title: Attrition of military enlistees with a medical waiver for chronic headache, 1995-2000.
abstract: BACKGROUND
  Recurrent headaches are disqualifying for military service if they are of sufficient severity or frequency to interfere with normal function in the past 3 years. The occupational impact of waiving this standard is evaluated.
  
  
  METHODS
  A retrospective cohort study of enlistees from January 1, 1995, through December 31, 2000, was performed. Enlistees with a waiver for recurrent headaches were compared with fully qualified enlistees (matched 3:1) for retention in the military, headache-related discharges, and hospitalizations.
  
  
  RESULTS
  The 174 individuals with waivers for a history of recurrent headaches were retained on active duty at the same rate as the 522 matched control subjects (log rank test, p = 0.91). Medical record review of waivers documented no debilitating headaches within 1 year before the medical examination.
  
  
  CONCLUSIONS
  These results validate the current headache waiver criteria from the perspective of retention and suggest a more lenient medical accession standard. Future studies should evaluate the morbidity and occupational impact of headaches in the U.S. military.
authors.affiliation: U.S. Pacific Fleet, Pearl Harbor, HI 96860.
authors.forename: Christopher
authors.initials: C
authors.lastname: Jankosky
authors.forename: David W
authors.initials: DW
authors.lastname: Niebuhr
authors.forename: Timothy E
authors.initials: TE
authors.lastname: Powers
authors.forename: Margot R
authors.initials: MR
authors.lastname: Krauss
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002908:Chronic Disease; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D006261:Headache / Q000453:epidemiology / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008887:Military Medicine; D008889:Military Personnel / Q000706:statistics & numerical data*; D009784:Occupational Diseases / Q000453:epidemiology / Q000503:physiopathology*; D012008:Recurrence; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D014938:Work Capacity Evaluation