During the 15-year surveillance period, there were 2,233 incident diagnoses of malignant melanoma among members of the active component of the U.S. military (unadjusted incidence rate 1.08 cases per 10,000 person-years [p-yrs]). Unadjusted incidence rates were highest in the fi xed-wing pilot/ crew group (2.45 per 10,000 p-yrs); lowest in the infantry, special operations, combat engineer group (0.77 per 10,000 p-yrs); and intermediate among healthcare providers (1.33 per 10,000 p-yrs) and all others (1.07 per 10,000 p-yrs). During the 15-year period, rates of malignant melanoma diagnoses among U.S. military members overall increased in an exponential fashion in relation to years of active service. However, this relationship varied across occupational groups. Most notably, after several years of service, rates of melanoma diagnoses increased relatively rapidly among pilots and the crews of fixed-wing aircraft (e.g., fighters, bombers, cargo/personnel transporters) and those in occupations inherently conducted outdoors (e.g., infantry, special operations, combat engineers). In contrast, melanoma diagnosis rates increased relatively slowly among healthcare providers and those in "other" military occupations. The findings reiterate the importance of limiting, to the extent possible given mission requirements, exposures of military members to solar ultraviolet and cosmic ionizing radiation.
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