Darby S C, Muirhead C R, Doll R, Kendall G M, Thakrar B
ICRF Cancer Epidemiology Unit, University of Oxford, Radcliffe Infirmary.
Br J Ind Med. 1990 Dec;47(12):793-804. doi: 10.1136/oem.47.12.793.
The Registrar General's decennial supplements on occupational mortality provide only limited information on mortality in the armed forces in the United Kingdom. Mortality has therefore been studied among a group of 30,619 United Kingdom servicemen who served abroad in tropical or desert areas in the 1950s and 1960s, and who remained in the services for a total of at least five years. Mortality from all causes of death, all neoplasms, and all other known non-violent causes was lower than that expected from rates for all men in England and Wales, whereas mortality from accidents and violence was raised. These differences remained after adjustment for social class, affected both officers and other ranks, and had not disappeared even after the men had been followed up for at least 20 years. When mortality from 20 specific cancers and 10 other disease groups was examined there were significant excesses for cancers of the oesophagus (standardised mortality ratio (SMR) = 146; p = 0.03) and prostate (SMR = 156; p = 0.03), and significant deficits for cancers of the lung (SMR = 73; p less than 0.001), stomach (SMR = 66; p = 0.002), bladder (SMR = 53; p = 0.02), other specified neoplasms (SMR = 48; p = 0.001), coronary heart disease (SMR = 76; p less than 0.001), bronchitis, emphysema, and chronic obstructive lung disease (SMR = 42; p less than 0.001), and for five further groups of diseases unrelated to smoking or alcohol. Examination of mortality in each of the three services separately identified two specific hazards in the Royal Navy; seven deaths from mesothelioma occurred compared with less than 2.06 expected (p less than 0.005), and there was also an excess of neoplasms and of other diseases associated with alcohol (SMRs of 181 and 229; p = 0.002 and less than 0.001). Mortality from smoking related diseases other than those associated with alcohol was low in all three services, particularly among officers.
英国总登记官每十年发布的职业死亡率补充报告,仅提供了关于英国武装部队死亡率的有限信息。因此,对一组30619名英国军人进行了研究,这些军人在20世纪50年代和60年代曾在热带或沙漠地区服役,且总共在部队服役至少五年。所有死因、所有肿瘤以及所有其他已知非暴力死因的死亡率均低于英格兰和威尔士所有男性的预期死亡率,而事故和暴力导致的死亡率则有所上升。在对社会阶层进行调整后,这些差异依然存在,对军官和其他职级人员均有影响,甚至在对这些军人进行了至少20年的随访之后,这些差异仍未消失。当对20种特定癌症和10个其他疾病组的死亡率进行检查时,发现食管癌(标准化死亡率比(SMR)=146;p=0.03)和前列腺癌(SMR=156;p=0.03)的死亡率显著过高,而肺癌(SMR=73;p<0.001)、胃癌(SMR=66;p=0.002)、膀胱癌(SMR=53;p=0.02)、其他特定肿瘤(SMR=48;p=0.001)、冠心病(SMR=76;p<0.001)、支气管炎、肺气肿和慢性阻塞性肺病(SMR=42;p<0.001)以及另外五组与吸烟或饮酒无关的疾病的死亡率则显著过低。分别对三个军种的死亡率进行检查时,发现皇家海军存在两种特定风险;间皮瘤导致7人死亡,而预期死亡人数不到2.06人(p<0.005),与酒精相关的肿瘤和其他疾病的死亡率也过高(SMR分别为181和229;p=0.002和<0.001)。在所有三个军种中,与吸烟相关但与酒精无关的疾病的死亡率都很低,尤其是在军官中。