An analysis is provided from 19,265 Physical Evaluation Board diagnoses from 10,406 Navy personnel from 1998 to 2000. The leading diagnostic categories were musculoskeletal and mental disorders as well as for subgroups of women and officers. Musculoskeletal conditions were 41.6% of the diagnoses and decreased with advancing age (42.9% for <30 years; 41.1% for 30-40 years; 37.6% for >40 years; chi2 for trend [1 df] = 26.4; p = 0.000). Mental disorders were 11.8% of the diagnoses and also decreased with advancing age (14.1% for <30 years; 10.4% for 30-40 years; 8.8% for >40 years; chi2 for trend [1 df] = 84; p = 0.000). Diagnoses for injury and poisoning (8.9%), nervous system (7.6%), and ill-defined conditions (4.7%) completed the top five categories below age 40 years, whereas circulatory disorders were evident after age 40 years. These findings suggest priorities for reducing overall medical disability losses in our active duty Navy forces.

The pharmaceutical industry has an obligation to identify adverse reactions to drug products during all phases of drug development, including the post-marketing period. Estimates of population exposure to pharmaceutical products are important to the post-marketing surveillance of drugs, and provide a context for assessing the various risks and benefits, including drug safety, associated with drug treatment. This paper describes a systematic approach to estimating post-marketing drug exposure using ex-factory shipment data to estimate the quantity of medication available, and dosage information (stratified by indication or other factors as appropriate) to convert the quantity of medication to person time of exposure. Unlike the non-standardized methods often used to estimate exposure, this approach provides estimates whose calculations are explicit, documented, and consistent across products and over time. The methods can readily be carried out by an individual or small group specializing in this function, and lend themselves to automation. The present estimation approach is practical and relatively uncomplicated to implement. We believe it is a useful innovation.