Assessment of Deployment-Related Exposures on Risk of Incident Mental Health Diagnoses Among Air Force Critical Care Providers: Nested Case-Control Study

• Published in: Military medicine 2016-02, Vol.181 (2), p.143-151
• Main Authors: Tvaryanas, Anthony P, Maupin, Genny M, Fouts, Brittany L
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Afghan Campaign 2001; Case-Control Studies; Compassion Fatigue - epidemiology; Female; Health Personnel - psychology; Health Personnel - statistics & numerical data; Humans; Iraq War, 2003-2011; Male; Mental Disorders - epidemiology; Middle Aged; Military Personnel - psychology; Military Personnel - statistics & numerical data; Occupational Exposure - statistics & numerical data; Risk Factors; Surveys and Questionnaires; Young Adult
• ISSN: 0026-4075; 1930-613X
• DOI: 10.7205/MILMED-D-14-00585

The purpose of this study was to determine the association between deployment-related occupational/environmental exposures and incident postdeployment mental health (PDMH) conditions in a defined population of military health care professionals working in the deployed critical care environment. A nested case-control study compared cohort members with a PDMH condition (cases, N = 146) with those without a PDMH condition (controls, N = 800) in terms of deployment-related exposures as ascertained using Postdeployment Health Assessment DD 2796 questionnaire data. Multivariable logistic regression models were used to compute odds ratios. Nonphysician career fields (i.e., nurses and medical technicians), exposure to dead bodies or people killed/wounded, history of a vehicular accident/crash, exposure to sand/dust, exposure to lasers, and use of mission-oriented protective posture (MOPP) overgarments were associated with increased likelihood for a PDMH condition. The infrequent exposures (i.e., vehicular accident/crash, lasers, and MOPP overgarments) were the exposures most strongly associated with subsequent PDHM conditions. For military health care providers returning from the deployed environment, several exposures are useful for predicting those at increased risk for a PDMH condition. However, there are likely many other important risk factors beyond those captured on the DD 2796 questionnaire.