The University of Southampton
University of Southampton Institutional Repository

Risk of injury in Royal Air Force training: does sex really matter?

Risk of injury in Royal Air Force training: does sex really matter?
Risk of injury in Royal Air Force training: does sex really matter?
Introduction
Musculoskeletal injuries are common during military and other occupational physical training programs. Employers have a duty of care to reduce employees’ injury risk, where females tend to be at greater risk than males. However, quantification of principle co-factors influencing the sex–injury association, and their relative importance, remain poorly defined. Injury risk co-factors were investigated during Royal Air Force (RAF) recruit training to inform the strategic prioritization of mitigation strategies.

Material and Methods
A cohort of 1,193 (males n = 990 (83%); females n = 203 (17%)) recruits, undertaking Phase-1 military training, were prospectively monitored for injury occurrence. The primary independent variable was sex, and potential confounders (fitness, smoking, anthropometric measures, education attainment) were assessed pre-training. Generalized linear models were used to assess associations between sex and injury.

Results
In total, 31% of recruits (28% males; 49% females) presented at least one injury during training. Females had a two-fold greater unadjusted risk of injury during training than males (RR = 1.77; 95% CI 1.49–2.10). After anthropometric, lifestyle and education measures were included in the model, the excess risk decreased by 34%, but the associations continued to be statistically significant. In contrast, when aerobic fitness was adjusted, an inverse association was identified; the injury risk was 40% lower in females compared with males (RR = 0.59; 95% CI: 0.42–0.83).

Conclusions
Physical fitness was the most important confounder with respect to differences in males’ and females’ injury risk, rather than sex alone. Mitigation to reduce this risk should, therefore, focus upon physical training, complemented by healthy lifestyle interventions.
Aerobic Fitness, Injury, Physical Training, Royal Air Force, Sex, Smoking
170-177
Fallowfield, J.L.
94d9253e-7a35-4e47-b6c7-eabe6f14cc6b
Leiper, R G
b9bebf13-3fae-4055-a044-f5ce6f060f52
Shaw, A.M.
210c5da7-ed6b-4694-a0be-e3fc6d579158
Whittamore, D R
474c563e-dab4-4d09-a4f4-e548d45b8f40
Lanham-New, S.A.
d6552d11-22a0-41d7-a30c-d7cb35ede4c9
Allsopp, A.J.
f60a004a-d68b-46c6-a2e0-0232c7a63bf4
Kluzek, S.
833bf2d6-2a2f-4ed1-887f-1b1c78ba98f7
Arden K., Nigel
23af958d-835c-4d79-be54-4bbe4c68077f
Sanchez-Santos, M.T.
31b97d12-d959-400e-8a98-3b0be20559ed
Fallowfield, J.L.
94d9253e-7a35-4e47-b6c7-eabe6f14cc6b
Leiper, R G
b9bebf13-3fae-4055-a044-f5ce6f060f52
Shaw, A.M.
210c5da7-ed6b-4694-a0be-e3fc6d579158
Whittamore, D R
474c563e-dab4-4d09-a4f4-e548d45b8f40
Lanham-New, S.A.
d6552d11-22a0-41d7-a30c-d7cb35ede4c9
Allsopp, A.J.
f60a004a-d68b-46c6-a2e0-0232c7a63bf4
Kluzek, S.
833bf2d6-2a2f-4ed1-887f-1b1c78ba98f7
Arden K., Nigel
23af958d-835c-4d79-be54-4bbe4c68077f
Sanchez-Santos, M.T.
31b97d12-d959-400e-8a98-3b0be20559ed

Fallowfield, J.L., Leiper, R G, Shaw, A.M., Whittamore, D R, Lanham-New, S.A., Allsopp, A.J., Kluzek, S., Arden K., Nigel and Sanchez-Santos, M.T. (2020) Risk of injury in Royal Air Force training: does sex really matter? Military Medicine, 185 (1-2), 170-177. (doi:10.1093/milmed/usy177).

Record type: Article

Abstract

Introduction
Musculoskeletal injuries are common during military and other occupational physical training programs. Employers have a duty of care to reduce employees’ injury risk, where females tend to be at greater risk than males. However, quantification of principle co-factors influencing the sex–injury association, and their relative importance, remain poorly defined. Injury risk co-factors were investigated during Royal Air Force (RAF) recruit training to inform the strategic prioritization of mitigation strategies.

Material and Methods
A cohort of 1,193 (males n = 990 (83%); females n = 203 (17%)) recruits, undertaking Phase-1 military training, were prospectively monitored for injury occurrence. The primary independent variable was sex, and potential confounders (fitness, smoking, anthropometric measures, education attainment) were assessed pre-training. Generalized linear models were used to assess associations between sex and injury.

Results
In total, 31% of recruits (28% males; 49% females) presented at least one injury during training. Females had a two-fold greater unadjusted risk of injury during training than males (RR = 1.77; 95% CI 1.49–2.10). After anthropometric, lifestyle and education measures were included in the model, the excess risk decreased by 34%, but the associations continued to be statistically significant. In contrast, when aerobic fitness was adjusted, an inverse association was identified; the injury risk was 40% lower in females compared with males (RR = 0.59; 95% CI: 0.42–0.83).

Conclusions
Physical fitness was the most important confounder with respect to differences in males’ and females’ injury risk, rather than sex alone. Mitigation to reduce this risk should, therefore, focus upon physical training, complemented by healthy lifestyle interventions.

Text
20180531 RAF Rct Trg and Injury Manuscript Revised - Accepted Manuscript
Download (123kB)

More information

Accepted/In Press date: 23 June 2018
e-pub ahead of print date: 21 August 2018
Published date: January 2020
Keywords: Aerobic Fitness, Injury, Physical Training, Royal Air Force, Sex, Smoking

Identifiers

Local EPrints ID: 425658
URI: http://eprints.soton.ac.uk/id/eprint/425658
PURE UUID: 41c5568a-f521-44c0-b115-34e294cf265c

Catalogue record

Date deposited: 31 Oct 2018 17:30
Last modified: 28 Apr 2022 05:45

Export record

Altmetrics

Contributors

Author: J.L. Fallowfield
Author: R G Leiper
Author: A.M. Shaw
Author: D R Whittamore
Author: S.A. Lanham-New
Author: A.J. Allsopp
Author: S. Kluzek
Author: Nigel Arden K.
Author: M.T. Sanchez-Santos

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×