Table 2 Key data from included studies
From: Injury rates in female and male military personnel: a systematic review and meta-analysis
References | Population | Reporting method | Factors for which findings were adjusted | Key findings | Injury incidence rate/1000/year* | RR (♀:♂) | Critical appraisal score |
|---|---|---|---|---|---|---|---|
Anderson [4] | Active-Duty US Army (363 females, 4384 males) over 12 months | Self-reported survey | Gender, age, BF, smoking, fitness physical demand | Injury incidence over 12 months | |||
♀ = 53% ♂ = 42% | ♀ = 530/1000/year ♂ = 420/1000/year | 1.26 [1.14–1.40] p < 0.01) aRR = 0.95 [0.86–1.05] | 60% | ||||
Anderson [20] | Active-Duty US Army (43 women, 727 men) over 12 months | Self-reported survey | None | Injury rate Pre-deployment | |||
♀ 42.6/1000/month ♂ 36.2/1000/month | ♀ = 511.2/1000/year ♂ = 434.5/1000/year | 1.18 [0.87–1.59] p = 0.33 | 83% | ||||
On-deployment | |||||||
♀ 14.0/1000/month ♂ 19.0/1000/month | ♀ = 168.0/1000/year ♂ = 228.0/1000/year | 0.71 [0.36–1.42] p = 0.33 | |||||
Bell [21] | Trainees undergoing US Army Basic Training over 8 weeks (352 women, 509 men) | Medical records | Fitness, age and race | Injury rate over 8 weeks of basic training | |||
♀ = 57% ♂ = 27% | ♀ = 3721.8/1000/year ♂ = 1767/1000/year | 2.1 [1.78–2.47] aRR = 1.14 [0.48–2.72] | 92% | ||||
Bijur [6] | 558 West Point Officer Cadets in 6 weeks of basic training and initial 6 months of all training (85 women, 473 men) | Medical records | Fitness | Injury rate in 6 weeks of basic training | |||
♀ = 67/85 cadets 78.8/100 cadets ♂ = 152/473 cadets 32.1/100 cadets After adjusting for fitness, difference between males and females was only 20/100 cadets, as opposed to 46.7/100 previously (including multiple injuries) | ♀ = 6829.3/1000/year ♂ = 2782.0/1000/year | 2.45 [2.06–2.91] p < 0.001 | 92% | ||||
By end of 1st semester (subsequent 20 weeks of training) | |||||||
♀ = 47.5/100 cadets 4 ♂ = 40.5/100 cadets (p = 0.42) | ♀ = 1235/1000/year ♂ = 1053/1000/year | 1.16 [0.90–1.49] p = 0.25 | |||||
End of 2nd semester (2nd 6-month period of training) | |||||||
♀ = 32.3/100 cadets ♂ = 38.8/100 cadets (p = 0.42) | ♀ = 646/1000/year ♂ = 776/1000/year | 0.82 [0.59–1.14] p = 0.23 | |||||
Billings [23] | Recruits in US Air Force Academy Basic Training over 12 months (224 women, 986 men) | Combination of 3 systems | None | Injury incidence per annum | |||
♀ = 1067 per 1000 cadets ♂ = 615.6/1000 cadets No difference in number of restricted duty days | ♀ = 1067/1000/year ♂ = 615.6/1000/year | 1.73 [1.67–1.80] | 75% | ||||
Blacker [22] | Recruits in British Army Basic Training over 12 weeks (1480 females, 11,937 males) | Medical records | Fitness | Injury incidence over 12 weeks basic training | |||
♀ = 0.173/100 person days (202/1480) ♂ = 0.061/100 person days (550/11,937) HR 2.91 [2.48–3.43] p < 0.001 Sex did not feature in the multivariate model predicting injury risk. 2.4 km run time was a significant risk factor for injury (p < 0.001) | ♀ = 631.5/1000/year ♂ = 222.7/1000/year | 2.96 [2.55–3.44] p < 0.001 | 100% | ||||
Cosio-Lima [24] | Active-duty US Army soldiers over 9.5 months (6 females, 143 males) | Medical records | None | Injury incidence in 9.5 months | |||
♀ = 33% ♂ = 50.3% | ♀ = 422.6/1000/year ♂ = 644.8/1000/year | 0.66 [0.21–2.08] p = 0.48 | 75% | ||||
Darakjy [25] | Active-Duty US Armor Division soldiers during 37 days of continuous training (413 females, 4101 males) | Medical records | None | Injury rate in 37 days | |||
♀ = 22.9/1000 soldiers/week ♂ = 11.8/1000 soldiers/week | ♀ = 1190.8/1000/year ♂ = 613.6/1000/year | 1.93 [1.54–2.32] p < 0.001 | 83% | ||||
Fadum [38] | Active-Duty Norwegian Military Women over 12 months (1068 females, 8100 males) | Self-reported survey | None | Injury rates over 12 months | |||
♀ = 284/1068 (26.6%) ♂ = 2034/8100 (25.1%) | ♀ = 265.9/1000/year ♂ = 251.1/1000/year | 1.06 [0.95–1.18] p = 0.29 | 85% | ||||
Grier [26] | Trainees at US Army Ordinance school with courses ranging from 9–16 weeks (498 females, 3757 males) | Self-reported survey and medical records (prospective and retrospective) | * Stratified | Injury rate for 9–16 weeks training | |||
♀ = 61% ♂ = 36% | 1.70 [1.56–1.84] p < 0.001 | 83% | |||||
Havenetidis [27] | Greek Army Officer Cadets in training for 7 weeks (20 females, 233 males) | Physician recorded | None | Injury rate during 7 weeks of training | |||
♀ = 35% ♂ = 31.7% | ♀ = 2607.1/1000/year ♂ = 2365.8/1000/year | 1.10 [0.59–2.06] p = 0.76 | 67% | ||||
Henderson [39] | US Army Recruits undergoing Basic Training for 8 weeks (237 females, 371 males) and trainees in US Combat Medics AIT (10 week) (287 females, 439 males) | Medical records | None | BCT cumulative injury incidence | BCT | ||
♀ = 51.5% (122/237) ♂ = 26.1% (97/371) | ♀ = 3355.2/1000/year ♂ = 1704.1/1000/year | 1.97 [1.59–2.43] p < 0.001 | 75% | ||||
AIT cumulative injury incidence | AIT | ||||||
♀ = 29.6% (85/287) ♂ = 23.7% (104/439) | ♀ = 1544.3/1000/year ♂ = 1235.3/1000/year | 1.25 [0.98–1.60] p = 0.078 | |||||
Jones [28] | Recruits in US Army Basic Training for 8 weeks (186 females, 124 males) | Medical records | None | Injury rates | |||
♀ = 50.5% ♂ = 27.4% | ♀ = 3294.0/1000/year ♂ = 1787.2/1000/year | 1.84 [1.34–2.54] p < 0.001 | 83% | ||||
Jones [29] | Recruits in US Army Basic Training for 8 weeks (41,727 females, 143,398 male) | Medical records | None | Injury rates | |||
♀ = 40.3% ♂ = 15.7% | ♀ = 2626.7/1000/year ♂ = 1023.3/1000/year | 2.57 [2.52–2.61] p < 0.001 | 83% | ||||
Kerr [30] | Recruits in Irish Army Basic Training for 16 weeks (40 females, 354 males) | Medical records | None | Injury incidence | |||
♀ = 99.26 injuries/1000-man weeks ♂ = 56.96 injuries/1000-man weeks | ♀ = 5161.5/1000/year ♂ = 2961.9.1/1000/year | 1.76 [1.06–2.94] | 75% | ||||
Injury rates | |||||||
♀ = 54/40 ♂ = 271/354 | |||||||
Knapik [33] | Recruits in US Army basic training for 8 weeks (Summer: 434 females, 733 males) (Fall: 591 females, 810 males) | Medical records | None | Summer injury rates | Summer | ||
♀ = Summer 63.1% ♂ = Summer 37.0% | ♀ = 4115.0/1000/year ♂ = 2409.7/1000/year | 1.71 [1.52–1.92] p < 0.001 | 92% | ||||
Fall injury rates | Fall | ||||||
♀ = 44.8% ♂ = 18.9% | ♀ = 2922.6/1000/year ♂ = 1231.2/1000/year | 2.37 [2.00–2.81] p < 0.001 | |||||
Total injury rates | |||||||
♀ = 539/1025 ♂ = 424/1543 | ♀ = 3427.4/1000/year ♂ = 1791.0/1000/year | 1.91 [1.73–2.11] p < 0.001 | |||||
Knapik [31] | Recruits in US Army basic training for 8 weeks (247 females, 567 males) | Medical records | None | Injury rates for ‘control group’ | |||
♀ = 1.07/100 person days (148/247) ♂ = 0.56/100 person days (178/567) | ♀ = 3905.4/1000/year ♂ = 2046.2/1000/year | 1.91 [1.63–2.24] p < 0.001 | 83% | ||||
Knapik [32] | Recruits in US Army Basic Training for 8 weeks) (452 females, 733 males) | Medical records | None | Injury incidence rates | |||
♀ 1.16/100 person days ♂ 0.56/100 person days | ♀ = 4234.0/1000/year ♂ = 2044.0/1000/year | 2.07 [1.83–2.35] p < 0.001 | 92% | ||||
Kovcan [40] | Active-Duty Slovenian Armed Forces over one year. (11 females, 118 males) | Injury report form | None | Prevalence | |||
♀ = 27.7% ♂ = 50.8% | ♀ = 272.7/1000/year ♂ = 508.5/1000/year | 0.54 [0.20–1.43] p = 0.21 | 75% | ||||
Nye [34] | Active-Duty USAF monitored over 7 years. (6398 females, 61,506 males) | Database | None | Injury rates over 7 years | |||
♀ = 71.8% (4597/6398) ♂ = 67.1% (41,278/61,506) | ♀ = 102.6/1000/year ♂ = 95.9/1000/year | 1.07 [1.05–1.09] p < 0.001 | 92% | ||||
Nye [41] | Recruits in USAF Basic Training (8.5 week) 14,550 females, 52,975 males) | Database | None | Overall incidence rate in 8.5 weeks training | |||
♀ = 29.4 [28.6–30.3] injuries /1000 person weeks (2862/14550) ♂ = 15.1 [14.7–15.4] injuries/1000 person weeks (5586/52975) | ♀ = 1196.6/1000/year ♂ = 641.5/1000/year | 1.87 [1.79–1.94] p < 0.001 | 80% | ||||
Piantanida [35] | Cadets in US Marines officer Basic training for 6 weeks. (30 females, 450 males) | Medical records | None | Cumulative injury incidence in 6 weeks | |||
♀ = 80% ♂ = 59.5% | ♀ = 6952.4/1000/year ♂ = 5175.7/1000/year | 1.34 [1.11–1.63] p < 0.003 | 75% | ||||
Snedcor [36] | Recruits in US Airforce Basic Training for 30 training days. (5250 females, 8660 males) | Outpatient visits | None | Injury rate over basic training | |||
♀ = 63.0/1000 person weeks [60.6–65.5] (1743/5250) ♂ = 27.8/1000 person weeks [26.4–29.2] 1329/8660) | ♀ = 3276.0/1000/year ♂ = 1445.6/1000/year | 2.16 [2.03–2.30] aRR = 2.22 [2.09–2.37] | 83% | ||||
Strowbridge [37] | Active-Duty British Army Personnel over 1 year (178 females, 3377 males) | Medical records | None | Injury rate over 1 year | |||
♀ = 44.5/1000/month ♂ = 26.6/1000/month | ♀ = 534.0/1000/year ♂ = 319.2/1000/year | 1.67 [1.45–1.93] p < 0.001 | 67% | ||||
Sulsky [42] | Recruits in US Army Basic Training for 8 weeks. (21,651 females, 139,020 males) | Medical records | None | At least one injury in basic training | |||
♀ = 61% (16,833/21,651) ♂ = 39% (54,784/139,020) | ♀ = 5067.4/1000/year ♂ = 2568.5/1000/year | 1.97 [1.95–1.99] p < 0.001 | 91% |