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Traumatic deaths during U.S. Armed Forces basic training, 1977–2001

  • Stephanie L Scoville
    Correspondence
    Address correspondence and reprint requests to: Stephanie Scoville, DrPH, WRAIR/USACHPPM, 503 Robert Grant Avenue, Room 2A31, Silver Spring MD 20910-7500, USA
    Affiliations
    U.S. Army Center for Health Promotion and Preventive Medicine, Directorate of Epidemiology and Disease Surveillance (Scoville), Aberdeen Proving Ground, Maryland, USA

    Uniformed Services University of the Health Sciences, Department of Preventive Medicine and Biometrics (Scoville, Gardner), Bethesda, Maryland, USA

    Armed Forces Institute of Pathology, Division of Mortality Surveillance (Scoville, Gardner, Potter), Rockville, Maryland, USA
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  • John W Gardner
    Affiliations
    Uniformed Services University of the Health Sciences, Department of Preventive Medicine and Biometrics (Scoville, Gardner), Bethesda, Maryland, USA

    Armed Forces Institute of Pathology, Division of Mortality Surveillance (Scoville, Gardner, Potter), Rockville, Maryland, USA
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  • Robert N Potter
    Affiliations
    Armed Forces Institute of Pathology, Division of Mortality Surveillance (Scoville, Gardner, Potter), Rockville, Maryland, USA
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      Abstract

      Background

      A Recruit Mortality Registry, linked to the Department of Defense Medical Mortality Registry, was created to provide comprehensive medical surveillance data for deaths occurring during enlisted basic military training.

      Methods

      Recruit deaths from 1977 through 2001 were identified and confirmed through redundant sources. Complete demographic, circumstantial, and medical information was sought for each case and recorded on an abstraction form. Mortality rates per 100,000 recruit-years were calculated by using recruit accession data from the Defense Manpower Data Center.

      Results

      There were 276 recruit deaths from 1977 through 2001 and age-specific recruit mortality rates were less than half of same-age U.S. civilian mortality rates. Only 28% (77 of 276) of recruit deaths were classified as traumatic (suicide, unintentional injury, and homicide), in comparison to three quarters in both the overall active duty military population and the U.S. civilian population (ages 15–34 years). The age-adjusted traumatic death rates were highest in the Army (four times higher than the Navy and Air Force, and 80% higher than the Marine Corps). The majority (60%) of traumatic deaths was due to suicide, followed by unintentional injuries (35%), and homicide (5%). The overall age-adjusted traumatic mortality rate was more than triple for men compared with women in all military services (rate ratio=3.9; p=0.01).

      Conclusions

      There was a lower proportion of traumatic deaths in recruits compared to the overall active duty military population and same-age U.S. civilian population. This finding could be attributed to close supervision, emphasis on safety, and lack of access to alcohol and motor vehicles during recruit training.
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      References

        • Helmkamp J.
        • Kennedy R.
        Causes of death among U.S. military personnel.
        Mil Med. 1996; 161: 311-317
      1. Helmkamp J, Kennedy R. National mortality profile of active duty personnel in the U.S. Armed Forces: 1980–1993. Cincinnati OH: U.S. Department of Health and Human Services, September 1996. (Publication No. 96-103)

      2. Department of Defense. Military personnel casualty matters, policies and procedures. Washington DC, December 18, 2000. (Instruction No. 1300.18)

      3. Powell K, Branche-Dorsey C, Fingerhut L, Perrotta D. Chapter 1. Deaths due to injury. In: Jones B, Hansen B, eds. Injuries in the military: a hidden epidemic. Aberdeen Proving Ground, MD: U.S. Army Center for Health Promotion and Preventive Medicine, November 1996. (Technical Report No. 29 HA 4844 97):1−16

        • Powell K.
        • Fingerhut L.
        • Branche C.
        • Perrotta D.
        Deaths due to injury in the military.
        Am J Prev Med. 2000; 18: 26-32
        • Gardner J.
        • Cozzini C.
        • Kelley P.
        • et al.
        The Department of Defense Medical Mortality Registry.
        Mil Med. 2000; 165: 57-61
      4. Helmkamp J, Gardner J, Amoroso P. Chapter 2. Deaths due to injuries: casualty office data. Mil Med 1999;164(suppl 8):1−72

        • Drehner D.
        • Neuhauser K.
        • Neuhauser T.
        • Blackwood G.
        Death among U.S. Air Force basic trainees, 1956 to 1996.
        Mil Med. 1999; 164: 841-847
        • Wagner S.
        • Clark M.
        U.S. Navy and Marine Corps recruit training deaths in San Diego, California, 1973–1985; a review of 31 cases.
        J Forensic Sci. 1992; 37: 185-194
      5. Scoville S, Gardner J, Magill A, Potter R, Kark J. Nontraumatic deaths during U.S. Armed Forces Basic Training, 1977–2001. Am J Prev Med 2004;26:205−12

      6. Pastor P, Makuc D, Reuben C, Xia H. Chartbook on trends in the health of Americans. Health, United States, 2002. Hyattsville MD: National Center for Health Statistics, 2002

      7. Rothman K. Standardization of rates. In: Modern epidemiology. Boston: Little, Brown and Company, 1986:41–5

        • Rothman K.
        Estimation of confidence limits for the cumulative probability of survival in life table analysis.
        J Chronic Dis. 1978; 31: 557-560
        • Mantel N.
        • Haenszel W.
        Statistical aspects of the analysis of data from retrospective studies of disease.
        J Natl Caner Inst. 1959; 22: 719-748
        • Sears M.
        Adverse effects of beta-agonists.
        J Allergy Clin Immunol. 2002; 110: 322-328
        • Beasley R.
        • Pearce N.
        • Crane J.
        • Burgess C.
        Beta-agonists.
        J Allergy Clin Immunol. 1999; 104: S18-30
        • Pearce N.
        • Hensley M.
        Epidemiologic studies of beta agonists and asthma deaths.
        Epidemiol Rev. 1998; 20: 173-186
        • Clark K.
        • Li Y.
        • Krauss M.
        • Kelley P.
        The asthma accession standard.
        Mil Med. 2000; 165: 852-854
        • Ross R.
        • Ochsner M.
        • Boyd C.
        Acute intracranial boxing-related injuries in U.S. Marine Corps recruits.
        Mil Med. 1999; 164: 68-70
      8. Hoyert D, Arias E, Smith B, Murphy S, Kochanek K. Deaths: final data for 1999. National vital statistics reports; Vol. 49, No. 8. Hyattsville MD: National Center for Health Statistics, 2001

        • Helmkamp J.
        Suicides in the military.
        Mil Med. 1995; 160: 45-50
      9. Suicide prevention and psychological autopsy. Washington DC: Department of the Army, September 30, 1988. (Pamphlet 600-24)