Background/purpose: Injury epidemiology studies in military populations utilize either medical chart reviewed or self-reported injury data. Medical chart reviewed injury data may not be complete if subjects do not seek medical care. Injury self-reports may suffer from issues with recall, especially for older and less severe injuries. The purpose of this study was to combine medical chart reviewed and self-reported data using the capture-recapture (CRC) approach to estimate the ascertainment-corrected incidence of musculoskeletal injury among a sample of Army Soldiers. Methods: CRC analysis was conducted by using the Chapman modification of the Peterson estimator to two sources of unintentional musculoskeletal injury data: medical chart reviews and injury self-reports, to estimate the cumulative incidence during a one year period. Results: Injury data were available for 287 subjects (age: 27.5 ± 6.3 years (mean ± standard deviation), gender: males 88.2%). The cumulative incidence of musculoskeletal injuries during a one year period was 17.8% in the medical chart reviews and 19.5% in the injury self-reports. The CRC estimate of the cumulative incidence was 54.0% (95% confidence interval: 38.5%, 69.5%). The overall, medical chart review and self-report ascertainment percent were 57.4%, 32.9% and 36.1%, respectively. When various injury types were analyzed separately, overall ascertainment varied by injury type. The overall ascertainment percent were 75.0% for fractures, 53.8% for sprains, 43.8% for strains, and 35.8% for pain/spasm/ache. Conclusion: The overall ascertainment was moderate, and varied by injury type. There is a need for further investigation of the application of the CRC method to musculoskeletal injury data in military populations. Assessment of the relative benefits of musculoskeletal injury data obtained using various methods of ascertainment such as medical chart reviews and injury self-reports in military populations is also needed.

Sunburn, a preventable skin condition, is a major risk factor for skin cancer. Severe burns can result in emergency department visits and in some cases hospitalization. Many people spend hours in direct sunlight while at the beach, which could lead to sunburn. We pooled data from 13 prospective cohorts of beachgoers in the United States (n=84,411) to describe incidence of sunburn, risk factors associated with an increased risk of sunburn, and the health burden resulting from time lost from work or school, visits to the doctor, and medication use. The incidence of sunburn in this population in the 10-12 days after the beach visit was 14% (n=9,882), excluding those with sunburn at enrollment. Sunburn incidence increased with greater time spent in the sun. Approximately 8% of beachgoers only exposed for <1 hour reported sunburn, whereas almost 20% spending ≥5 hours in the sun reported sunburn (p<0.001). Those with any water contact were also more likely to report sunburn (15% versus 11%, p<0.001). Among all participants, 66% applied sunblock. When skin type was considered, the highest incidence was noted among those who report repeated sunburns (17%) or freckles when in the sun (13%) compared to 11% who typically get dark tans. The incidence of sunburn varied considerably by age group. Children ages <1 year had the lowest incidence of sunburn (2%) whereas adults between the ages of 19-35 had the highest incidence of sunburn (18%). Preliminary analyses indicate that among beachgoers with incident sunburn; 34% take over-the-counter medications, 1% seek medical care from a physician, 0.5% take prescription medications, 0.1% visit an emergency department, and 11% miss time from work/school or daily activities due to sunburn. Sunburn is common among beachgoers, and may be associated with substantial public health burden. This abstract does not represent EPA policy