Update: Exertional rhabdomyolysis, active component, U.S. Armed Forces, 2017-2021.

Area of Science:

• Military Medicine
• Occupational Health
• Exercise Physiology

Background:

• Exertional rhabdomyolysis (ER) is a serious condition resulting from muscle breakdown due to intense physical activity.
• Understanding ER incidence and risk factors in military populations is crucial for injury prevention and readiness.
• Previous studies have highlighted ER as a significant concern within the armed forces.

Purpose of the Study:

• To determine the incidence and trends of exertional rhabdomyolysis among active component service members from 2017 to 2021.
• To identify specific demographic, occupational, and service branches at higher risk for ER.
• To inform medical providers about diagnostic considerations for ER in service members.

Main Methods:

• Retrospective analysis of incident cases of exertional rhabdomyolysis.
• Utilized data from active component service members between 2017 and 2021.
• Calculated unadjusted incidence rates per 100,000 person-years (p-yrs) and analyzed subgroup-specific rates.

Main Results:

• In 2021, 513 cases of ER occurred, with an incidence rate of 38.6 per 100,000 p-yrs.
• Highest incidence rates were observed in males, those under 20, non-Hispanic Black service members, Marines, Army members, and recruits.
• Rates peaked in 2018 and showed a slight decrease by 2021; non-Hispanic Black service members and Marine Corps members consistently had the highest rates.

Conclusions:

• Exertional rhabdomyolysis remains a notable health issue in the military, with specific subgroups at elevated risk.
• The findings underscore the need for targeted prevention strategies, particularly for recruits and those in high-exertion roles.
• Medical providers should maintain a high index of suspicion for ER in service members presenting with relevant symptoms, especially in hot and humid conditions.