King's Centre for Military Health Research, Department of Psychological Medicine, King's College London, London, UK.
Lancaster Medical School, Lancaster University, Lancaster, UK.
Int J Epidemiol. 2023 Aug 2;52(4):1025-1034. doi: 10.1093/ije/dyad050.
We investigated whether military personnel involved in chemical warfare agent research at Porton Down had increased rates of mortality or cancer incidence.
This was a historical cohort study comprising male UK veterans who participated in the 'Service Volunteer Programme', 1941-89, identified from Porton Down experiment books, and a comparison group of similar 'non-Porton Down' veterans identified from military personnel files. Of 19 233 records retrieved for each group, 18 133 (94%) Porton Down and 17 591 (92%) non-Porton Down were included in our analytical sample. Mortality and cancer incidence data were obtained from national registries up to December 2019.
Over a median follow-up of 48.1 years, 10 935 Porton Down veterans (60.3%) and 10 658 non-Porton Down veterans (60.6%) had died. After adjustment for age, year of birth and military service characteristics, overall, Porton Down veterans had a 6% higher rate of all-cause mortality compared with non-Porton Down veterans [hazard ratio (HR) = 1.06, 95% confidence interval (CI) 1.03-1.09]. For cause-specific mortality, Porton Down veterans had higher rates of death from genitourinary diseases (HR = 1.34, 95% CI 1.05-1.70) and deaths attributable to alcohol (HR = 1.44, 95% CI 1.07-1.94), with weaker associations observed for deaths from infectious and parasitic diseases (HR = 1.32, 95% CI 0.99-1.78), lung cancer (HR = 1.10, 95% CI 1.01-1.20) and external causes (HR = 1.15, 95% CI 1.00-1.32). Associations with all-cause mortality were stronger for veterans who attended Porton Down between 1960 and 1964 (HR = 1.34, 95% CI 1.19-1.50); likelihood-ratio test, P = 0.006. There was no association between attendance at Porton Down and overall cancer incidence (HR = 1.00, 95% CI 0.95-1.03).
Overall, mortality rates were slightly higher in Porton Down veterans, but there was no difference in cancer incidence. Associations for mortality were stronger in Porton Down veterans who attended in the early 1960s.
我们调查了在波顿唐从事化学战剂研究的军人是否有更高的死亡率或癌症发病率。
这是一项历史队列研究，包括参加了 1941 年至 1989 年“服务志愿者计划”的英国男性退伍军人，他们是从波顿唐实验簿中确定的，以及从军事人员档案中确定的类似的“非波顿唐”退伍军人的对照组。为每组检索了 19233 份记录，其中 18133 份（94%）波顿唐和 17591 份（92%）非波顿唐记录被纳入我们的分析样本。死亡率和癌症发病率数据是从国家登记处获得的，截至 2019 年 12 月。
在中位随访 48.1 年后，10935 名波顿唐退伍军人（60.3%）和 10658 名非波顿唐退伍军人（60.6%）死亡。调整年龄、出生年份和兵役特征后，总体而言，波顿唐退伍军人的全因死亡率比非波顿唐退伍军人高 6%[风险比（HR）=1.06，95%置信区间（CI）1.03-1.09]。对于特定原因的死亡率，波顿唐退伍军人的泌尿生殖系统疾病死亡率更高（HR=1.34，95%CI 1.05-1.70）和归因于酒精的死亡率更高（HR=1.44，95%CI 1.07-1.94），而传染病和寄生虫病死亡率（HR=1.32，95%CI 0.99-1.78）、肺癌（HR=1.10，95%CI 1.01-1.20）和外部原因死亡率（HR=1.15，95%CI 1.00-1.32）的相关性较弱。对于 1960 年至 1964 年期间参加波顿唐的退伍军人，与全因死亡率的相关性更强（HR=1.34，95%CI 1.19-1.50）；似然比检验，P=0.006。参加波顿唐与总体癌症发病率之间没有关联（HR=1.00，95%CI 0.95-1.03）。
总体而言，波顿唐退伍军人的死亡率略高，但癌症发病率没有差异。在 20 世纪 60 年代早期参加波顿唐的退伍军人的死亡率相关性更强。
