Commuting and sick leave: a retrospective longitudinal study among a Belgian military population.

OBJECTIVES: In a military context, people often have to deal with long commuting distance. The aim of the current study is to investigate to what extent commuting distances predict sickness absence among a military population. METHODS: The present study is based on a dynamic cohort of active-duty military personnel of the Belgian Defence. A proportional hazard Andersen-Gill model was used to determine the effect of commuting distance on the recurrence of sickness absence, considering relevant covariates. In a second model, an interaction term for commuting and traffic congestion was introduced. RESULTS: Higher commuting distances led to higher risk of recurring sickness absence, which was 9%, 15%, 8% and 11% higher, respectively, for distances of 5-14 km, 15-29 km, 30-59 km or >60 km compared with a distance of <5 km.A commuting distance of 30-59 km increased the risk with 47%, 33%, 35% and 76% if the reported traffic congestion was, respectively, 5-20%, 20-40%, 40-70% and 70-100% compared with a commuting distance of <5 km and a reported traffic congestion of 0-5%. A commuting distance of >60 km increased the risk with 25% and 76%, respectively, for a reported traffic congestion of 5-20% and 70-100% compared with a commuting distance of <5 km and a reported traffic congestion of 0-5%. CONCLUSIONS: These findings support measures to reduce the distance and frequency of commuting in order to reduce sickness absence, considering for example remote working, a more responsible geographical distribution of the offices or a revision of the employees' job-changing policies.

Longitudinal changes in hearing threshold levels for noise-exposed military personnel.

PURPOSE: Military personnel are exposed to variable and sometimes very high noise in their professional environment. The aim of this study is to evaluate through a longitudinal study if our hearing conservation program has to be adapted to consider specific interventions for subgroups of our military population still subject to a higher risk of hearing loss. METHODS: We conducted a retrospective longitudinal study in 2015-2016 to describe the evolution of hearing threshold levels of military personnel as measured during periodic audiometric screening over a period of 6 years (2009-2014) after the implementation of our hearing conservation program. A linear mixed model explored the relationship of pure-tone average (PTA) on 3, 4 and 6 KHz with probability of noise exposure, gender, age at baseline, time since baseline, hearing loss at baseline and ear. RESULTS: For 18,672 military individuals, our results show a small but statistically significant increase of 0.08 dB per year in PTA on 3, 4 and 6 KHz over the 6-year period that is consistently decelerating as a function of time. An additional annual increase of hearing thresholds due to higher age and moderate and high probability of exposure to noise was also found. CONCLUSIONS: No major adaptation of our hearing conservation program is required but efforts should be strengthened to better evaluate and counsel older individuals and subjects exposed to noise regarding avoidance of noise and correct use of personal hearing protection.

Occupational exposure to noise and the prevalence of hearing loss in a Belgian military population: a cross-sectional study.

The armed forces are highly exposed to occupational noise. The aim of this study was to evaluate the prevalence and noise exposures associated with the severity of hearing loss (HL) in a Belgian military population. A cross-sectional study was carried out at the Centre for Medical Expertise (CME) and in four Units of Occupational Medicine (UOM). Hearing thresholds were determined by audiometry. The examination included a questionnaire on hearing-related medical history, and noise exposure in military and leisure time activity. A multinomial logistic regression model was used to assess the association of the severity of HL with tinnitus, with the military occupation, and with noise exposures. Of the 2055 subjects aged 18-55 years, 661 (32.2%) had a slight HL (25-40 dB), 280 (13.6%) had a moderate HL (45-60 dB) and 206 (10.0%) had a severe HL (> 60 dB) of 4 and 6 kHz for both ears. The prevalence of slight, moderate and severe HL increased significantly with age and was higher for subjects from Paracommando and infantry units. Fighting in Built-Up Area (FIBUA) training, shooting with large caliber weapons, and participation in military exercises were the best determinants of HL in this population. These results suggest that subjects from infantry and Paracommando units run the highest risk of HL because they are exposed to very loud noises in their professional life, like large caliber shooting and FIBUA training.

Body mass index, physical activity, and smoking in relation to military readiness.

The objective of the study was to analyze the influence of excess weight, regular physical activity, and smoking on the military readiness of the Belgian Armed Forces in a cross-sectional online survey. A multinomial logistic regression was used to study the influence of modifiable risk factors on participation in the physical fitness test. In our study population (n = 4,959), subjects with a body mass index higher than 25 kg/m(2), smokers, and subjects with a lower level of vigorous physical activity were significantly more likely to have failed the physical fitness test. In the Belgian Armed Forces, serious efforts should be made to encourage vigorous physical activity, smoking cessation, and weight loss to preserve our military readiness. Instead of relying on civilian public health interventions, Belgian Defense should develop its own specific approaches to prevent weight gain, improve physical fitness, and influence smoking attitude.

Socioeconomic, health, and dietary determinants of physical activity in a military occupational environment.

BACKGROUND: Health-related advantages of physical activity are well documented. The aim was to detect socioeconomic, health, and dietary determinants of physical activity. METHODS: A cross-sectional design was used. Mailed questionnaires were sent to 5,000 Belgian military men. Dietary patterns were determined using the Mediterranean Diet Score (MDS). For physical activity, the validated International Physical Activity Questionnaire was used. RESULTS: Participation rate was 37% (n = 1,852). Mean total metabolic equivalent task (MET-total) varied between 6,224 MET-minutes/week for the age category 20 to 29 years to 4,578 MET-minutes/week for the age category 50 to 59 years. About 58% of the participants had a body mass index (BMI) above 25.0 kg/m(2). Logistic regression indicated a strong relation between MDS and MET-vigorous. A BMI increase of 1 kg/m(2) was associated with an odds ratio of 0.95 (95% confidence interval: 0.93-0.98), meaning that each increase of 1 kg/m(2) decreased MET-vigorous with 5%. Each additional life year decreased MET-vigorous with 3%. CONCLUSIONS: The high level of physical activity and the physical activity promoting and facilitating occupational environment seem to be insufficient to prevent adiposity. Vigorous physical activity was most discriminative and negatively related with increasing BMI, age, and smoking and positively related with MDS.