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Outline. BackgroundUpdate to USAF Recruit Mortality StudySCT data from Lackland AFBConclusion. Background. USAF BMT screens all recruits upon entryScreened with Sickle prep"Confirmed with hemoglobin electrophoresisCounseled on increased risk for medical complicationsGiven the option to lea
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1. USAF Recruit Mortality Data Maj Katerina Neuhauser
AFIERA/RSRH
Brooks AFB, TX 78235-5116
2. Outline Background
Update to USAF Recruit Mortality Study
SCT + data from Lackland AFB
Conclusion
3. Background USAF BMT screens all recruits upon entry
Screened with “Sickle prep”
Confirmed with hemoglobin electrophoresis
Counseled on increased risk for medical complications
Given the option to leave military service
5. Cause of Death Natural includes the following categories:
Cardiac
Infectious diseases
Rhabdomyolysis
Heat-relatedNatural includes the following categories:
Cardiac
Infectious diseases
Rhabdomyolysis
Heat-related
6. Deaths among USAF Recruits with Positive SCT:1956-2001 7 recruits positive SCT
All black between 18-22 yrs of age Out of the 80 –SCT deaths:
Sudden death (20)
Rhabdomyolysis (2)
Meningiococcemia (6)
Suicide (10)
+SCT -SCT or unspecified
Cause of Death N % N %
Sudden death 3 43% 20 25%
Rhabdomyolysis 2 28% 2 3%
Meningiococcemia 1 14% 6 8%
Suicide 1 14% 10 13%
Total 7 80
Note: Not all –SCT deaths outlinedOut of the 80 –SCT deaths:
Sudden death (20)
Rhabdomyolysis (2)
Meningiococcemia (6)
Suicide (10)
+SCT -SCT or unspecified
Cause of Death N % N %
Sudden death 3 43% 20 25%
Rhabdomyolysis 2 28% 2 3%
Meningiococcemia 1 14% 6 8%
Suicide 1 14% 10 13%
Total 7 80
Note: Not all –SCT deaths outlined
7. +SCT Deaths: 1956-2001 5 SCT+ deaths temporally related to exercise
4 occurred during warmest months (May – Sep)
Kark found 28-40X higher exertion-induced sudden unexplained death among heterozygous recruits from 1977-1981
Neuhauser calculated a risk ratio of 23.53 (19.55 ,30.01) for non-traumatic deaths from 1986-1994 using autopsy data on recruit deaths
-- For the purposes of the study previously preformed, it was assumed that 0.08% of caucasians and 8% of black inductees were SST positive (literature)
With this information, we calculated a risk ratio of 23.53 (19.55, 30.01)
1) Looked only at non-traumatic deaths
2) Small number of deaths in any given year so data followed a Poisson distribution
3) This was taken into account to calculate the RR, to obtain a narrow CI
- Data similar to that obtained by Kark where heterozygous individuals had 28-40X higher risk of death-- For the purposes of the study previously preformed, it was assumed that 0.08% of caucasians and 8% of black inductees were SST positive (literature)
With this information, we calculated a risk ratio of 23.53 (19.55, 30.01)
1) Looked only at non-traumatic deaths
2) Small number of deaths in any given year so data followed a Poisson distribution
3) This was taken into account to calculate the RR, to obtain a narrow CI
- Data similar to that obtained by Kark where heterozygous individuals had 28-40X higher risk of death
10. Conclusions Few USAF recruit deaths in any given year
Most deaths occur during first 3 wks of training
Only 7 of 87 deaths from 1956-2001 were SCT +
SCT+ deaths temporally associated with exercise
Higher RR for SCT+ non-traumatic deaths
No information on exertional deaths among SCT+ individuals after basic training
Lackland AFB identifies 3 +SCT /1000/wk
Lackland AFB retains 89% of +SCT recruits after preventive counseling
11. Contact Information Maj Katerina Neuhauser
AFIERA/RSRH
DSN 240-1573
Katerina.Neuhauser@brooks.af.mil