Injury rates in female and male military personnel: a systematic review and meta-analysis

Abstract Background An effective military force is required to be agile, capable, efficient, and potent. Injuries to military personnel interrupt active-duty service and can detract from overall capability. These injuries are associated with a high individual and organizational burden, with lost wor...

Full description

Bibliographic Details
Main Authors: Ben Schram, Elisa Canetti, Robin Orr, Rodney Pope
Format: Article
Language:English
Published: BMC 2022-07-01
Series:BMC Women's Health
Subjects:
Online Access:https://doi.org/10.1186/s12905-022-01899-4
_version_ 1828371782221955072
author Ben Schram
Elisa Canetti
Robin Orr
Rodney Pope
author_facet Ben Schram
Elisa Canetti
Robin Orr
Rodney Pope
author_sort Ben Schram
collection DOAJ
description Abstract Background An effective military force is required to be agile, capable, efficient, and potent. Injuries to military personnel interrupt active-duty service and can detract from overall capability. These injuries are associated with a high individual and organizational burden, with lost work time and financial costs—all problematic for the ongoing functioning of a military force. Injury control strategies have therefore been described as force multipliers. Female personnel form an integral part of any modern defence force, but little research has examined their specific experiences of injury, to inform targeted injury control efforts. The aim of this review was to identify and synthesise findings from studies of injury rates and patterns in female military personnel, comparing them to those of male personnel. Methods A systematic search was conducted for studies which compared injury rates between the sexes at any stage of military service, from basic training through to deployment. Databases searched included PUBMED, CINAHL and Medline through OVID. Methodological quality of eligible articles was assessed using the Critical Appraisal Skills Program (CASP), and AXIS tools and data were extracted, synthesized, and, where possible, underwent meta-analysis. Results Of 2287 identified studies, a total of 25 studies were eligible and included. Methodological quality ranged from 60% up to a perfect score of 100%, with an average of 82% across all studies. Relative risks for injuries (reported as RR [95%CI]) to females when compared to males were 2.10 [1.89–2.33] during basic training, 1.70 [1.33–2.17] during officer training, and 1.23 [1.05–1.43] post initial training. After adjustment for differences between the sexes in average fitness levels (2-mile run time), there was no longer a significant difference in injury rates (adjusted RR: 0.95 [0.86–1.05]). Female personnel tended to make bigger improvements in their fitness during basic training than males and tended to report their injuries more frequently and sooner than males. Conclusion While this review found a higher rate of reported injuries in female military personnel when compared to male personnel, differences between the sexes in average fitness levels and injury reporting behaviours may largely explain this rate difference. The difference in rates of reported injuries was greatest during basic training, and reduced thereafter, possibly due in part to a reduced difference in fitness between the sexes or increased opportunity to self-determine workloads relative to fitness levels.
first_indexed 2024-04-14T06:53:59Z
format Article
id doaj.art-10e4a246cc5b434fbfc4d2ba7fcea125
institution Directory Open Access Journal
issn 1472-6874
language English
last_indexed 2024-04-14T06:53:59Z
publishDate 2022-07-01
publisher BMC
record_format Article
series BMC Women's Health
spelling doaj.art-10e4a246cc5b434fbfc4d2ba7fcea1252022-12-22T02:06:57ZengBMCBMC Women's Health1472-68742022-07-0122111410.1186/s12905-022-01899-4Injury rates in female and male military personnel: a systematic review and meta-analysisBen Schram0Elisa Canetti1Robin Orr2Rodney Pope3Tactical Research Unit, Bond Institute of Health and Sport, Bond UniversityTactical Research Unit, Bond Institute of Health and Sport, Bond UniversityTactical Research Unit, Bond Institute of Health and Sport, Bond UniversitySchool of Community Health, Charles Sturt UniversityAbstract Background An effective military force is required to be agile, capable, efficient, and potent. Injuries to military personnel interrupt active-duty service and can detract from overall capability. These injuries are associated with a high individual and organizational burden, with lost work time and financial costs—all problematic for the ongoing functioning of a military force. Injury control strategies have therefore been described as force multipliers. Female personnel form an integral part of any modern defence force, but little research has examined their specific experiences of injury, to inform targeted injury control efforts. The aim of this review was to identify and synthesise findings from studies of injury rates and patterns in female military personnel, comparing them to those of male personnel. Methods A systematic search was conducted for studies which compared injury rates between the sexes at any stage of military service, from basic training through to deployment. Databases searched included PUBMED, CINAHL and Medline through OVID. Methodological quality of eligible articles was assessed using the Critical Appraisal Skills Program (CASP), and AXIS tools and data were extracted, synthesized, and, where possible, underwent meta-analysis. Results Of 2287 identified studies, a total of 25 studies were eligible and included. Methodological quality ranged from 60% up to a perfect score of 100%, with an average of 82% across all studies. Relative risks for injuries (reported as RR [95%CI]) to females when compared to males were 2.10 [1.89–2.33] during basic training, 1.70 [1.33–2.17] during officer training, and 1.23 [1.05–1.43] post initial training. After adjustment for differences between the sexes in average fitness levels (2-mile run time), there was no longer a significant difference in injury rates (adjusted RR: 0.95 [0.86–1.05]). Female personnel tended to make bigger improvements in their fitness during basic training than males and tended to report their injuries more frequently and sooner than males. Conclusion While this review found a higher rate of reported injuries in female military personnel when compared to male personnel, differences between the sexes in average fitness levels and injury reporting behaviours may largely explain this rate difference. The difference in rates of reported injuries was greatest during basic training, and reduced thereafter, possibly due in part to a reduced difference in fitness between the sexes or increased opportunity to self-determine workloads relative to fitness levels.https://doi.org/10.1186/s12905-022-01899-4WomenArmyDefenceTactical
spellingShingle Ben Schram
Elisa Canetti
Robin Orr
Rodney Pope
Injury rates in female and male military personnel: a systematic review and meta-analysis
BMC Women's Health
Women
Army
Defence
Tactical
title Injury rates in female and male military personnel: a systematic review and meta-analysis
title_full Injury rates in female and male military personnel: a systematic review and meta-analysis
title_fullStr Injury rates in female and male military personnel: a systematic review and meta-analysis
title_full_unstemmed Injury rates in female and male military personnel: a systematic review and meta-analysis
title_short Injury rates in female and male military personnel: a systematic review and meta-analysis
title_sort injury rates in female and male military personnel a systematic review and meta analysis
topic Women
Army
Defence
Tactical
url https://doi.org/10.1186/s12905-022-01899-4
work_keys_str_mv AT benschram injuryratesinfemaleandmalemilitarypersonnelasystematicreviewandmetaanalysis
AT elisacanetti injuryratesinfemaleandmalemilitarypersonnelasystematicreviewandmetaanalysis
AT robinorr injuryratesinfemaleandmalemilitarypersonnelasystematicreviewandmetaanalysis
AT rodneypope injuryratesinfemaleandmalemilitarypersonnelasystematicreviewandmetaanalysis