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PubMed2006

Job stress, depression, work performance, and perceptions of supervisors in military personnel.

OBJECTIVE: Recent studies have identified high levels of job stress in military personnel. This study examined the relationship among job stress, depression, work performance, types of stressors, and perceptions about supervisors in military personnel. METHODS: Eight hundred nine military personnel answered a 43-item survey on work stress, physical and emotional health, work performance, perceptions about leadership, job stressors, and demographics. RESULTS: More than one- quarter (27.4%) of this military population reported suffering from significant job stress. Both the report of work stress and depression were significantly related to impaired work performance, more days of missed work, poorer physical health, and negative perceptions about the abilities of supervisors and commanders. Depression and job stress were significantly and positively related to each other. CONCLUSIONS: These results support accumulating data indicating that work stress is a significant occupational health hazard in the routine military work environment. Targeting and eliminating sources of job stress should be a priority for the U.S. military to preserve and protect the mental health of military personnel.

Adult↗
PubMed1995

The risk of Helicobacter pylori infection among U.S. military personnel deployed outside the United States.

To determine whether military personnel deployed outside the United States are at increased risk of Helicobacter pylori infection, 1,000 male U.S. Navy and Marine Corps personnel (mean age 22 years) were evaluated. Study subjects included 200 recruits, 500 shipboard personnel deployed for six months to South America, West Africa, and the Mediterranean, and 300 ground troops deployed for five months to Saudi Arabia. Among all 1,000 subjects, 247 (25%) were seropositive for H. pylori IgG antibody by an enzyme-linked immunosorbent assay; 24% of new recruits and 25% of troops who had been on active duty for a mean of four years. The prevalence of H. pylori antibody was higher among subjects who were older, nonwhite, foreign-born, and seropositive for antibody to hepatitis A virus. Among the 601 initially seronegative subjects evaluated before and after a 5-6 month deployment outside the United States, five seroconverted, for a rate of infection of 1.9% per person-year of exposure. As found in other populations in developed countries, these data indicate that among U.S. military personnel a large proportion of H. pylori infections occur before adulthood and infection is related to demographic factors. These preliminary findings also suggest that deployed U.S. military personnel may be at increased risk of H. pylori infection compared with adult populations in developed countries either from exposure in developing countries or from crowding.

Adolescent↗
PubMed1999

Drug resistance patterns, genetic subtypes, clinical features, and risk factors in military personnel with HIV-1 seroconversion.

BACKGROUND: Regular testing of military personnel identifies early HIV infection; this identification provides a sentinel cohort in which to describe the evolving molecular epidemiology of HIV-1 transmission. OBJECTIVE: To describe the prevalence and epidemiologic correlates associated with the acquisition of non-subtype B and drug-resistant HIV infections. DESIGN: Cross-sectional study. SETTING: Military referral hospital. PATIENTS: 95 military personnel with HIV-1 seroconversion. MEASUREMENTS: Self-reported questionnaire, CD4 cell counts, plasma HIV-1 RNA levels, and nucleic acid sequence analysis for drug-resistant mutations and HIV-1 genetic subtype. RESULTS: 95 patients were enrolled between February 1997 and February 1998. The likely geographic location of HIV-1 acquisition was overseas in 8% of patients, the United States in 68%, and either overseas or the United States in 24%. Seven patients (7.4%) had subtype E infection; the remainder had subtype B infection. Eight of 31 (26%) treatment-naive patients had mutations in the reverse transcriptase or protease gene associated with drug resistance. CONCLUSIONS: The percentage of HIV-1 non-subtype B infection and antiretroviral drug-resistant mutations was relatively high in U.S. military personnel with recently acquired HIV-1 infection.

CD4 Lymphocyte Count↗
PubMed2003

Dimensionality of military professional values items: an exploratory factor analysis of data from the spring 1996 Sample Survey of Military Personnel.

The Sample Survey of Military Personnel in Spring 1996 included detailed questions specifically about soldiers' professional values, centered on personal beliefs about loyalty and integrity values. Maximum likelihood factor analysis yielded four factors, labeled military dedication, integrity, job commitment, and military bearing. Scales developed from these factors showed acceptable internal consistency reliability and correlated as expected with measures of satisfaction with Army life, retention, soldier morale, combat preparedness, and overall job satisfaction. A regression analysis indicated that the best predictors of loyalty to the Army and to the United States were job commitment and military bearing, not integrity, as had been expected.

Adult↗
PubMed1991

HIV and periodontal health. A study of military personnel with HIV.

In 230 military personnel who were seropositive for the human immunodeficiency virus, the prevalence of viral and fungal infections in the mouth was clearly related to the degree of immune dysfunction as measured by T4-lymphocyte counts. The relation between periodontal health and T4 counts was less clear. Tobacco use was related to the increased occurrence of both mucosal lesions and periodontal diseases.

Adolescent↗
PubMed2003

Dimensionality of military job satisfaction items: an exploratory factor analysis of data from the spring 1996 Sample Survey of Military Personnel.

The Sample Survey of Military Personnel in the spring of 1996 asked detailed questions of Army personnel about job satisfaction. Maximum likelihood factor analysis yielded four factors: satisfaction with supervision, with job environment, with the duty specifically, and with opportunity for development, factors similar to those used in Smith's Job Descriptive Index, 1992. Scales developed from these factors showed acceptable internal consistency reliability and correlated as expected with measures of satisfaction with Army life, retention, morale, combat preparedness, and overall job satisfaction. Some divergent validity was established with measures of personal/family stress and with previous job stress. Demographic data suggested that soldiers with higher education found more satisfying job opportunities while those with higher rank, more years of service, and higher age reported greater satisfaction with job fulfillment, perhaps a consequence of selection effects.

Adult↗
PubMed1976

Viral hepatitis: problems of incidence and control in military personnel.

(A) Hepatitis B virus (HBV) is now the major cause of infectious viral hepatitis in U.S. military personnel and probably also in the civilian population over 15 years of age. (B) The incidence of icteric, viral hepatitis is much higher in U.S. military personnel than in comparable age groups in the civilian population. The 17-to 20-year-old enlisted men show the highest rates. (C) In parts of the world (e.g., U.S.A., Germany) where most of the inapparent infection is caused by the adw subtype of HBV, most of the acute clinical disease is caused by the ayw subtype. In the U.S.A. and Germany, 95% or more of HB(s) Ag isolates from U.S. military personnel with acute hepatitis is ayw. (D) It may be many years before one can expect to have sufficient data for a decision as to the possible availability of an effective HBV vaccine. Accordingly, a decision is urgently needed regarding either the immediate use of the best practically available hepatitis immune gamma globulin, that can be prepared by modern techniques, for the prevention of hepatitis in U.S. military personnel or postponement of such use until an adequate and properly controlled trial can be carried out in active duty military personnel in an area of high incidence.

Adolescent↗
PubMed2001

Occupational skin diseases in national servicemen and military personnel in Singapore, 1989-1999.

This is a study of occupational skin disease among military personnel and conscripts in Singapore. All military personnel and conscripts diagnosed with occupational dermatoses in the National Skin Centre, Singapore, between 1989-1999 were studied retrospectively. Conscripts and regulars comprised 7.3% of all occupational skin disease patients seen. All were male, with a mean age of 23 years. Irritant contact dermatitis was more common than allergic contact dermatitis, by 4.4:1. The most common vocations associated with occupational skin diseases are those involving vehicle repairs and maintenance (48%) and food handling (19%). The most common irritants were oil/grease (66%), wet work (23%) and solvents (18%). The most common allergens were food (40%) and chromates (20%). Military personnel and conscripts make up a significant proportion of occupational skin disease patients seen in Singapore.

Adolescent↗
PubMed1989

Lumbar disk disease in active duty military personnel.

We studied a group of active duty military personnel with well-defined, lumbar discogenic, radicular pain syndromes. Our study group included 29 patients, 12 of whom required surgery during the study period. Three of the 29 patients had to be medically retired from active military service. Two patients required permanent limited-duty assignment and 10 others required prolonged (6 months or more) periods of limited duty. These findings highlight the significant adverse impact of lumbar disk disease on fitness for full active duty in military personnel.

Adult↗
PubMed1991

Standardized comparisons of the use of alcohol, drugs, and cigarettes among military personnel and civilians.

BACKGROUND: Understanding the effectiveness of policies and programs aimed at combating substance abuse in the military requires comparison with the civilian population from which military personnel are drawn. METHODS: Standardized comparisons of the use of alcohol, drugs, and cigarettes among military personnel and civilians were conducted with data from the 1985 Worldwide Survey of Alcohol and Nonmedical Drug Use among Military Personnel and the 1985 National Household Survey on Drug Abuse. The two data sets were equated for age and geographic location of respondents, and civilian substance use rates were standardized to reflect the sociodemographic distribution of the military. RESULTS: Military personnel were significantly less likely than civilians to use drugs, but were significantly more likely to use alcohol and cigarettes and to engage in heavy use of alcohol and cigarettes. Heavy drinking was especially likely among young military men. Military women were similar to military men in their smoking and drug use patterns. CONCLUSIONS: Findings suggest that military policies and programs have been notably effective in reducing drug use, but that efforts to limit alcohol and cigarette use should be intensified. Military efforts directed against alcohol abuse should be targeted toward younger men, while smoking and drug prevention programs should be directed toward both men and women.

Adolescent↗
PubMed2006

Prevalence of iron deficiency and iron deficiency anemia among three populations of female military personnel in the US Army.

BACKGROUND: Iron deficiency is the most prevalent micronutrient deficiency disease in the world and occurs in young women in the United States. Female military personnel represent a unique population faced with intense physical and cognitive demands. OBJECTIVE: The objective of this study was to determine the prevalence of iron deficiency and iron deficiency anemia among three populations of female military personnel in the US Army. METHODS: Iron status was assessed in 1216 volunteers. Volunteers were recruited from three groups: immediately following initial entry to the Army (IET), immediately following basic combat training (AIT), or following at least six months of permanent assignment (PP). Iron deficiency was determined using a three variable model, including cut-off values for serum ferritin, transferrin saturation, and red cell distribution width (RDW). Iron deficiency anemia was categorized by iron deficiency and a hemoglobin (Hgb) value of <12 g/dL. RESULTS: The prevalence of iron deficiency was greater in women in the AIT group (32.8%) than in the IET and PP groups (13.4 and 9.6%, respectively). The prevalence of iron deficiency anemia was greater in the AIT group (20.9%) than in the IET and PP groups (5.8 and 4.8%, respectively). Furthermore, the prevalence of iron deficiency anemia was greater in Hispanic (21.9%) and African-American military personnel (22.9%) than in Caucasian military personnel (10.5%). CONCLUSIONS: These data indicate that female military personnel experience diminished iron status following training, and that iron nutriture is an important issue facing females in the military.

Adult↗
PubMed2006

The role of TST in the diagnosis of latent tuberculosis infection among military personnel in South Korea.

BACKGROUND: The rapid and accurate diagnosis of latent tuberculosis infection (LTBI) is crucial in military settings because military personnel live in crowded circumstances and are of an age group with a high incidence of tuberculosis (TB). We tried to elucidate whether the tuberculin skin test (TST) accurately reflects the risk of TB infection among military personnel, in a setting of intermediate TB prevalence and where bacille Calmette-Guérin (BCG) vaccination is mandatory. METHODS: A multi-stage cluster survey was conducted among military personnel in South Korea. Participants were grouped according to their risk of TB infection: Group 1, no identifiable risk of TB; Groups 2 and 3, recent casual (Group 2) or close (Group 3) contact with smear-positive TB patients. RESULTS: Of 1045 participants, 857 (82.0%) had been BCG-vaccinated. The odds ratio (OR) of a positive TST (10 mm cut-off) for Group 2 (n = 184) and Group 3 (n = 83) compared with Group 1 (n = 778) were 0.95 (95%CI 0.67-1.38) and 1.7 (95%CI 1.06-2.70), respectively (P value for trend 0.16). CONCLUSIONS: The TST does not accurately reflect the risk of LTBI among young military personnel in a setting where there is intermediate TB prevalence and extensive BCG coverage.

Adult↗
PubMed2000

Chemical exposure guidelines for deployed military personnel.

In light of the absence of guidelines and standards applicable to deployed military personnel, the U.S. Army Center for Health Promotion and Preventive Medicine (USACHPPM) has completed Technical Guide 230A, Short-term Chemical Exposure Guidelines for Deployed Military Personnel. This guide provides estimated concentration levels associated with various types of effects for short-term exposures from 1 hour up to 2 weeks. A second TG (TG230B, Long-term Chemical Exposure Guidelines for Deployed Military Personnel) is being developed to address potentially longer deployment related exposures (i.e. greater than 2 weeks up to 1 year). This article focuses on TG230A which describes varying severity levels and health effects associated with short-term chemical exposures in a format consistent with the existing doctrinal military risk management paradigm. It is a consolidated reference tool for trained military medical staff to evaluate different chemical hazards, and will ensure more expedient risk management decisions during deployments. The TG also establishes the standard reference for pre- and post-deployment evaluations and risk management decisions, including determinations of resource requirements and equipment specifications.

Air Pollutants, Occupational↗
PubMed1989

Prevalence, trends, and correlates of alcohol use, nonmedical drug use, and tobacco use among U.S. military personnel.

This paper presents data on substance use by military personnel from a series of worldwide surveys conducted in 1985, 1982, and 1980 with primary emphasis on the 1985 survey. Estimates are based on responses from participants serving on active duty in the Army, Navy, Marine Corps, and Air Force. Results for 1985 indicate pervasive use of alcohol, substantial use of tobacco, and low nonmedical use of drugs among military personnel. Average daily consumption of alcohol declined significantly from 1.4 ounces in 1982 to 1.2 ounces in 1985, but the patterns of use remained relatively constant. Nonmedical drug use during the past 30 days declined significantly, from 27.0% in 1980, to 19.0% in 1982, to 8.9% in 1985. Cigarette smoking declined significantly from 51.4% in 1982 to 46.2% in 1985. Current alcohol and drug use is concentrated among younger, less educated, unmarried, and junior and mid-career enlisted personnel. Cigarette pack years are higher among males, whites, those with less than a high school education, and senior enlisted personnel. Results show progress in reducing drug use and smoking in the military, but little change in patterns of alcohol use. New initiatives and approaches by the military to further reduce substance abuse are discussed.

Adolescent↗
PubMed2001

Serosurvey of Borrelia burgdorferi infection among U.S. military personnel: a low risk of infection.

A serosurvey of 9,673 United States military personnel was conducted to estimate infection rates with Borrelia burgdorferi sensu stricto, which is the cause of Lyme disease in the United States. Initial screening of sera from 9,673 military personnel on active duty in 1997 was performed by enzyme-linked immunosorbent assay (ELISA); supplemental testing of all ELISA-positive sera was performed by Western blot. Initial screening identified 1,594 (16.5%) ELISA-positive samples, but only 12 (0.12%, 95% confidence interval [CI] = 0.05-0.19%) were confirmed by Western blot. Antecedent serum samples collected from 1988 to 1996 were available for 7,368 (76%) subjects, accounting for 34,020 person-years of observation. Just two of the nine Western blot-positive individuals for whom antecedent samples were available seroconverted during military service for an annual incidence rate of six seroconversions per 100,000 persons (95% CI = 0.7-21.5). The risk of Lyme disease in the U.S. military population was found to be low. Although there may be sub-groups of military personnel who could potentially benefit from vaccination, force-wide use of the Lyme disease vaccine is not warranted.

Adolescent↗
PubMed2005

Suicide among regular-duty military personnel: a retrospective case-control study of occupation-specific risk factors for workplace suicide.

OBJECTIVE: The purpose of this study was to examine the epidemiology, phenomenology, and occupation-specific risk factors for suicide among regular-duty military personnel as a model for other professions at risk for workplace suicide. METHOD: Suicide incidence and methods were determined in a retrospective military cohort comprising all deaths (N=732) of regular-duty military personnel in the Irish Defence Forces between 1970 and 2002. A retrospective, case-control study using pair-matched military comparison subjects was conducted to determine occupation-specific risk factors for suicide, particularly by firearm, among military personnel. Risk factors were subjected to chi-square analysis or independent t tests and entered into a binary logistic regression analysis model. RESULTS: The period-averaged suicide rate for the cohort was 15.3/100,000. Firearm suicides accounted for 53% of the cases. Suicides that took place on duty occurred predominantly when personnel were alone shortly after duty commencement in the morning. Bivariate and logistic regression analyses identified psychiatric illness and a past history of deliberate self-harm, morning duty (shortly after duty assumption and consequent access to firearms), and a recent medical downgrading as independent risk factors predicting firearm suicide among military personnel. CONCLUSIONS: Occupation influences suicide method. Access to and opportunity to use lethal means in the workplace are distinct but related occupation-specific suicide risk factors in the military and in other at-risk professions. In professions where access to lethal means is inevitable, moderating opportunity for suicide is crucially important. In regular-duty military personnel, a medical downgrading, combined with risk factors established in civilians such as younger age, male gender, psychiatric illness, and past self-harm, increases the risk of suicide. The findings may be used to guide military harm-reduction strategies and have applicability in strategies for other professions at risk for workplace suicide.

Adolescent↗
PubMedDate not supplied

Prevalence and consequences of drug abuse among U.S. military personnel: 1980.

A worldwide survey of nonmedical drug use among U.S. military personnel was conducted in 1980. A stratified multistage probability sample was drawn and a questionnaire administered by staff of Burt Associates, Inc. The results show that 27% of the military personnel reported they had used some type of drug or drugs nonmedically in the past 30 d; 36% reported such use within the past year. Prevalence rates are presented for each of nine drug categories. Nonmedical drug use is limited primarily to junior enlisted personnel. The overwhelming majority of nonmedical drug use in the military is occasional or experimental in nature. From these results obtained, it is estimated that 3% of Department of Defense (DOD) junior enlisted personnel were physiologically drug dependent and a total of 4% were physiologically or psychologically drug dependent at some time during the preceding 12 months. The proportions of junior enlisted personnel reporting consequences of drug use and work impairment because of drug use are also presented. There is no general pattern of nonmedical use being more prevalent among military personnel than comparable civilians.

Adolescent↗