HEALTH / WELL-BEING

Mortality among UK Gulf War veterans

Article

This research explored the mortality rates of UK Gulf War veterans who were identified as having served in the Gulf War between September, 1990, and June, 1991. This so called ‘Gulf cohort’ consisted of 53 462 veterans who were studied in comparison to a control group of Armed Forces personnel (the Era cohort) where each individual was matched for age, gender, service and rank. Individuals were followed from the 1st of April 1991 up until the 31st of March 1999 or the earliest of the following: date of death or emigration from the UK. The study identified the Gulf cohort had lower mortality rates due to “disease-related” causes and slightly higher mortality rates from “external” causes, although these were accident-related rather than due to suicide.

Abstract

Background Armed forces personnel who served in the Gulf War report more current ill-health than those who were not deployed. There has been concern expressed that they may also experience higher mortality rates. Methods A retrospective cohort study was done including all 53 462 UK Gulf War veterans (Gulf cohort) and a comparison group equivalent in size of personnel who were not deployed but matched for age, sex, rank, service, and level of fitness (Era cohort). Individuals were identified on central registers of the Office for National Statistics and information on death among cohort subjects, including cause of death, obtained. Follow-up extended from April 1, 1991 (the end of the Gulf War) until March 31, 1999. Findings There were 395 deaths among the Gulf cohort and 378 deaths amongst the Era cohort (mortality rate ratio [MRR] 1·05, 95% CI 0·91–1·21). Mortality from “external” causes was higher in the Gulf cohort (Gulf 254, Era 216; MRR 1·18 [0·98–1·42] while mortality from “disease-related” causes was lower (Gulf 122, Era 141; 0·87 [0·67–1·11]). The higher mortality rate from “external” causes in the Gulf cohort was principally due to higher mortality rates from accidents. There was, however, no excess of deaths recorded as suicide in the Gulf cohort. Interpretation This follow-up of veterans of the Gulf war has shown, 8 years after the end of the conflict, that although they have experienced higher mortality rates than a comparison cohort, the excess mortality rate is very small and does not approach statistical significance. The excess is related mainly to accidents rather than disease, a pattern that is consistent both with US veterans of the Gulf war and veterans from other conflicts.

Full Reference

Macfarlane, G., Thomas, E. & Cherry, N. (2000). Mortality among UK Gulf War veterans. The Lancet, 356(9223), 17-21.