From left, Senior Airman Kenneth Havro, Airman 1st Class Anthony Soik and Senior Airman Jordan Belloff, members of the 86th Security Forces Squadron at Ramstein Air Base, Germany, pose with their energy drinks of choice.

KAISERSLAUTERN, Germany — When pulling three 12-hour shifts in as many days, Airman 1st Class Florentino Vasquez, 20, reaches for a Red Bull or Monster Energy to keep him alert at his post.

Usually, one is enough to get Vasquez, an 86th Security Forces Squadron member, through his shift. On occasion, he said, he drinks two.

It’s hard to get enough sleep when working long hours, he said. “They keep me up,” he said of energy drinks, until he “crashes” when he gets home and “sleeps like a baby.”

It’s no secret that energy drinks are the beverage of choice among some in the military. Last year, Monster Energy beat out Mountain Dew as the top-selling cold beverage in the Army and Air Force Exchange Service worldwide, according to AAFES officials.

Amid growing concern about the effects of energy drink consumption, an Air Force researcher is conducting the service’s first comprehensive study of energy drink usage among the force’s active-duty and civilian personnel.

“We just don’t know how much folks are consuming them — in quantities, duration and what’s driving it,” said Maj. Nicholas Milazzo, chief of pharmacy research for the 60th Medical Group’s clinical investigation facility at Travis Air Force Base, Calif.

Launched in September, the online survey targets 12 bases. Two are in Europe — Aviano and Lakenheath air bases — and the others in the States.

Previous Air Force studies on energy drink usage have been limited to one base.

The wider study comes as energy drinks have come under scrutiny amid concerns about the safety of the highly caffeinated drinks, which aren’t regulated by the government because they’re sold as dietary supplements.

In October, the family of Anais Fournier, 14, filed a wrongful death lawsuit against the makers of Monster Energy, alleging the company’s drinks contributed to the teen’s death in December 2011. Fournier, who had an underlying heart condition, went into cardiac arrest after consuming two 24-ounce cans in a 24-hour period, according to The Record Herald in Waynesboro, Pa.

An FDA report released in November linked 18 deaths to Monster Energy and 5-hour Energy from 2004 through Oct. 23, 2012. The FDA said the cases were presented as reported by patients and health care providers, and do not represent any conclusion about whether the products actually caused the reactions.

Officials at Landstuhl Regional Medical Center in Germany said its cardiology clinic sees many patients with heart palpitations, racing heart, lightheadedness and exertional chest pain in patients who consume ergogenic supplements, which include energy drinks. Doctors there said there are no concrete data to suggest a cause-and-effect relationship.

Milazzo said there have been no reports of deaths attributed to energy drinks in the military, but the limited knowledge about the physical effects of energy drinks and how many Air Force personnel consume them is a potential health risk. He cited a government report released last year that showed a tenfold increase from 2005 to 2009 in U.S. emergency department visits related to energy drink intake.

“The majority of those patients that came in complaining of problems with consumption were between the ages of 18 and 39, which is primarily the age of our active-duty members,” Milazzo said. “I think there’s a misperception that if you can buy it without a prescription or if you can purchase it off the shelf, it’s safe for you. They just see it as … ‘it’s a pick-me-up. It’s no different than coffee, no different than a soda … that has caffeine.’ ”

While the FDA limits the amount of caffeine in sodas and other beverages to no more than 71 milligrams per 12-ounce can, there are no caffeine restrictions on energy drinks, Milazzo said. “They have other components that are … herbal agents,” he said. “Some of those things are well-studied; some of them aren’t. They’re not monitored by the FDA, and so we have limited clinical data on them.”

Some airmen at Ramstein Air Base who consume energy drinks said they weren’t worried about the effects on their health.

“I’ve been drinking them for years, and they’ve been fine for me,” said Senior Airman Kenneth Havro, 25, of the 86th Security Forces Squadron.

Havro said he drinks three to four Rock Star energy drinks daily, in addition to about half a dozen cups of coffee. The only drawback, he said, is the risk of cavities and “the crash” that follows the jolt from the caffeine and sugar.

Staff Sgt. Mike Judy, 27, also with the 86th Security Forces Squadron, cut back on his energy drink consumption when he wanted to lose weight. “They have so much sugar; it’s not really helpful on a diet,” he said. Judy, who works the midnight shift, said a lot of his co-workers “drink them to get through the shift.”

Retail sales of energy drinks for AAFES topped $99 million in fiscal 2011, up from about $91 million in fiscal 2010, according to AAFES, which sold nearly 39 million units of energy drinks in fiscal 2011.

The Defense Commissary Agency sold nearly 6 million units of energy drinks worldwide in fiscal 2012, with retail sales of more than $14 million, according to DeCA.

Staff members at the Health and Wellness Center on Ramstein said they often see airmen with an energy drink while attending a class at the center.

“Our ‘Be Well’ class … they’ll bring the brand name (energy) drinks in,” said Lt. Col. Peggy Ann Milam, the center’s flight commander.

Milam and her staff will ask airmen complaining of fatigue about their eating and sleeping habits and caffeine intake. They’ll encourage an airman who uses energy drinks to cut back and get more sleep.

Energy drinks can actually make people feel more tired, as a recent Centers for Disease Control and Prevention report indicated. That study, published last month, found that U.S. servicemembers in Afghanistan who consumed three or more caffeine-charged energy drinks a day were prone to sleepiness and dozing off while on guard duty.

The problem is caffeinated energy drinks can interrupt sleep cycles, Milam said, preventing someone from sleeping when they need to and causing them to feel less energetic later.

“Our No. 1 question is, ‘How much sleep do you get at night?’ ” Milam said. “So often, that’s the first thing to be compromised.”

Capt. Lindzi Howder, the wellness center’s nutrition program manager and a clinical dietician, said she’ll be interested to see the findings of the Air Force survey.

Are airmen “using it because they’re working too much — they don’t get enough breaks? Are they not educated about how to sustain a healthy lifestyle? Is it that they really like the energy drinks?” she said.

Milazzo said that’s one of the goals: “It could be deployments, working 12-hour shifts, wanting to be more alert … we’re just not sure.”

The 17-question survey, which takes about five minutes to complete, is voluntary and anonymous. It should be completed at all 12 bases by the end of December, Milazzo said.

The results from each base will be presented to the wing commander, he said, and eventually will be published in a military journal.

“This is just to gather information and look for patterns and trends,” Milazzo said. “It’s not that we’re trying to change policy; it’s not that we’re trying to ban use of the items.”

Stars and Stripes’ Joshua DeMotts contributed to this report.

svanj@estripes.osd.mil