Death among U.S. Air Force basic trainees, 1956 to 1996

Basic military training in the U.S. Air Force exposes recruits to multiple environmental and psychological stressors. Deaths often prompt examination of the training process.

This retrospective case study evaluates recruit deaths at Lackland Air Force Base between 1956 and 1996 in terms of demographic, clinical, and environmental variables.

Eighty-five deaths occurred, with 81% being natural, 13% suicide, 4% accidental, and 2% not classified. Ninety-four percent of recruits who died were male, and 60% were 17 to 19 years of age. The average death rate was 2.8/100,000 recruits. Seven recruits were sickle cell trait (SCT)-positive. The relative risk for nontraumatic deaths between expected SCT-positive and non-SCT-positive populations was 23.53 (confidence interval, 19.55-30.01). Thirty-five percent (30 recruits) died from cardiac causes, resulting in a death rate of 1.0/100,000 trainees. Thirty-three percent (28 recruits) died primarily from infections. Six deaths were due to heat stroke, 11 to suicide, and 3 to accidents.

As a result of improvements in immunizations, changes in hydration and exercise policies, limited access to vehicles, close supervision, the "buddy system," and the institution of the Navy-Air Force Medical Evaluation Test, only a few deaths occurred in any given year.