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Risk Factors for Accident Death in the U S Army, 2004?2009 #MMPMID25441238
Lewandowski-Romps L; Peterson C; Berglund PA; Collins S; Cox K; Hauret K; Jones B; Kessler RC; Mitchell C; Park N; Schoenbaum M; Stein MB; Ursano RJ; Heeringa SG
Am J Prev Med 2014[Dec]; 47 (6): 745-53 PMID25441238show ga
Background: Accidents are one of the leading causes of death among U.S. active duty Army soldiers. Evidence-based approaches to injury prevention could be strengthened by adding person-level characteristics (e.g., demographics) to risk models tested on diverse soldier samples studied over time. Purpose: To identify person-level risk indicators of accident deaths in Regular Army soldiers during a time frame of intense military operations, and to discriminate risk of not-line-of-duty (NLOD) from line-of-duty (LOD) accident deaths. Methods: Administrative data acquired from multiple Army/Department of Defense sources for active duty Army soldiers during 2004?2009 were analyzed in 2013. Logistic regression modeling was used to identify person-level sociodemographic, service-related, occupational, and mental health predictors of accident deaths. Results: Delayed rank progression or demotion and being male, unmarried, in a combat arms specialty, and of low rank/service length increased odds of accident death for enlisted soldiers. Unique to officers was high risk associated with aviation specialties. Accident death risk decreased over time for currently deployed, enlisted soldiers while increasing for those never deployed. Mental health diagnosis was associated with risk only for previous and never-deployed, enlisted soldiers. Models did not discriminate NLOD from LOD accident deaths. Conclusions: Adding more refined person-level and situational risk indicators to current models could enhance understanding of accident death risk specific to soldier rank and deployment status. Stable predictors could help identify high risk of accident deaths in future cohorts of Regular Army soldiers.