Injuries in the military - A review and commentary focused on prevention

Background: In November 1996, the Armed Forces Epidemiological Board (AFEB) Injury Prevention and Control Work Group issued a report that cited injuri es as the leading cause of morbidity and mortality among military service m embers. This article reviews the types and categories of military morbidity and mortality data examined by the AFEB work group and the companion Depar tment of Defense (DoD) Injury Surveillance and Prevention Work Group. This article further uses the injury data reviewed to illustrate the role of sur veillance and research in injury prevention. The review provides the contex t for discussion of the implications of the AFEB work group's findings for the prevention of injuries in the military. Methods: The AFEB work group consisted of 11 civilian injury epidemiologist s, health professionals and scientists from academia, and other non-DoD gov ernment agencies, plus six military liaison officers. Injury data from medi cal databases were provided to the civilian experts on the AFEB work group by the all-military DoD Injury Surveillance and Prevention Work Group. The AFEB work group assessed the value of each database to the process of preve ntion and made recommendations for improvement and use of each data source. Results: Both work groups found that injuries were the single leading cause of deaths, disabilities, hospitalizations, outpatient visits, and manpower losses among military service members. They also identified numerous data sources useful for determining the causes and risk factors for injuries. Th ose data sources indicate that training injuries, sports, falls, and motor vehicle crashes are among the most important causes of morbidity for milita ry personnel. Conclusions: While the work group recommends ways to prevent injuries, they felt the top priority for injury prevention must be the formation of a com prehensive medical surveillance system. Data front this surveillance system must be used routinely to prioritize and monitor injury and disease preven tion and research programs. The success of injury prevention will depend no t just on use of surveillance but also partner ships among the medical, sur veillance, and safety agencies of the military services as well as the mili tary commanders, other decision makers, and service members whose direct ac tions can prevent injuries and disease.