[Analysis of Sickness-Related Days of Absence among Soldiers of the German Armed Forces from 2008 to 2018 Part 2: Retrospective Analysis of Risk Factors for Long-Term Illnesses].

BACKGROUND

Long-term illnesses have far-reaching consequences for the patients themselves, as well as for society as a whole. The aim of this study was to analyze risk factors for long-term illnesses among soldiers of the German armed forces in order to derive target group-specific and risk-adapted prevention measures.

METHOD: The sick leaves of all soldiers of the German armed forces in the period 2008-2018 were analyzed descriptively and risk factors were determined using two-dimensional contingency tables for the attributes gender, military career group, age group and main diagnosis in relation to sick leave (>42 and>84 days), whereby a statistically significant odds ratio (OR)>1.00 (McNemar test, p<0.05) had to be present. Risk constellations were identified by linking risk factors with the three most common underlying ICD-10 diagnoses.

RESULTS

The age groups 30-39 years (OR 1.13; 95% confidence interval [1.10; 1.16]), 40-49 years (OR 1.50 [1.45; 1.54]), 50-59 years (OR 1.81 [1.74; 1.88]), the military career group of non-commissioned officers (OR 1.35 [1.32; 1.37]) and officers (OR 1 .26 [1.23; 1.30]), as well as female gender (OR 1.23 [1.19; 1.26]) were identified as risk factors. Main diagnoses from the ICD-10 chapters "mental and behavioral disorders (F-codes)" (OR 6.50 [6.35; 6.65]), "diseases of the musculoskeletal system (M-codes)" (OR 2.54 [2.48; 2.60]) and "injuries, poisoning and certain other consequences of external causes (S-T-codes)" (OR 3.37 [3.30; 3.45]) were also risk factors. The ICD-10 diagnoses "reactions to severe stress and adjustment disorders (F43)" and "depressive episode (F32)" were among the three most frequent diagnoses for all analyzed attributes. Non-commissioned officers with "knee injuries (S83)", officers with "intervertebral disc disorders (M51)" and women with "pregnancy complaints (O26)" were risk constellations.

CONCLUSION

In addition to the comprehensive relevance of diagnoses of "mental and behavioral disorders", the study identified further risk factors and risk constellations for long-term illnesses. Based on this results target group-specific and risk-adapted prevention measures can be developed, e. g. as part of company health management. Concepts for "women's health" should also be implemented in the future. The effects of target group-specific and risk-adapted prevention measures need to be analyzed in follow-up studies.