title: U.S. military recruits waived for pathological curvature of the spine: increased risk of discharge from service.
abstract: Selective accession waivers for medically disqualifying conditions like spinal curvature are one way the military meets its manpower needs. We evaluated retention patterns during the first 2 years of service of a cohort of military recruits with waivers for pathological curvature of the spine (spinal curvature). Recruits waived for spinal curvature (n = 417), who accessed from 1998 to 2005 were identified and matched with 3 qualified recruits. Kaplan-Meier survival analysis and Cox proportional hazards model were used to compare survival patterns and adjusted attrition hazard estimates. Waived recruits experienced significantly increased risk of "all cause" discharge (relative risk = 1.3; 95% confidence interval: 1.1, 1.5) and "existing prior to service" discharge (relative risk = 2.4; confidence interval: 1.6, 3.5). Despite the increased risk of discharge, current waiver criteria allowed a majority with spinal curvature to complete at least 2 years of service. Policy makers must consider risks and benefits before modifying the current accession standard for spinal curvature.
authors.affiliation: Department of Epidemiology, Walter Reed Army Institute of Research, 503 Robert Grant Road, Silver Spring, MD 20910,USA
authors.forename: Sheryl A
authors.initials: SA
authors.lastname: Bedno
authors.forename: Bradley
authors.initials: B
authors.lastname: Gardiner
authors.forename: Yuanzhang
authors.initials: Y
authors.lastname: Li
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Wiesen
authors.forename: Jordan A
authors.initials: JA
authors.lastname: Firestone
authors.forename: David W
authors.initials: DW
authors.lastname: Niebuhr
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008889:Military Personnel; D010560:Personnel Selection; D016016:Proportional Hazards Models; D013121:Spinal Curvatures / Q000453:epidemiology* / Q000473:pathology; D014481:United States / Q000453:epidemiology