title: Risk of motor vehicle accident death among 1.3 million veterans of the Iraq and Afghanistan wars.
abstract: We conducted a cohort study of recent wartime veterans to determine the postservice mortality risk due to motor vehicle accidents (MVAs).
  
  
  
  Veterans were identified from the Defense Manpower Data Center records. Deployment to te Iraq or Afghanistan war zone was determined from the Contingency Tracking System. Vital status of 317,581 deployed and 964,493 nondeployed veterans was followed from their discharge dates between 2001 to 2007 until earlier of date of death or December 31, 2009. Underlying causes of death were obtained from the National Death Index Plus.
  
  
  
  Based on 9,353 deaths (deployed, 1,650; nondeployed, 7,703), of which 779 were MVA deaths as drivers (166; 613), both cohorts had 25 to 24% lower mortality risk from all causes but had 44 to 45% higher risk of MVA deaths relative to the U.S. general population. The higher MVA mortality risk was not associated with deployment to the war zone. After controlling for age, sex, race, marital status, branch of service, and rank, the risk for deployed veterans was comparable to that of nondeployed veterans (hazard ratio = 0.91; 95% confidence interval, 0.77-1.09).
  
  
  
  Veterans exhibit significantly higher risk of MVA deaths compared to the U.S. general population. However, deployment to the Iraq or Afghanistan war was not associated with the excess risk.
authors: a Office of Public Health , U.S. Department of Veterans Affairs , Washington , D.C.
authors: Tim A
authors: TA
authors: Bullman
authors: b Institute for Clinical Research , Washington , D.C.
authors: Han K
authors: HK
authors: Kang
authors: c National Center for Telehealth and Technology , U.S. Department of the Army , Tacoma , Washington.
authors: Derek J
authors: DJ
authors: Smolenski
authors: c National Center for Telehealth and Technology , U.S. Department of the Army , Tacoma , Washington.
authors: Nancy A
authors: NA
authors: Skopp
authors: c National Center for Telehealth and Technology , U.S. Department of the Army , Tacoma , Washington.
authors: Gregory A
authors: GA
authors: Gahm
authors: c National Center for Telehealth and Technology , U.S. Department of the Army , Tacoma , Washington.
authors: Mark A
authors: MA
authors: Reger
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality*; D000328:Adult; D055826:Afghan Campaign 2001-; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D016016:Proportional Hazards Models; D012042:Registries; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014728:Veterans; D014947:Wounds and Injuries / Q000401:mortality*
keywords: Iraq and Afghanistan wars; Motor vehicle accidents; hazard ratios; standardized mortality ratios; veterans