Mortality in British military participants in human experimental research into chemical warfare agents at Porton Down: cohort study.
Mortality in British military participants in human experimental research into chemical warfare agents at Porton Down: cohort study.
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DOI：
10.1136/bmj.b613
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发表时间：
2009-03-24
期刊：
影响因子：
--
通讯作者：
Carpenter LM
中科院分区：
文献类型：
--
作者：
Venables KM;Brooks C;Linsell L;Keegan TJ;Langdon T;Fletcher T;Nieuwenhuijsen MJ;Maconochie NE;Doyle P;Beral V;Carpenter LM
目的调查1941 ~ 1989年参加化学战剂实验研究的人员死亡率的长期影响。设计历史队列研究。数据来源：英国政府研究机构的档案，英国军事人员记录，以及国家死亡和癌症记录。参与者18 276名男性成员的英国武装部队谁花了一个或多个短期（中位数4天之间的第一次和最后一次测试）在Porton Down和对照组的17 600名非Porton Down退伍军人随后到2004年12月31日。主要观察指标：Porton Down与非Porton Down退伍军人的死亡率比，以及每个退伍军人组与普通人群的标准化死亡率比。这两个比率都按年龄组和日历期进行了调整。结果波顿唐退伍军人在入伍年份（中位数1951年）与非波顿唐退伍军人相似，但服役时间较长（中位数6.2 v5.0年）。在平均随访43年后，40%（7306）的Porton Down和39%（6900）的非Porton Down退伍军人死亡。全因死亡率在Porton Down退伍军人中略高（率比1.06，95%置信区间1.03至1.10，P<0.001），英国以外的死亡率更高（1.26，1.09至1.46）。在检查的12个特定原因组中，Porton Down退伍军人的传染病和寄生虫病死亡率增加（1.57，1.07至2.29），泌尿生殖系统（1.46，1.04至2.04），循环（1.07，1.01至1.12），以及外部（非医学）（1.17，1.00至1.37）原因，原位、良性和未指明肿瘤导致的死亡减少（0.60，0.37至0.99）。化学品暴露类型与死因特异性死亡率之间没有明确的关系。两组退伍军人的死亡率均低于一般人群（标准化死亡率比为0.88，0.85至0.90; 0.82，0.80至0.84）。结论：Porton Down的死亡率略高于非Porton Down退伍军人。由于缺乏关于其他重要因素的信息，如吸烟或海外服务，因此不可能将Porton Down的少量超额死亡率归因于化学品暴露。
Objective To investigate any long term effects on mortality in participants in experimental research related to chemical warfare agents from 1941 to 1989. Design Historical cohort study. Data sources Archive of UK government research facility at Porton Down, UK military personnel records, and national death and cancer records. Participants 18 276 male members of the UK armed forces who had spent one or more short periods (median 4 days between first and last test) at Porton Down and a comparison group of 17 600 non-Porton Down veterans followed to 31 December 2004. Main outcome measures Mortality rate ratio of Porton Down compared with non-Porton Down veterans and standardised mortality ratio of each veteran group compared with the general population. Both ratios adjusted for age group and calendar period. Results Porton Down veterans were similar to non-Porton Down veterans in year of enlistment (median 1951) but had longer military service (median 6.2 v 5.0 years). After a median follow-up of 43 years, 40% (7306) of Porton Down and 39% (6900) of non-Porton Down veterans had died. All cause mortality was slightly greater in Porton Down veterans (rate ratio 1.06, 95% confidence interval 1.03 to 1.10, P<0.001), more so for deaths outside the UK (1.26, 1.09 to 1.46). Of 12 cause specific groups examined, rate ratios in Porton Down veterans were increased for deaths attributed to infectious and parasitic (1.57, 1.07 to 2.29), genitourinary (1.46, 1.04 to 2.04), circulatory (1.07, 1.01 to 1.12), and external (non-medical) (1.17, 1.00 to 1.37) causes and decreased for deaths attributed to in situ, benign, and unspecified neoplasms (0.60, 0.37 to 0.99). There was no clear relation between type of chemical exposure and cause specific mortality. The mortality in both groups of veterans was lower than that in the general population (standardised mortality ratio 0.88, 0.85 to 0.90; 0.82, 0.80 to 0.84). Conclusions Mortality was slightly higher in Porton Down than non-Porton Down veterans. With lack of information on other important factors, such as smoking or service overseas, it is not possible to attribute the small excess mortality to chemical exposures at Porton Down.
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