Rates of dismissal due to health reasons among conscripts in the Republic of Belarus depending on service periods (2003–2018)

Abstract

Relevance. One of the most reliable and robust indicators of the health of military personnel is dismissal due to health reasons, it is practically not affected by external distortions, and dismissal-related nosologies are determined in hospital and subsequently approved by military medical experts.Intention. Analysis of the dismissal rate due to health reasons among conscripts in the Republic of Belarus for 16 years (2003-2018).Methodology. We conducted a statistical analysis of annual medical reports about the state of health and morbidity of conscripts (form N 3/MED) and annual reports about medical examination (form N 5/CVVK). Dismissal rates for the entire service time and for the periods I (0–6 months), II (7–12 months) and III (13–18 months) were identified and analyzed. Dismissal-related nosologies were correlated with the codes of the International Statistical Classification of Diseases, Behavioral Disorders and Injuries, 10th revision (ICD-10).Results and Discussion. The average annual dismissal rate for conscripts from the Armed Forces of the Republic of Belarus for 16 years from 2003 to 2018 amounted to (15.62 ± 0.58) ‰, including (8.11 ± 0.36) ‰ in the first period of service, (5.24 ± 0.28) ‰ in the II period and (2.27 ± 0.09) ‰ in the III period, i.e. 51.9, 33.5 and 14.6 %, respectively in the structure of dismissal for the entire period of service. The main reasons for the dismissal of conscripts from the Armed Forces of the Republic of Belarus were mental and behavioral disorders (ICD-10 chapter V), digestive diseases (chapter XI), diseases of the musculoskeletal system and connective tissue (chapter XIII), cardiovascular system diseases (chapter IX) and skin and subcutaneous tissue diseases (chapter XII) with levels of (4.74 ± 0.35), (2.74 ± 0.31), (2.13 ± 0.18), (1.80 ± 0.30) and (0.73 ± 0.09) ‰, respectively. In the structure of dismissal, the rates of these diseases amounted to 77.7 %. When analyzing the leading classes, during the periods of service the military-epidemiological significance of dismissals due to mental disorders and behavioral disorders (chapter V), cardiovascular system diseases (chapter IX), skin and subcutaneous tissue diseases (chapter XII) turned out to decrease, and military-epidemiological significance of dismissals due to diseases of the digestive system (chapter XI) increased. In addition, during periods of service the number of dismissals of conscripts with certain infectious and parasitic diseases (chapter I), with injuries, poisoning and some other consequences of external causes (chapter XIX) increased. Most commonly, conscripts were dismissed from the Armed Forces of the Republic of Belarus due to diseases of the esophagus, stomach and duodenum (K20–K31 according to ICD-10), personality and behavioral disorders in adulthood (F60– F69), neurotic, associated with stress, and somatoform disorders (F40–F48), other heart diseases (pericarditis, endocarditis, etc., I30–I52) and mood disorders (affective disorders, F30–F39). In the structure of dismissal, percentages amounted to 13.7, 9.1, 6.3, 4.1 and 4.1 %, respectively; in total – 37.3 %.Conclusion. The medical and statistical indicators of dismissal can help calculate the likelihood of health disorders associated with daily life and military service, and determine the strategy of the medical service in taking measures for recreation and rehabilitation of potential and actual conscripts.