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PubMed2006

The importance of body weight and weight management for military personnel.

Weight or fat reduction and maintenance among military personnel and attainment of desired body composition and physical appearance are considered important. A high level of body fat has been shown to have an adverse effect on performance in a number of military activities. The effect of rapid weight loss on performance appears to depend on the method of weight loss, the magnitude of weight loss, and the type of exercise or activity performance test used. Personnel who undertake imprudent weight-loss strategies, that is, personnel who try to change their usual body size by chronically restricting their food and fluid intake, may suffer a number of problems. Overweight personnel and their military coaches are just as susceptible to false ideas about weight loss and dieting as the rest of the community. Inappropriate weight loss causes a loss of lean tissue and can reduce, rather than enhance, performance. The understanding and promotion of safe, effective, appropriate weight-loss and weight-maintenance strategies represent important functions of the military system and officials. The greatest likelihood of success requires an integrated program, both during and after the weight-loss phase, in which assessment, increased energy expenditure through exercise and other daily activities, energy intake reduction, nutrition education, lifestyle changes, environmental changes, and psychological support are all components.

Body Fat Distribution↗
PubMedDate not supplied

Comparison of health habits of military personnel with civilian populations.

The relationship between health habits and health status has gained attention in the literature in recent decades. In this report, the health habits of a particular occupational group--the military--are compared with those of the civilian population, and the extent to which the health habits of the military personnel are associated with their health status is examined. Responses to two surveys conducted in 1985 were analyzed by age group, sex, race, and educational level. The comparisons involved six of the seven health habits included in the Alameda study. Military personnel, because they are younger and their lives are more regimented, excel in meeting weight standards for the services and engaging in desirable levels of physical activity. Smoking habits of military personnel were less favorable than those of the civilians. An examination of the health status of the military for the year preceding the survey suggested that some health habits have immediate manifestations, but the impact of others may not be evident until later in life.

Adolescent↗
PubMed1992

Risk of viral hepatitis among military personnel assigned to US Navy ships.

A prevalence study of 2072 male US shipboard military personnel scheduled for deployment to South America/West Africa and the Mediterranean was conducted to determine whether serologic evidence of prior hepatitis A, B, or C infection is associated with exposure in foreign countries. There were 210 subjects (10.1%) who had antibodies to hepatitis A virus (anti-HAV), 76 (3.7%) to hepatitis B core antigen (anti-HBc), and 9 (0.4%) to hepatitis C virus (anti-HCV). By multivariate analysis, anti-HAV seropositivity was independently associated with age, non-white racial/ethnic groups, birth outside of the United States, and prior Caribbean deployment for less than 1 year. Anti-HBc seropositivity was independently associated with black and Filipino race/ethnicity, foreign birth, a history of a sexually transmitted disease, South Pacific/Indian Ocean deployment (less than 12 months), and South Pacific or Mediterranean duty for (greater than 1 year). No geographic risk factors were associated with anti-HCV positivity. These data indicate that military personnel deployed outside the United States are at increased risk of viral hepatitis infection and should be considered for vaccination.

Adult↗
PubMed2002

The relationship between life adjustment and parental bonding in military personnel with adjustment disorder in Taiwan.

The aim of the present study was to examine the characteristics of military personnel with adjustment disorder to give them more appropriate treatment. The participants were 36 military personnel who met the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria of adjustment disorder as diagnosed by a psychiatrist at a teaching hospital in southern Taiwan. Another 24 persons were recruited as an age-matched control group. Each individual completed the clinical interview and the Wechsler Adult Intelligence Scale-Revised and then completed the questionnaires which included demographic information, the Parental Bonding Instrument, the Eysenck Personality Questionnaire, and the Chinese Health Questionnaire. We found statistically significant differences between the case and control groups in personality and parental bonding attitudes. Soldiers with higher neuroticism, lower extraversion, and maternal overprotection had an increased risk of suffering from adjustment disorder. The inclusion of family function and the military environment and such other factors as cultural variables is recommended for future study. The statistical approach of structural equation modeling also should be considered in future studies to determine competing risk factors and mediating effects.

Adjustment Disorders↗
PubMed1997

Factors influencing perceived need for dental care by active duty U.S. military personnel.

This study explores factors that influence perceived need for dental care among active duty U.S. military personnel. The data were collected on a prestratified random sample of 12,950 (76% response rate) service members between April 1994 and January 1995. Participants received a comprehensive oral examination from a dentist and answered queries concerning perceived need on self-administered questionnaires. Using bivariate and logistic regression analyses, we examined the association between demographic and clinical measures and perceived need for dental care. Bivariate results show that half of all U.S. military personnel perceive a need for dental care, with statistically significant differences across race, rank, education, branch of service, dental health class, and dental utilization. Logistic regression results show that the likelihood of perceived need is influenced by age, race, rank, branch of service, dental disease, dental health class, and dental utilization. Extensive dental decay is the strongest predictor of perceived need in this population.

Adolescent↗
PubMed2002

Posttraumatic stress disorder symptoms influence health status of deployed peacekeepers and nondeployed military personnel.

Posttraumatic stress disorder (PTSD) is associated with depression and alcohol abuse. PTSD symptoms also contribute to poor health among military veterans. The aim of the present study was to test models pertaining to the direct and indirect influences of PTSD symptoms on the health status of deployed and sociodemographically comparable nondeployed military personnel. Participants were 1,187 deployed male peacekeepers and 669 nondeployed male military personnel who completed a battery of questionnaires, including measures of PTSD symptoms, depression, alcohol use, and general health status. Structural equation modeling was used to test predictions regarding the direct and indirect influences of PTSD symptoms on health status. Results indicate that PTSD symptoms have a direct influence on health, regardless of deployment status. PTSD symptoms also indirectly promote poorer health through influence on depression, but not alcohol use, in deployed and nondeployed peacekeepers. Increased alcohol use did not contribute to poorer health beyond the contribution of PTSD symptoms alone. Future research directions are discussed.

Alcoholism↗
PubMed2004

Human immunodeficiency virus/acquired immunodeficiency syndrome knowledge and risk factors in Ethiopian military personnel.

Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS)-related knowledge and behaviors were assessed in face-to-face structured interviews with 314 Ethiopian military personnel. A significant finding of this research was the association between HIV/AIDS knowledge and risky sexual behavior. That is, military personnel who had inaccurate knowledge about HIV/AIDS transmission and prevention were 3.4 times as likely to engage in combined sexual risk behaviors compared with personnel with accurate knowledge, after controlling for age, military rank, and marital status (odds ratio, 3.4; 95% confidence interval, 1.86-6.22). This finding highlights the potential value of educational programs in slowing the spread of HIV/AIDS in sub-Saharan Africa.

Adolescent↗
PubMed2004

Secondary and tertiary transfer of vaccinia virus among U.S. military personnel--United States and worldwide, 2002-2004.

In December 2002, the Department of Defense (DoD) began vaccinating military personnel as part of the pre-event vaccination program. Because vaccinia virus is present on the skin at the site of vaccination, it can spread to other parts of the body (i.e., autoinoculation) or to contacts of vaccinees (i.e., contact transfer). To prevent autoinoculation and contact transfer, DoD gave vaccinees printed information that focused on hand washing, covering the vaccination site, and limiting contact with infants (1,2). This report describes cases of contact transfer of vaccinia virus among vaccinated military personnel since December 2002; findings indicate that contact transfer of vaccinia virus is rare. Continued efforts are needed to educate vaccinees about the importance of proper vaccination-site care in preventing contact transmission, especially in household settings.

Adolescent↗
PubMed2004

Surveillance for enteric parasites among U.S. military personnel and civilian staff on Joint Task Force Base-Bravo in Soto Cano, Honduras and the local population in Comayagua and La Paz, Honduras.

A study was conducted in Honduras to address whether military personnel assigned to Joint Task Force-Bravo in Soto Cano, Honduras, routinely acquire parasite infections, and the results were compared with those collected from civilian base workers and the general local population in the nearby towns of Comayagua and La Paz. Results from this study report 21 species of enteric parasites among Hondurans living in Comayagua and La Paz, 13 species among local Hondurans working as base civilian personnel, and 3 species among U.S. military servicemen and women. The most prevalent organism found was Blastocystis hominis, infecting 95 people (35.8% of 265 samples). Prevalence rates in this study are similar to documented reports on parasite transmission in Central American countries and other areas of Honduras. Although preventive protocols for U.S. military "force protection" appear to be effective in controlling transmission, continuous surveillance for enteric parasites is warranted because of the high parasite loads in the populations with which military personnel come into contact.

Honduras↗
PubMed2003

Cutaneous leishmaniasis in U.S. military personnel--Southwest/Central Asia, 2002-2003.

Cutaneous leishmaniasis (CL), a vector-borne parasitic disease, is a risk for persons, including military personnel, who travel to or live in areas of the tropics, subtropics, and southern Europe where the disease is endemic. This report provides preliminary data about 22 cases of CL in military personnel deployed during 2002-2003 to three countries in Southwest/Central Asia (Afghanistan, Iraq, and Kuwait). The patients were evaluated and treated at Walter Reed Army Medical Center (WRAMC) in the District of Columbia during August 2002-September 2003. U.S. health-care providers should consider the possibility of CL in persons with chronic skin lesions who were deployed to Southwest/Central Asia or who were in other areas where leishmaniasis is endemic.

Adult↗
PubMed2005

Bacterial species diversity in cigarettes linked to an investigation of severe pneumonitis in U.S. Military personnel deployed in operation iraqi freedom.

This report presents results from a study on the bacterial diversity of cigarette brands collected from military personnel during the U.S. Army's investigation of a series of cases of acute eosinophilic pneumonitis in military personnel deployed in Operation Iraqi Freedom. Eight species of Bacillus, including five new species, and one new species of Kurthia were isolated from the cigarettes. Some of these species have been identified elsewhere as causes of hypersensitivity pneumonitis and other respiratory syndromes. All of the isolates were facultative anaerobes, and many displayed mucoid growth under anaerobic conditions. In addition, many isolates also displayed the ability to form surface biofilms under liquid culture. Although biofilm formation and mucoid growth were not correlated, the former was found to be much more pronounced under anaerobic conditions as opposed to aerobic ones. The implications of these findings are discussed.

Acute Disease↗
PubMed2004

Acute eosinophilic pneumonia among US Military personnel deployed in or near Iraq.

CONTEXT: Acute eosinophilic pneumonia (AEP) is a rare disease of unknown etiology characterized by respiratory failure, radiographic infiltrates, and eosinophilic infiltration of the lung. OBJECTIVES: To describe a case series of AEP, illustrate the clinical features of this syndrome, and report the results of an epidemiologic investigation. DESIGN, SETTING, AND PARTICIPANTS: Epidemiologic investigation of cases of AEP identified both retrospectively and prospectively from March 2003 through March 2004 among US military personnel deployed in or near Iraq. Survivors were offered a follow-up evaluation. MAIN OUTCOME MEASURE: Morbidity and mortality related to AEP. RESULTS: There were 18 cases of AEP identified among 183,000 military personnel deployed in or near Iraq during the study period, yielding an AEP incidence of 9.1 per 100,000 person-years (95% confidence interval, 4.3-13.3). The majority of patients (89%) were men and the median age was 22 (range, 19-47) years. All patients used tobacco, with 78% recently beginning to smoke. All but 1 reported significant exposure to fine airborne sand or dust. Known causes of pulmonary eosinophilia (eg, drug exposures or parasitic disease) were not identified. Epidemiologic investigation revealed no evidence of a common source exposure, temporal or geographic clustering, person-to-person transmission, or an association with recent vaccination. Six patients underwent bronchoalveolar lavage (median eosinophilia of 40.5%). All patients developed peripheral eosinophilia (range, 8%-42%). Mechanical ventilation was required in 67% for a median of 7 (range, 2-16) days. Two soldiers died; the remainder responded to corticosteroids and/or supportive care. Twelve individuals were reevaluated a median of 3 months after diagnosis. At that point, 3 patients reported mild dyspnea and 1 reported wheezing. All patients had finished treatment and had either normal or nearly normal spirometry results. None had recurrent eosinophilia. CONCLUSIONS: AEP occurred at an increased rate among this deployed military population and resulted in 2 deaths. Failure to consider AEP in the differential diagnosis of respiratory failure in military personnel can result in missing this syndrome and possibly death. The etiology of AEP remains unclear, but the association with new-onset smoking suggests a possible link.

Acute Disease↗
PubMed1994

The effects of mustard gas, ionizing radiation, herbicides, trauma, and oil smoke on US military personnel: the results of veteran studies.

Late effects of exposure to certain environmental hazards as a consequence of their active military service have become an issue of particular concern to veterans and the public at large. Approximately one out of four Americans is a veteran or a family member of a veteran. The US military develops and uses increasingly complex and sophisticated weaponry. As the military technology changes, so do the kinds of health issues to be addressed. The changing composition of military personnel, most notably the increasing number of women veterans and their expanding role into combat-related activities, will affect both the health issues to be addressed and the kind of health care to be provided. The emerging role of the military as peace-keepers in hostile but nonwar zones and as disaster-relief workers, endemic to the area and to psychological stressors unrelated to combat. The formation of a registry of military personnel exposed to potentially serious long-term health hazards would be highly advisable, whenever feasible. Such an exposure registry could serve as the basis for future medical surveillance and response to affected veterans and help avoid the kind of difficulty experienced in addressing health concerns of WWII veterans exposed to mustard gas and Vietnam veterans exposed to Agent Orange. Close cooperation between the Department of Veterans Affairs and the Department of Defense is essential in the identification of potential hazards and follow-up of affected individuals. Growing public awareness of potential occupational and environmental hazards, publicity surrounding such suspected health risks, and the limited scientific knowledge about low-level exposure to toxic substances may all lead to misunderstanding, unwarranted fear, and suspicion of government coverup. Establishment of an exposure registry of veterans may be seen as a government commitment to address the future effects of potential hazards.

Adult↗
PubMed2000

Estimated cost of dental treatment for active duty and recruit U.S. military personnel.

This paper estimates the cost of restoring U.S. military personnel to optimal oral health. The data come from a 30-site oral health survey of Army, Navy, Marine Corps, and Air Force personnel conducted from February 1994 to January 1995. A systematic random sample of 2,711 recruits was drawn. From a prestratified, random sample of 15,924 active duty personnel, 13,050 (82% response rate) participated in the survey. Applying their best clinical judgment, one dentist per site charted comprehensive dental treatment needs on each service member. Radiographs were used. After the samples were weighted to reflect the 1994 population of recruits (202,144) and active duty personnel (1,699,662), treatment costs were calculated applying median fees reported by U.S. general dentists in 1995. Results show total estimated costs of $1.9 billion for active duty personnel and $203 million for recruits. Periodontal disease accounts for the greatest proportion (47%) of active duty treatment costs, and oral surgery accounts for the greatest proportion (32%) of recruit treatment costs. The cost of restoring U.S. service members to optimal oral health is substantial.

Dental Care↗
PubMed1997

Lessons learned from producing health information booklets for deploying U.S. military personnel.

Health information booklets deliver information to large groups quickly and economically. Rapidly deploying soldiers are a group that needs such information. Military personnel responsible for the health of troops should know of the materials produced to meet this need so that they can facilitate booklet distribution. The Walter Reed Army Institute of Research within the U.S. Army Medical Research and Material Command has produced health information booklets in support of deployments to Southwest Asia, Somalia, Rwanda, Haiti, and the former Republics of Yugoslavia. This article describes these booklets' content, use during military operations, distribution, costs, and benefits. A discussion of lessons learned includes steps to develop and evaluate health information and is followed by an explanation of the current situation. We offer suggestions to improve the booklet development process; our experience may be helpful to others developing health information materials for military personnel or civilians.

Books↗
PubMed1991

Travelers' diarrhea among United States military personnel during joint American-Egyptian armed forces exercises in Cairo, Egypt.

A study was conducted of travelers' diarrhea in a United States military population on deployment in Cairo, Egypt, during July and August 1987. Acute diarrhea requiring medical attention developed in 183 (4%) of 4,500 troops. A possible etiologic agent was identified in 49% of all diarrhea cases. Enteric pathogens associated with cases of diarrhea included: Enterotoxigenic Escherichia coli (17% ST-producers, 13% LT-producers, and 3% LT/ST-producers); Shigella (9%); Campylobacter spp. (2%); Salmonella (2%); and Vibrio cholerae non-01 serogroup (2%). Other enteric pathogens isolated from one episode each of diarrhea included Aeromonas hydrophila group, Plesiomonas shigelloides, and Bacillus cereus. Yersinia enterocolitica, enteroinvasive E. coli, intoxications by Clostridium perfringens and Clostridium difficile, and pathogenic enteric parasites were not found in any of the 183 patients with diarrhea. A survey of military personnel not requesting medical care indicated that up to 40% of troops may have had diarrhea during this deployment. Acute gastroenteritis is a potential cause of substantial morbidity in U.S. military personnel deployed to Egypt.

Adolescent↗