Publications

The following manuscripts have been published or are currently in press. Listings are in chronological order, unless otherwise noted.

Title Publication Date/Location
Smallpox vaccination: comparison of self-reported and electronic vaccine records in the Millennium Cohort Study Human Vaccines 2007 Nov/Dec;3(6):245-51

LeardMann CA, Smith B, Smith TC, Wells TS, Ryan MAK, for the Millennium Cohort Study Team

Self-report of smallpox vaccination is very reliable. Results may be valuable in supporting global response to bioterrorism threats.

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Smokeless tobacco use related to military deployment, cigarettes, and mental health symptoms in a large, prospective cohort study among US service members Addiction 2012 May;107(5):983-994

Hermes ED, Wells TS, Smith B, Boyko EJ, Gackstetter GD, Miller SC, Smith TC, for the Millennium Cohort Study Team

Chronic use of smokeless tobacco has been linked to poor military training performance, early discharge, and a host of medical problems from cancer to heart disease. Smokeless tobacco initiation occurred in 1.9% and persistent use in 8.9% of Millennium Cohort participants. The study showed that deployment, combat exposure, smoking, and symptoms of posttraumatic stress disorder increased the risk for smokeless tobacco initiation, while deployment and combat exposure increased the risk for persistent use.

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Suicides Among Military Personnel Reply Journal of the American Medical Association 2013 Dec;310(23):2565-2566

Hoge CW, LeardMann CA, Boyko EJ

Discusses the complexity of suicidal behaviors and some challenges related to this type of research, while highlighting the strengths of using data from the Millennium Cohort to study suicide.

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The association of predeployment and deployment-related factors on dimensions of postdeployment wellness in US military service members The American Journal of Health Promotion 2013;28:2, 56-66

Bagnell ME, LeardMann CA, McMaster HS, Boyko EJ, Smith B, Granado, NS, and Smith TC

This study found that the majority of participants were well post-deployment, and military factors associated with post-deployment wellness included not experiencing combat and being trained as a combat specialist. Modifiable factors significantly associated with post-deployment wellness were also detected, including normal BMI, not smoking, and being physically active.

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The effects of exposure to documented open-air burn pits on respiratory health among deployers of the Millennium Cohort Study Journal of Occupational and Environmental Medicine 2012 June;54(6):708-716

Smith B, Wong CA, Boyko EJ, Phillips CJ, Gackstetter GD, Ryan MAK, Smith TC, for the Millennium Cohort Study Team

Burn pit exposure within 3 or 5 miles was not associated with newly reported asthma, chronic bronchitis or emphysema, or self-reported respiratory symptoms. In general, these findings do not support an elevated risk for respiratory outcomes among personnel deployed within proximity of documented burn pits in Iraq. Increased symptom reporting, however, was observed among Air Force deployers located within 2 miles of Joint Base Balad, though this finding was marginally significant with no evidence of trend.

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The Epidemiology of Irritable Bowel Syndrome in the US Military: Findings from the Millennium Cohort Study American Journal of Gastroenterology 2016;111:93-104

Riddle MS, Welsh M, Porter CK, Nieh C, Boyko EJ, Gackstetter GD, Hooper TI

This study describes the incidence of irritable bowel syndrome (IBS) and its association with antecedent infectious gastroenteritis among Millennium Cohort Study participants using survey data and post-deployment health assessments and medical encounter data in the military health system. Consistent with other studies, the risk of IBS increased after acute enteric infection. Novel findings included increased risk of incident IBS among those with post-traumatic stress disorder (PTSD) and preceding life stressors, as well as stronger associations between infectious gastroenteritis and IBS among those with antecedent depression or anxiety. These results reinforce the need to prevent acute gastrointestinal infections and their chronic consequences among our Service members. Additional studies on the underlying biopsychosocial mechanisms of IBS may help to explain these findings.

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The impact of deployment experience and prior healthcare utilization on enrollment in a large military cohort study BMC Medical Research Methodology 2013 Jul 11;13:90

Horton JL, Jacobson IJ, Littman AJ, Alcaraz JE, Smith B, and Crum-Cianflone NF

This study compared the characteristics of invited subjects (responders and nonresponders) prior to the enrollment cycle. Military personnel who deployed in support of OIF/OEF and those who presented for routine outpatient care were significantly more likely to enroll in a longitudinal cohort study examining their health and military experiences, while those with baseline mental disorders or longer hospital stays were less likely to enroll. These findings, which controlled for demographic and other potential confounders, suggest differential enrollment by deployment experience and health status, and may help guide recruitment efforts in future studies.

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The impact of prior deployment experience on civilian employment after military service Occupational and Environmental Medicine 2013; 70: 408-417

Horton JL, Jacobson IG, Wong CA, Wells TS, Boyko EJ, Smith B, Ryan MA, and Smith TC

Employment after military service, in particular after stressful deployment experiences, is a concern for many veterans and policymakers. Among this large cohort of veterans, we found that prior deployment and PTSD were not significantly associated with job status post-service; in contrast, depression, panic/anxiety disorder, and poor physical health increased the risk of unemployment among certain groups. These findings may guide policy for veterans most in need of post-military employment support.

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The Millennium Cohort Study: A 21-year prospective cohort study of 140,000 military personnel Military Medicine 2002 Jun;167(6):483-8.

Gray GC, Chesbrough KB, Ryan MAK, Amoroso P, Boyko EJ, Gackstetter GD, Hooper TI, Riddle JR, for the Millennium Cohort Study Group

The origins and development of the Millennium Cohort Study are described. The largest prospective study in military history was established to answer the most difficult questions about long-term health after military service.

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The Millennium Cohort Study: answering long-term health concerns of US military service members by integrating longitudinal survey data with military health system records Military Health Care From predeployment to post-separation 1st ed. New York, NY: Routledge;2013: 55-77

Crum-Cianflone N

In: Amara J, Hendricks A, eds

This textbook chapter provides a detailed summary of the first decade of the Millennium Cohort Study. The chapter includes an overview of the study methodology and key publications including a review of foundational papers and epidemiologic studies examining the associations of military service experiences with mental, behavioral, and physical health outcomes.

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