Association of health behaviors and risk factors for injury: A study of military personnel

PURPOSE: To document injury rates and associated risk factors in a physically active population. METHODS: Data on personal fitness training, Army physical fitness test (APFT) results, health risk behaviors, and injury during the last 12 months were collected by survey. APFT results were converted into quartiles (Q), where Q1= low performance and Q4 = high performance. Odds ratios (OR) and 95% confidence intervals (95%CI) were obtained from multivariate logistic regression. RESULTS: Among the 2,287 male soldiers surveyed (mean age = 26.7 ± 6.0, range 17-50), injury incidence was 42%. Over half of injured Soldiers (57%) were placed on limited duty, with 36% placed on limited duty ≥ 30 days. The most common diagnosis was sprain or strain (48%), followed by fracture (11%). Leading causes of sprains/strains included repetitive movement/overexertion (42%) and slips/trips/falls (35%). Leading causes of fractures were slips/trips/falls (43%) and exercising/walking/road marching (27%). Males with the slowest run times (i.e., lowest aerobic fitness) had higher injury risk compared to those with highest aerobic fitness (OR (Q1/Q4) =1.81, 95%CI 1.31-2.51). Smokers experienced higher injury risk (OR (smoker/nonsmoker) = 1.26, 95%CI 1.03-1.54), as did soldiers with a higher body mass index (BMI) ≥30 (OR (BMI ≥30/BMI 18.5-24.9) = 1.54, 95%CI 1.08-2.19). CONCLUSION: Injury risk factors in this Army unit included higher BMI, smoking, lower aerobic fitness, and activities where falls, slips, or trips may be common. Implementation of countermeasures to improve aerobic fitness, reduce body fat, and prevent slips/trips/falls, should reduce the incidence of injuries in similar physically active populations.