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Occup Environ Med. 2002 September; 59(9): 601–607.
PMCID: PMC1740361

Risk factors for occupational knee related disability among enlisted women in the US Army

Abstract

Aims: To identify sociodemographic and occupational determinants of knee related disability discharge from the US Army among enlisted women, and to investigate effect modification.

Methods: A case-control study of 692 cases of knee related disability discharge and 2080 incidence density matched controls nested within the population of all 244 000 enlisted women on active duty in the US Army, 1980–97. We used logistic regression to identify determinants of disability, stratified to explore effect modification by demographic and work characteristics.

Results: The risk of disability discharge was twice as high (odds ratio (OR) 2.4, 95% confidence interval (CI): 1.71 to 3.47) for the oldest (33–60 years) versus the youngest (17–21 years) women. Non-whites had lower risk than whites (OR 0.5, 95% CI: 0.41 to 0.60), as did married (OR 0.7, 95% CI: 0.54 to 0.81) relative to non-married women. Those of lower rank (pay grades E1–E3) were at five times the risk of disability discharge compared to those of higher ranks (pay grades E4–E9, OR 5.0, 95% CI: 2.86 to 8.33), while ORs were highest for those with longer duration of service compared to women on active duty for a year or less (OR 1.4, 95% CI: 0.8 to 2.55 after 12 years). Race modified several effects, including that of rank. Age, duration of service, and pay grade were too highly correlated to draw firm conclusions about their independent modifying effects on risk of disability discharge from the Army.

Conclusions: Sociodemographic factors had larger effects than occupational characteristics on risk of knee related disability discharge from the US Army. Interactions suggest subgroups at differing risk levels that might be targeted for more detailed investigations.

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Selected References

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  • Ross J, Woodward A. Risk factors for injury during basic military training. Is there a social element to injury pathogenesis? J Occup Med. 1994 Oct;36(10):1120–1126. [PubMed]
  • Amoroso PJ, Canham ML. Chapter 4. Disabilities related to the musculoskeletal system: Physical Evaluation Board Data. Mil Med. 1999 Aug;164(8 Suppl):1–73. [PubMed]
  • Jensen LK, Eenberg W. Occupation as a risk factor for knee disorders. Scand J Work Environ Health. 1996 Jun;22(3):165–175. [PubMed]
  • Jensen LK, Mikkelsen S, Loft IP, Eenberg W. Work-related knee disorders in floor layers and carpenters. J Occup Environ Med. 2000 Aug;42(8):835–842. [PubMed]
  • Leino P, Hasan J, Karppi SL. Occupational class, physical workload, and musculoskeletal morbidity in the engineering industry. Br J Ind Med. 1988 Oct;45(10):672–681. [PMC free article] [PubMed]
  • Thelin A. Hip joint arthrosis: an occupational disorder among farmers. Am J Ind Med. 1990;18(3):339–343. [PubMed]
  • Vingård E, Alfredsson L, Goldie I, Hogstedt C. Occupation and osteoarthrosis of the hip and knee: a register-based cohort study. Int J Epidemiol. 1991 Dec;20(4):1025–1031. [PubMed]
  • Klünder KB, Rud B, Hansen J. Osteoarthritis of the hip and knee joint in retired football players. Acta Orthop Scand. 1980 Dec;51(6):925–927. [PubMed]
  • Panush RS, Schmidt C, Caldwell JR, Edwards NL, Longley S, Yonker R, Webster E, Nauman J, Stork J, Pettersson H. Is running associated with degenerative joint disease? JAMA. 1986 Mar 7;255(9):1152–1154. [PubMed]
  • Feuerstein M, Berkowitz SM, Peck CA., Jr Musculoskeletal-related disability in US Army personnel: prevalence, gender, and military occupational specialties. J Occup Environ Med. 1997 Jan;39(1):68–78. [PubMed]
  • Sulsky SI, Mundt KA, Bigelow C, Amoroso PJ. Case-control study of discharge from the U.S. Army for disabling occupational knee injury: the role of gender, race/ethnicity, and age. Am J Prev Med. 2000 Apr;18(3 Suppl):103–111. [PubMed]
  • Burdorf A, Rossignol M, Fathallah FA, Snook SH, Herrick RF. Challenges in assessing risk factors in epidemiologic studies on back disorders. Am J Ind Med. 1997 Aug;32(2):142–152. [PubMed]
  • Bresnitz EA, Frumkin H, Goldstein L, Neumark D, Hodgson M, Needleman C. Occupational impairment and disability among applicants for Social Security disability benefits in Pennsylvania. Am J Public Health. 1994 Nov;84(11):1786–1790. [PubMed]
  • Cooper C, McAlindon T, Coggon D, Egger P, Dieppe P. Occupational activity and osteoarthritis of the knee. Ann Rheum Dis. 1994 Feb;53(2):90–93. [PMC free article] [PubMed]
  • Felson DT, Hannan MT, Naimark A, Berkeley J, Gordon G, Wilson PW, Anderson J. Occupational physical demands, knee bending, and knee osteoarthritis: results from the Framingham Study. J Rheumatol. 1991 Oct;18(10):1587–1592. [PubMed]
  • Jones BH, Cowan DN, Tomlinson JP, Robinson JR, Polly DW, Frykman PN. Epidemiology of injuries associated with physical training among young men in the army. Med Sci Sports Exerc. 1993 Feb;25(2):197–203. [PubMed]
  • Kelsh MA, Sahl JD. Sex differences in work-related injury rates among electric utility workers. Am J Epidemiol. 1996 May 15;143(10):1050–1058. [PubMed]
  • Tomlinson JP, Lednar WM, Jackson JD. Risk of injury in soldiers. Mil Med. 1987 Feb;152(2):60–64. [PubMed]
  • Zwerling C, Sprince NL, Ryan J, Jones MP. Occupational injuries: comparing the rates of male and female postal workers. Am J Epidemiol. 1993 Jul 1;138(1):46–55. [PubMed]

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