Understanding the effect of deployment on the risk of fatal motor vehicle crashes: A nested case-control study of fatalities in Gulf War era veterans, 1991-1995

被引:31
作者
Hooper, TI
DeBakey, SF
Bellis, KS
Kang, HK
Cowan, DN
Lincoln, AE
Gackstetter, GD
机构
[1] Uniformed Serv Univ Hlth Sci, Dept Prevent Med & Biometr, Bethesda, MD 20814 USA
[2] Hlth Res & Anal LLC, Rockville, MD 20852 USA
[3] Dept Vet Affairs, War Related Illness & Injury Study Ctr, Washington, DC 20420 USA
[4] EPICON Associates LLC, Silver Spring, MD 20901 USA
关键词
motor vehicle; accident; gulf war; military; mortality; case-control;
D O I
10.1016/j.aap.2005.11.009
中图分类号
TB18 [人体工程学];
学科分类号
1201 ;
摘要
Motor vehicle crashes (MVCs) are an important cause of morbidity and premature loss of life among military personnel during peacetime and particularly following combat. A nested case-control study of fatal MVC occurring between 1991 and 1995 was conducted in a cohort of Gulf War era veterans. Cases were validated MVC deaths in the Fatality Analysis Reporting System. Controls were selected using risk set sampling by gender and year of case ascertainment in a 10: 1 ratio. Preliminary results, consistent with previous reports of increased fatal MVC risk among returning combat veterans, showed a crude odds ratio of 1.45 (95% confidence interval 1.27-1.65). Multivariable logistic regression modeling was used to identify important independent predictors, as well as to quantify the influence of deployment on a risk profile for fatal MVC. Because of significant interaction between deployment and inpatient diagnosis of substance abuse, the final model was stratified by deployment status. Results suggest that demographic, military, and behavioral characteristics of deployed healthy warriors are similar to the risk profile for fatal MVC. In addition to young, single, high school-educated, enlisted male personnel, those who served during times of ground combat, particularly in infantry, gun crews, or seamanship occupations, should be targeted for preventive interventions. (c) 2005 Elsevier Ltd. All rights reserved.
引用
收藏
页码:518 / 525
页数:8
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