Occupational Correlates of Low Back Pain Among U.S. Marines Following Combat Deployment.

摘要

Since the initiation of Operation Iraqi Freedom in 2003, many U.S. service members have experienced routine deployments to combat environments, which present numerous occupational hazards that may result in musculoskeletal conditions such as low back pain (LBP). Active-duty U.S. Marines with an initial deployment to Iraq or Kuwait between 2005 and 2008 were identified from electronic deployment records and linked to medical databases (n = 36,680). The outcome of interest was an ICD-9-CM code indicating LBP (724.2) within 1 year postdeployment. Multivariate logistic regression examined the effect of occupation on LBP. Overall, 4.1% (n = 1,517) of Marines were diagnosed with LBP within 1 year postdeployment. After adjusting for covariates, the occupational groups: service/supply (odds ratio OR 1.33, 95% confidence interval CI, 1.12-1.59) and electrical/mechanical/craftsworker (OR 1.31, 95% CI, 1.12-1.53) had higher odds of LBP when compared with the referent group administrative/other. Within these groups, the highest LBP prevalence was in the construction (8.6%), law enforcement (6.2%), materiel receipt, storage, issue (6.0%), and automotive repair subgroups (5.8%). In summary, while infantry occupations purposefully engage the enemy and often face sustained physical rigors of combat-related activity, LBP was most prevalent in non- infantry occupations. Future studies should include detailed exposure histories to elucidate occupation-specific etiologies of LBP in order to guide prevention efforts.