@article{ref1,
title="Divergent trends in accidental deaths since return from an Afghanistan/Iraq deployment among Army soldiers",
journal="Annals of epidemiology",
year="2024",
author="Adams, Rachel Sayko and Forster, Jeri E. and Gradus, Jaimie L. and Hoffmire, Claire A. and Hostetter, Trisha A. and Larson, Mary Jo and Smith, Alexandra A. and Walsh, Colin G. and Brenner, Lisa A.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="PURPOSE: Accidental death is a leading cause of mortality among military members and Veterans; however, knowledge is limited regarding time-dependent risk following deployment and if there are differences by type of accidental death. <br><br>METHODS: Longitudinal cohort study (N=860,930) of soldiers returning from Afghanistan/Iraq deployments in fiscal years 2008-2014. Accidental deaths (i.e., motor vehicle accidents [MVA], accidental overdose, other accidental deaths), were identified through 2018. Crude and age-adjusted mortality rates, rate ratios, time-dependent hazard rates and trends postdeployment were compared across demographic and military characteristics. <br><br>RESULTS: During the postdeployment observation period, over one-third of deaths were accidental; most were MVA (46.0%) or overdoses (37.9%). Across accidental mortality categories (all, MVA, overdose), younger soldiers (18-24, 25-29) were at higher risk compared to older soldiers (40+), and females at lower risk than males. MVA death rates were highest immediately postdeployment, with a significant decreasing hazard rate over time (annual percent change [APC]: -6.5%). Conversely, accidental overdose death rates were lowest immediately following deployment, with a significant increasing hazard rate over time (APC: 9.9%). <br><br>CONCLUSIONS: Observed divergent trends in risk for the most common types of accidental deaths provide essential information to inform prevention and intervention planning for the immediate postdeployment transition and long-term.<p /> <p>Language: en</p>",
language="en",
issn="1047-2797",
doi="10.1016/j.annepidem.2024.01.002",
url="http://dx.doi.org/10.1016/j.annepidem.2024.01.002"
}