Sex disparities in self-reported musculoskeletal injuries in the Canadian Armed Forces.

Recent comprehensive systematic review studies indicate that biological sex is strongly associated with musculoskeletal injuries (MSKi) in military populations, with females being at greater risk. These trends have yet to be explored in Canadian military personnel. Our goal was to determine the association between biological sex and MSKi in the Canadian Armed Forces (CAF). An online survey was conducted with active-duty and former CAF members aged 18-65 years. Sex disparities in MSKi (acute or repetitive strain [RSI]) were analyzed using bivariate associations and binary logistic regressions with significance level at p<0.05. Analyses were stratified by military environment (i.e., Army, Navy, and Air Force). From the 1,947 respondents whose biological sex was reported, 855 were females and 1092 were males. Rates of RSI sustained while serving among females and males were 76.2% and 70.5% (p=0.011), respectively, whereas 61.4% of females reported acute injuries compared to 63.7% of males (p=0.346). Females were more likely to report overall RSI (adjusted odds ratio [aOR]: 1.397; 95% confidence intervals [CI]: 1.068-1.829), RSI having a greater impact on daily activities (aOR [95%CI]: 2.979 [2.093-4.239]) and greater impact on career progress/length (aOR [95%CI]: 1.448 [1.066-1.968]). Greater impact of acute injuries on daily activities (aOR [95%CI]: 1.688 [1.198-2.379]) was also more prevalent in females. This study identifies sex-disparities pertaining to MSKi in the CAF, indicates types, and suggests contributing factors of MSKi.