Leidos/Naval Submarine Medical Research Laboratory (NSMRL). SUBMED Dept. Box 900, Groton, CT 06349, USA.
Naval Submarine Medical Research Laboratory (NSMRL). SUBMED Dept. Box 900, Groton, CT 06349, USA.
Mil Med. 2024 Aug 19;189(Suppl 3):592-597. doi: 10.1093/milmed/usae197.
Illnesses among Navy divers degrade readiness, decrease manpower levels, and increase costs for medical care. Prior research has shown that Navy divers have high rates of the types of illnesses that might be because of diving in contaminated water. The objectives of this study were to examine medical records of U.S. Navy Sailors from 2016 to 2022 and determine if divers have higher incidence rates of health conditions that might be associated with contaminated water diving compared to non-divers.
For this retrospective cohort study, we used data from the Defense Medical Epidemiology Database (DMED). The DMED is operated by the Armed Forces Health Surveillance Division and uses data from the Defense Manpower Data Center to classify occupations. The DMED provides free online access to a de-identified subset of data contained within the Defense Medical Surveillance System.The population was U.S. Navy enlisted males, aged 25 to 29 years. Divers were compared to non-divers using 8 selected diagnoses that may reasonably be associated with diving in contaminated water.
During the study period, the database contained a total of 5,474 diver and 827,406 non-diver person-years. Of the 8 diagnoses, the ones with the largest number of cases for divers were upper respiratory infections with 128 and ear disorders with 62. The relative risks (RRs) for divers compared to non-divers were higher for otitis externa (RR = 1.44; confidence interval = 1.03, 2.01) and for ear disorders (RR = 1.15; confidence interval = 0.89, 1.47); for the other 6 diagnoses, the divers had lower rates than the non-divers.
The high RRs found for otitis externa and ear disorders support the need to devote resources to better understand the reasons for these higher risks and to develop, test, and implement targeted risk-reduction strategies. Future studies should attempt to link verified contaminated water exposures with adverse health outcomes and calculate risks based on criteria such as age and dive factors.
海军潜水员的疾病会降低战备能力，降低人力水平，并增加医疗费用。先前的研究表明，海军潜水员患有多种疾病的发病率很高，这些疾病可能是由于在受污染的水中潜水所致。本研究的目的是检查 2016 年至 2022 年美国海军水手的医疗记录，并确定与非潜水员相比，潜水员是否有更高的与受污染水潜水相关的健康状况发病率。
在这项回顾性队列研究中，我们使用了来自国防医疗流行病学数据库（DMED）的数据。DMED 由武装部队健康监测司运营，使用来自国防人力数据中心的数据对职业进行分类。DMED 免费在线提供国防医疗监测系统中包含的部分经身份识别数据子集的访问权限。该人群为年龄在 25 至 29 岁的美国海军现役男性。潜水员与非潜水员使用 8 种可能与受污染水潜水合理相关的选定诊断进行比较。
在研究期间，数据库共包含 5474 名潜水员和 827406 名非潜水员人年。在这 8 种诊断中，潜水员的病例数最多的是上呼吸道感染，有 128 例，耳部疾病有 62 例。与非潜水员相比，潜水员的相对风险（RR）更高的是外耳炎（RR=1.44；置信区间=1.03，2.01）和耳部疾病（RR=1.15；置信区间=0.89，1.47）；对于其他 6 种诊断，潜水员的发病率低于非潜水员。
外耳炎和耳部疾病的高 RR 支持投入资源以更好地了解这些更高风险的原因，并制定、测试和实施有针对性的降低风险策略的必要性。未来的研究应尝试将经证实的受污染水暴露与不良健康结果联系起来，并根据年龄和潜水因素等标准计算风险。
