Military occupational health: a systematic review
e202512088
Keywords:
Occupational health, Military personnel, Interventions, Occupational risks, Mental healthAbstract
BACKGROUND // Occupational health in military settings requires analyzing occupational risks, prevention strategies, and comprehensive care systems. This article presents
a qualitative narrative systematic review that examines the scientific literature on occupational health in armies and navies, addressing the challenges faced by military
personnel and the intervention strategies implemented to improve their well-being.
METHODS // The methodology followed the PRISMA guidelines, graphically representing the process of searching, selecting, and excluding studies through a flow diagram, resulting in a total of 41 articles included in the final sample analyzed. The search strategy was designed according to the SPIDER criteria and was conducted in Web of Science, Scopus, PubMed, PsycINFO, and Google Scholar. VOSviewer was used to construct and visualize bibliometric networks.
RESULTS // Emerging trends in military personnel health care were identified, including mental health, injury prevention, and innovative technologies. The bibliometric analysis showed a concentration of research on mental health, post-traumatic stress, and musculoskeletal injuries, with a growing interest in a more comprehensive approach.
CONCLUSIONS // Based on these findings, implications for policy-making and clinical practice were discussed, highlighting the need for preventive programs tailored to operational profiles, early psychological intervention protocols, periodic assessments of psychosocial risks, and organizational strategies to reduce workload, according to rank, service branch, and operational environment.
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References
1. Adams RE, Urosevich TG, Hoffman SN, Kirchner HL, Hyacinthe JC, Figley CR et al. Social support, help-seeking, and mental health outcomes among veterans in non-VA facilities: results from the veterans’ health study. Mil Behav Health. 2017;5(4):393-405. https://doi.org/10.1080/21635781.2017.1333067
2. Brewin CR, Andrews B, Valentine JD. Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. J Consult Clin Psychol. 2000;68(5):748-766. https://doi.org/10.1037//0022-006x.68.5.748
3. Hoge CW, Auchterlonie JL, Milliken CS. Mental health problems, use of mental health services, and attrition from military service after returning from deployment to Iraq or Afghanistan. JAMA. 2006;295(9):1023-1032. https://doi.org/10.1001/jama.295.9.1023
4. Moore MJ, Shawler E, Jordan CH, Jackson CA. Veteran and military mental health issues. En: StatPearls. StatPearls Publishing; 2024. https://pubmed.ncbi.nlm.nih.gov/34283458/
5. Hoyt MT, Hein CL. Combat and operational stress control in the prolonged field care environment. Army.mil. 2021. https://www.armyupress.army.mil/Portals/7/military-review/Archives/English/SO-21/hoyt-combat-operational-stress/hoyt.pdf
6. Hobfoll SE, Lilly RS. Resource conservation as a strategy for community psychology. J Community Psychol. 1993;21(2):128-148. https://doi.org/10.1002/1520-6629(199304)21:2<128::AID-JCOP2290210206>3.0.CO;2-5
7. Jones FD. Lessons of war for psychiatry. En: Psychiatry. Springer US; 1985. p. 515-519. https://link.springer.com/chapter/10.1007/978-1-4613-2365-5_79
8. Cederbaum JA, Wilcox SL, Sullivan K, Lucas C, Schuyler A. The influence of social support on dyadic functioning and mental health among military personnel during postdeployment reintegration. Public Health Rep. 2017;132(1):85-92. https://doi.org/10.1177/0033354916679984
9. Braithwaite M, Nicholson G, Thornton R, Jones D, Simpson R, McLoughin D et al. Armed Forces occupational health-a review. Occup Med (Lond). 2009;59(8):528-538. https://doi.org/10.1093/occmed/kqp140
10. Jones BH, Perrotta DM, Canham-Chervak ML, Nee MA, Brundage JF. Injuries in the military: a review and commentary focused on prevention. Am J Prev Med. 2000;18(3 Suppl):71-84. https://doi.org/10.1016/s0749-3797(99)00169-5
11. Yáñez Sepúlveda R, Cortés Roco G, Olivares Arancibia J, Reyes-Amigo T, Hurtado-Almonacid J, Vargas-Silva JF et al. Relación entre la Composición Corporal, Condición Física y Capacidad Operativa en Militares Chilenos. Int J Morphol. 2023;41(5):1323-1329. https://doi.org/10.4067/s0717-95022023000501323
12. Thaul S, O’Maonaigh H, Institute of Medicine (US) Committee on Battlefield Radiation Exposure Criteria. Exposición potencial a la radiación en operaciones militares: cómo proteger al soldado antes, durante y después. Washington, DC: National Academies Press; 1999. https://www.ncbi.nlm.nih.gov/books/NBK224066/
13. Waitzkin H, Cruz M, Shuey B, Smithers D, Muncy L, Noble M. Military personnel who seek health and mental health services outside the military. Mil Med. 2018;183(5–6):e232-e240. https://doi.org/10.1093/milmed/usx051
14. Loaiza O, Posada JL. Psicología militar: conceptualización e investigaciones contemporáneas. 2016. https://www.redalyc.org/articulo.oa?id=333147069006
15. Sizer L, Toland C. Trastorno por Estrés Postraumático (PTSD). Air University Press; 2015. https://www.airuniversity.af.edu/Portals/10/ASPJ_Spanish/Journals/Volume-27_Issue-1/2015_1_08_sizer_s.pdf
16. Shalev AY. Posttraumatic stress disorder and stress-related disorders. Psychiatr Clin North Am. 2009;32(3):687-704. https://doi.org/10.1016/j.psc.2009.06.001
17. Hoge CW, McGurk D, Thomas JL, Cox AL, Engel CC, Castro CA. Mild traumatic brain injury in U.S. soldiers returning from Iraq. N Engl J Med. 2008;358(5):453-463. https://doi.org/10.1056/NEJMoa072972
18. Fernández-Duarte CA, Flores-Pedroso MD, Gonzales-Calle S, García-Carrillo JA, Urazan-Chinchilla JC. Operaciones militares, despliegues de tropa y alteraciones en salud mental: una revisión de la literatura. Brújula Semilleros Investig. 2024;12(23):48-73. https://doi.org/10.21830/23460628.159
19. Hosseini SM, Hesam S, Hosseini SA. Burnout among military personnel: a systematic review. Iran J Psychiatry. 2023;18(2):213-236. https://doi.org/10.18502/ijps.v18i2.12371
20. Cooke A, Smith D, Booth A. Beyond PICO: the SPIDER tool for qualitative evidence synthesis. Qual Health Res. 2012;22(10):1435-1443. https://doi.org/10.1177/1049732312452938
21. Godoy-López JR. 2009-2019: evolución de la epidemiología de lesiones deportivas en las Fuerzas Armadas. Sanid Mil. 2022;78(4):229-235. https://scielo.isciii.es/pdf/sm/v78n4/1887-8571-sm-78-04-229.pdf
22. Murphy MC, Stannard J, Sutton VR, Owen PJ, Park B, Chivers PT et al. Epidemiology of musculoskeletal injury in military recruits: a systematic review and meta-analysis. BMC Sports Sci Med Rehabil. 2023;15(1). https://doi.org/10.1186/s13102-023-00755-8
23. Bird SP, Tarpenning KM, Marino FE. Designing resistance training programmes to enhance muscular fitness. Sports Med. 2005;35(10):841-851. https://doi.org/10.2165/00007256-200535100-00002
24. Bullock SH, Jones BH, Gilchrist J, Marshall SW. Prevention of physical training–related injuries. Am J Prev Med. 2009;38(1):S156-S181. https://doi.org/10.1016/j.amepre.2009.10.023
25. Bounds CL, Coppieters MW, Thomson HW, Larsen B, Evans K. Efficacy of conservative interventions for musculoskeletal conditions on pain and disability in active serving military personnel: a systematic review. Mil Med. 2023;189(1–2):e66-e75. https://doi.org/10.1093/milmed/usac409
26. Bøg M, Filges T, Jørgensen AMK. Deployment of personnel to military operations: impact on mental health and social functioning. Campbell Syst Rev. 2018;14(1):1-127. https://doi.org/10.4073/csr.2018.6
27. Katzman D, Kalman G, Almog O, Fogel I. Deployment of physician resources and innovative medical strategies in the 2023-2024 Israel-Hamas war: Israel’s strategy to deliver advanced life support and whole blood transfusion to the battlefield via forward medical teams and the impact on the case fatality rate. Mil Med. 2024. https://doi.org/10.1093/milmed/usae553
28. Adler AB, Castro CA. An occupational mental health model for the military. Mil Behav Health. 2013;1(1):41-45. https://doi.org/10.1080/21635781.2012.721063
29. Adler AB, Bliese PD, Castro CA. Deployment psychology: evidence-based strategies to promote mental health in the military. Washington (DC): American Psychological Association; 2011. https://doi.org/10.1037/12300-000
30. Alele FO, Malau-Aduli BS, Malau-Aduli AEO, Crowe M. Epidemiology of exertional heat illness in the military: a systematic review of observational studies. Int J Environ Res Public Health. 2020;17(19):7037. https://doi.org/10.3390/ijerph17197037
31. Badea D, Petrisor S. Ergonomics role’s reconsideration need within efficient military activities. Land Forces Acad Rev. 2012;17(1):43-49. https://www.proquest.com/scholarly-journals/ergonomics-roles-reconsideration-need-within/docview/1010633814/se-2
32. Vita C. Nuevas tecnologías para la sanidad militar. Sanid Mil. 2017;73(1):5-6. https://scielo.isciii.es/scielo.php?script=sci_abstract&pid=S1887-85712017000100005
33. Komalasari R, Mustafa C. Integrating machine learning and wearable technology to prevent musculoskeletal injuries in military training: a natural science approach. Mil Math Nat Sci (MUNISI). 2023. https://jurnal.idu.ac.id/index.php/munisi/article/view/16910
34. Morse S, Talty K, Kuiper P, Scioletti M, Heymsfield SB, Atkinson RL et al. Machine learning prediction of combat basic training injury from 3D body shape images. PLoS One. 2020;15(6):e0235017. https://doi.org/10.1371/journal.pone.0235017
35. Shah IA, Mishra S. Artificial intelligence in advancing occupational health and safety: an encapsulation of developments. J Occup Health. 2024;66(1). https://doi.org/10.1093/joccuh/uiad017
36. Tanielian T, Jaycox LH. Invisible wounds of war: psychological and cognitive injuries, their consequences, and services to assist recovery. Santa Monica (CA): RAND Corporation; 2008. http://www.jstor.org/stable/10.7249/mg720ccf
37. Creamer M, Wade D, Fletcher S, Forbes D. PTSD among military personnel. Int Rev Psychiatry. 2011;23(2):160-165. https://doi.org/10.3109/09540261.2011.559456
38. Xue C, Ge Y, Tang B, Liu Y, Kang P, Wang M et al. A meta-analysis of risk factors for combat-related PTSD among military personnel and veterans. PLoS One. 2015;10(3):e0120270. https://doi.org/10.1371/journal.pone.0120270
39. Kar N. Cognitive behavioral therapy for the treatment of post-traumatic stress disorder: a review. Neuropsychiatr Dis Treat. 2011;7:167-178. https://doi.org/10.2147/ndt.s10389
40. Dursun S, Coulthard J. The role of the military family in the rehabilitation and reintegration of ill and injured service members. In: MacDermid Wadsworth S, Riggs D, editors. War and family life: risk and resilience in military and veteran families. Cham: Springer; 2016. p. 255-274. https://doi.org/10.1007/978-3-319-21488-7_14
41. Silgo MG. Revisión de programas de resiliencia basados en la evidencia en los ejércitos. Sanid Mil. 2013;69(3):182-194. https://doi.org/10.4321/s1887-85712013000300005
42. Ha JH, Jue J. The mediating effect of group cohesion modulated by resilience in the relationship between perceived stress and military life adjustment. Sustainability. 2022;14(13):7794. https://doi.org/10.3390/su14137794
43. Coppola MN, Satterwhite R, Fulton LV, Shanderson LL, Pasupathy R. Military health system efficiency: a review of history and recommendations for the future. Mil Med. 2012;177(6):686-692. https://doi.org/10.7205/milmed-d-11-00171
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