several distinct purposes: Show the full significance of the problem of injuries for the military services. Demonstrate the value of existing databases for identifying causes, tracking rates and trends, and focusing resources for prevention and research. Use to modify and integrate existing information management systems and institute new systems, where necessary, to provide ongoing injury surveillance. This will supply commanders with the knowledge necessary to reduce injuries and protect their operating forces in all deployment modes.