Predictors of Injury in U.S. Army Basic Training

Abstract

Nine-week (wk) Army basic training (BT) physically challenges new recruits, some of whom are unaccustomed to high levels of activity. Injury incidence is 19% - 37% for men and 42% - 67% for women, with 80% - 85% of injuries being overuse-related. Similar types of injuries occur in sports and recreation. The association of health risk behaviors and BT injury is poorly understood due to insufficient data for baseline measures. PURPOSE: To examine potential risk factors for BT injury from a self-reported health and health risk behavior survey. METHODS: Between 1 October 2002 and 30 September 2003, 6584 male and 4754 female Regular Army recruits at Ft. Jackson, SC completed a165-item survey of health status and health risk behaviors. Survey data were linked to routinely collected medical data for 5324 men and 3873 women to identify those injured during BT. Univariate and multivariate logistic regression (adjusted for days of training) were used to examine the association of potential risk factors and BT injury. RESULTS: Cumulative injury incidence during BT was 27% and 54% for men and women, respectively. Mean age (±SD) was 21±4 years (yrs) for men and women. Independent risk factors for injury among men included older age (Odds Ratio [OR] [Υ≥23 yrs/≤18 yrs]=1.52; 95% confidence interval [CI]=1.25-1.85), history of physical abuse (OR [often/never]=1.48; 95% CI=1.10-1.98), history of extreme anger (OR [>1x-wk/never]=1.46; 95% CI=1.09-1.97), age began smoking (OR [≤12/≥18]=1.37; 95% CI=1.00-1.87), history of stiff/painful joints (OR [yes/no]=1.58; 95% CI=1.32-1.90), and non-high school graduate (OR [GED/high school diploma]=1.34; 95% CI=1.07-1.67). Among women, independent risk factors included being divorced (OR [divorced/never married]=2.68, 95% CI=1.55-4.63), lower BMI (OR [3rd quartile/1st quartile]=0.76; 95%CI=0.53-0.92), having fewer close friends/relatives for support (OR [1vs.5]=1.51; 95% CI=1.12-2.04), previous work-related injury (OR [yes/no]=1.70; 95% CI=1.30-2.22) and smoking (OR [smoked 1-2 packs/day/never smoked]=1.71; 95% CI=1.23-2.38). CONCLUSION: Independent risk factors for BT injury among men included history of physical abuse, higher levels of anger, and age began smoking and among women included less social support, smoking 1-2 packs/day, and a previous work-related injury.