TY - JOUR
T1 - Understanding the effect of deployment on the risk of fatal motor vehicle crashes
T2 - A nested case-control study of fatalities in Gulf War era veterans, 1991-1995
AU - Hooper, Tomoko I.
AU - Debakey, Samar F.
AU - Bellis, Kimberly S.
AU - Kang, Han K.
AU - Cowan, David N.
AU - Lincoln, Andrew E.
AU - Gackstetter, Gary D.
N1 - Funding Information:
This research was supported by U.S. Army Medical Research Acquisition Activity under work unit no. DAMD17-00-1-0111.
PY - 2006/5
Y1 - 2006/5
N2 - 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.
AB - 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.
KW - Accident
KW - Case-control
KW - Gulf War
KW - Military
KW - Mortality
KW - Motor vehicle
UR - http://www.scopus.com/inward/record.url?scp=33644896531&partnerID=8YFLogxK
U2 - 10.1016/j.aap.2005.11.009
DO - 10.1016/j.aap.2005.11.009
M3 - Article
C2 - 16405857
AN - SCOPUS:33644896531
SN - 0001-4575
VL - 38
SP - 518
EP - 525
JO - Accident Analysis and Prevention
JF - Accident Analysis and Prevention
IS - 3
ER -