| Background. Efforts to understand and prevent the rare, but tragic, occurrence of death among healthy, young military recruits trying to serve their country depend upon medical surveillance data and accurate determination of mortality rates by specific cause. The purpose of this study was to create a Recruit Mortality Registry that includes deaths that have occurred during Air Force, Navy, Marine Corps, and Army basic military training from 1977 through 2001, and to describe the epidemiology of recruit mortality due to traumatic and nontraumatic deaths.;Methods. Recruit deaths were identified and confirmed through redundant sources. Attempts were made to obtain a complete file on each death including all available medical and personnel records. Demographic, circumstantial, and medical information was recorded on an abstraction form developed for this study. Mortality rates per 100,000 recruit-years were calculated using recruit accession data from the Defense Manpower Data Center.;Results. There were 276 recruit deaths from 1977 through 2001 identified through the Recruit Mortality Registry. Age-specific recruit mortality rates were less than half of same-age U.S. civilian mortality rates. Between Services, the age-adjusted mortality rates were highest in the Army and lowest in the Air Force and Navy, with the Marine Corps in between. The majority (71%) of recruit deaths were classified as nontraumatic and 69% (136/196) of these were exercise-related. Of the exercise-related deaths, 42% (57/136) were cardiac deaths and at least one-third (45/136) were related to heat stress. Infectious agents accounted for 24% (48/196) of the nontraumatic deaths. Only 29% (80/276) of recruit deaths were classified as traumatic. Of these, the majority (58%) were due to suicide, followed by unintentional injuries (37%), and homicide (5%).;Conclusions. Comparison of military recruit mortality rates with the same-age U.S. civilian population establishes the safety of the basic military training environment. This can be attributed to selection factors in inducting healthy recruits, a well-supervised training environment, the tremendous focus on safety during recruit training, and lack of access to alcohol and motor vehicles. Preventive measures focused on reducing heat stress during exercise may be effective in reducing high rates of exercise-related death. |
