title: Vocational factors which predict seizure prognosis in young adults during military service.
abstract: The vocational parameters regarding epilepsy are not well established. Our aim was to assess the risk of seizures as a function of occupational stress and disease severity in military recruits of the IDF (Israel Defense Force) and to examine the effect of new classification criteria (used between the late nineties and early two thousands) in comparison with that of previous criteria (used during the mid-eighties to mid-nineties).
  
  
  
  The medical records of over 150,000 18-year-old men recruited to the IDF between the mid-nineties and the mid-two thousands were used to assemble a cohort, which was followed for a period of 36months. The severity of the disease was determined according to 3 categories, according to the medical history. The recruits were subdivided according to their occupational categories to Combat Units (CUs), Maintenance Units (MUs), and Administrative Units (AUs). We compared the incidence rates of the different groups with the findings from a previous follow-up.
  
  
  
  The annual incidence rates during 36months of follow-up were 0.026%, 4.7%, and 8.8%, in categories 1 to 3, respectively. The relative risk of seizure incidence in CU and MU was lower than in AU (0.42 and 0.81, p<0.0001). Similar findings were found in other disease categories.
  
  
  
  Job assignment to CU (less convenient conditions like sleep deprivation and strenuous physical activity) did not increase the incidence of seizures. It was found that EEG examination is an important criterion in the vocational evaluation of subjects that have had one or more seizures. This study supports the establishment of vocational criteria and recommends the integration of people diagnosed with epilepsy in most occupations.
authors: Maccabi Healthcare Services, The Occupational Medicine Department, Holon, Israel; The School of Public Health, Environmental and Occupational Medicine Department, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors: Michal
authors: M
authors: Tavor
authors: EEG and Epilepsy Unit, Department of Neurology, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Israel.
authors: Miri Y
authors: MY
authors: Neufeld
authors: The School of Public Health, Environmental and Occupational Medicine Department, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Maccabi Healthcare Services, Central Headquarter, Tel Aviv, Israel.
authors: Gabriel
authors: G
authors: Chodick
authors: The School of Public Health, Environmental and Occupational Medicine Department, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Israel Defense Force, Medical Corps, Israel.
authors: Oren
authors: O
authors: Zack
authors: Maccabi Healthcare Services, The Occupational Medicine Department, Holon, Israel.
authors: Ayala
authors: A
authors: Krakov
authors: Sackler Faculty of Medicine, Department of Dermatology, Sourasky Medical Center, Tel Aviv, Israel.
authors: Dan
authors: D
authors: Slodownik
authors: Maccabi Healthcare Services, The Occupational Medicine Department, Holon, Israel; The School of Public Health, Environmental and Occupational Medicine Department, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: moshe_sh@mac.org.il.
authors: Shlomo
authors: S
authors: Moshe
mesh_terms: D000293:Adolescent; D004827:Epilepsy / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D007557:Israel / Q000453:epidemiology; D008297:Male; D008889:Military Personnel; D009790:Occupations; D011379:Prognosis; D012306:Risk; D012640:Seizures / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D012892:Sleep Deprivation / Q000150:complications; D055815:Young Adult
keywords: Employment; Epilepsy; Seizure; Sleep deprivation; Work