Post Deployment Health Services, US Department of Veterans Affairs, 810 Vermont Ave, Washington DC, 20420, United States.
Cancer Epidemiol. 2019 Oct;62:101563. doi: 10.1016/j.canep.2019.07.002. Epub 2019 Jul 23.
Beginning in 1996 US military personnel served as peacekeeping forces in Bosnia/Kosovo. No studies have assessed the long-term post-deployment health of this US cohort. Based on the health concerns raised in studies of military personnel from other countries, this study focused on mortality due to Leukemia, respiratory disease, respiratory cancer, and heart disease.
This study compared the post-war cause-specific mortality of 53,320 veterans who deployed to Bosnia/Kosovo between 1996-2002 to that of 117,267 veterans who also served in the military between 1996-2002, but were not deployed to Bosnia/Kosovo. Expressed as standardized mortality ratios (SMR)s the cause-specific mortality for both deployed and non-deployed were compared separately to that of the US general population. Cause-specific mortality risks among Bosnia/Kosovo veterans relative to that of non-deployed veterans were assessed using Hazard Ratios (HR)s generated by Cox proportional-hazards models.
The overall mortality of both deployed and non-deployed veterans was almost half that of the US population, SMR = 0.59, 95%, C.I., 0.55-0.62 and SMR = 0.66, 95%, C.I., 0.64-0.68, respectively. Neither group of veterans had any excess of disease related mortality compared to that of the US population. Compared to non-deployed, deployed veterans did not experience any increased risks for any of the diseases of a priori interest.
It does not appear that US military deployed to Bosnia/Kosovo have any increased risks of disease related mortality. However, this study would not have been able to detect increased risk of cancers with latency periods that exceeded the 18 years of follow-up available in this study.
1996 年开始,美国军人作为维和部队在波斯尼亚和科索沃服役。目前尚无研究评估这一美国人群的长期部署后健康状况。基于其他国家军人研究中提出的健康问题,本研究主要关注白血病、呼吸道疾病、呼吸道癌和心脏病导致的死亡率。
本研究比较了 1996 年至 2002 年间部署到波斯尼亚和科索沃的 53320 名退伍军人与同期未部署到波斯尼亚和科索沃的 117267 名退伍军人的战后特定原因死亡率。以标准化死亡率(SMR)表示,分别比较了部署和未部署退伍军人的特定原因死亡率与美国一般人群的死亡率。使用 Cox 比例风险模型生成的风险比(HR)评估波斯尼亚和科索沃退伍军人与未部署退伍军人之间特定原因死亡率的风险。
部署和未部署退伍军人的总体死亡率均接近美国人口的一半,SMR=0.59,95%CI,0.55-0.62 和 SMR=0.66,95%CI,0.64-0.68。两组退伍军人的疾病相关死亡率均未超过美国人口。与未部署退伍军人相比,部署退伍军人没有任何一种预先确定的疾病风险增加。
部署到波斯尼亚和科索沃的美国军人似乎没有增加与疾病相关的死亡率。然而,本研究无法检测出潜伏期超过本研究 18 年随访时间的癌症的风险增加。