title: Risk Factors for Injuries During Military Static-Line Airborne Operations: A Systematic Review and Meta-Analysis.
abstract: OBJECTIVE
  To identify and analyze articles in which the authors examined risk factors for soldiers during military static-line airborne operations.
  
  
  METHODS
  We searched for articles in PubMed, the Defense Technical Information Center, reference lists, and other sources using the key words airborne, parachuting, parachutes, paratrooper, injuries, wounds, trauma, and musculoskeletal.
  
  
  METHODS
  The search identified 17 684 potential studies. Studies were included if they were written in English, involved military static-line parachute operations, recorded injuries directly from events on the landing zone or from safety or medical records, and provided data for quantitative assessment of injury risk factors. A total of 23 studies met the review criteria, and 15 were included in the meta-analysis.
  
  
  METHODS
  The summary statistic obtained for each risk factor was the risk ratio, which was the ratio of the injury risk in 1 group to that of another (baseline) group. Where data were sufficient, meta-analyses were performed and heterogeneity and publication bias were assessed.
  
  
  RESULTS
  Risk factors for static-line parachuting injuries included night jumps, jumps with extra equipment, higher wind speeds, higher air temperatures, jumps from fixed-wing aircraft rather than balloons or helicopters, jumps onto certain types of terrain, being a female paratrooper, greater body weight, not using the parachute ankle brace, smaller parachute canopies, simultaneous exits from both sides of an aircraft, higher heat index, winds from the rear of the aircraft on exit entanglements, less experience with a particular parachute system, being an enlisted soldier rather than an officer, and jumps involving a greater number of paratroopers.
  
  
  CONCLUSIONS
  We analyzed and summarized factors that increased the injury risk for soldiers during military static-line parachute operations. Understanding and considering these factors in risk evaluations may reduce the likelihood of injury during parachuting.
authors.affiliation: Portfolio of Epidemiology and Disease Surveillance, US Army Public Health Center, Aberdeen Proving Ground, MD.|Oak Ridge Institute for Science and Education, Aberdeen Proving Ground, MD.
authors.forename: Joseph
authors.initials: J
authors.lastname: Knapik
authors.affiliation: Portfolio of Epidemiology and Disease Surveillance, US Army Public Health Center, Aberdeen Proving Ground, MD.
authors.forename: Ryan
authors.initials: R
authors.lastname: Steelman
mesh_terms: D001359:Aviation; D001835:Body Weight; D006801:Humans; D015994:Incidence; D008889:Military Personnel; D018570:Risk Assessment; D012307:Risk Factors; D012449:Safety; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000209:etiology
keywords: musculoskeletal; night; parachute ankle brace; parachutes; parachuting; temperature; terrain; trauma; wind speed; wounds