Factors associated with neuromusculoskeletal injury and disability in Navy and Marine Corps personnel

Abstract

Introduction: Neuromusculoskeletal injuries (NMSKI) are ubiquitous in the military, which contribute to short- and long-term disability. Methods: NMSKI, limited duty (LIMDU), and long-term disability episode counts in the US Navy (USN) and Marine Corps (USMC) from December 2016 to August 2021 were extracted from the Musculoskeletal Naval Epidemiological Surveillance Tool. NMSKI, LIMDU, and long-term disability episodes incidence were calculated. A hurdle negative binomial regression evaluated the association of body region, sex, age, rank, age by rank, and service branch on NMSKI, LIMDU, and long-term disability incidence. Results: From December 2016 to August 2021, there were 2004196 NMSKI episodes (USN: 3285/1000 Sailors; USMC: 4418/1000 Marines), 16791 LIMDU episodes (USN: 32/1000 Sailors; USMC: 29/1000 Marines), and 2783 long-term disability episodes (USN: 5/1000 Sailors; USMC: 5/1000 Marines). There was a large-magnitude protective effect on NMSKI during the pandemic (RR, USN: 0.70; USMC: 0.75). Low back and ankle-foot were the most ubiquitous, primarily affecting female personnel, aged 25-44 years, senior enlisted, in the USMC. Shoulder, arm, pelvis-hip, and knee conditions had the greatest risk for disability, with female sex, enlisted ranks, ages 18-24 years, and service in the USMC the most salient factors. Discussion: The significant protective effect during the pandemic was likely a function of reduced physical exposure and access to non-urgent care. Geographically accessible specialized care and resources aligned with communities with the greatest risk is needed for the timely prevention, assessment, and treatment of NMSKI. Conclusion: Body region, sex, age, rank, and branch were salient factors for NMSKI.