Department of Medical Education, Brighton and Sussex Medical School, Brighton, UK
King's Centre for Military Health Research, Department of Psychological Medicine, King's College London, London, UK.
Occup Environ Med. 2024 Oct 8;81(9):480-488. doi: 10.1136/oemed-2024-109525.
We investigated whether UK military personnel exposed to sarin during the 'Service Volunteer Programme' at Porton Down had increased rates of mortality or cancer incidence over a 52-year follow-up.
A historical cohort study assembled from UK military records, comprising male veterans exposed to sarin during the 'Service Volunteer Programme' at Porton Down, UK (n=2975) and a comparison group of similar veterans who did not attend (n=2919). Mortality and cancer incidence data were obtained from national registries up to December 2019. Analysis was conducted using Cox regression adjusted for age, year of birth and service characteristics.
Over a median follow-up of 52.2 years (range 2 days to 74.6 years), 1598 (53.7%) sarin-exposed veterans and 1583 (54.3%) non-exposed veterans died. Adjusted HRs for all-cause mortality were raised for any sarin exposure (HR=1.08, 95% CI 1.01 to 1.16), two or more exposures (HR=1.25, 95% CI 1.04 to 1.49) and higher doses (air >15 mg.min/m) (HR=1.15, 95% CI 1.02 to 1.30). For cause-specific mortality, sarin exposure was associated with deaths from 'other' circulatory diseases (excludes ischaemic and cerebrovascular diseases) (HR=1.41, 95% CI 1.06 to 1.87) and alcohol-attributable deaths (HR=2.66, 95% CI 1.40 to 5.07). There was no association between sarin exposure and overall cancer incidence (HR=1.01, 95% CI 0.93 to 1.10), but cancer incidence was higher for alcohol-related neoplasms (HR=1.24, 95% CI 1.01 to 1.51).
Sarin exposure was associated with increased rates of mortality over a 50-year follow-up. The strongest associations were observed for deaths attributable to alcohol and 'other' circulatory diseases.
我们研究了在波顿唐进行的“服务志愿者计划”中接触沙林的英国军人在 52 年的随访中死亡率或癌症发病率是否增加。
这是一项从英国军人记录中组建的历史队列研究，包括在英国波顿唐的“服务志愿者计划”中接触沙林的男性退伍军人（n=2975）和未参加的类似退伍军人的对照组（n=2919）。死亡率和癌症发病率数据来自国家登记册，截至 2019 年 12 月。使用 Cox 回归分析，根据年龄、出生年份和服务特征进行调整。
在中位随访 52.2 年（范围 2 天至 74.6 年）期间，1598 名（53.7%）接触沙林的退伍军人和 1583 名（54.3%）未接触沙林的退伍军人死亡。调整后的全因死亡率危险比升高的暴露于任何沙林（HR=1.08，95%可信区间 1.01 至 1.16）、两次或更多次暴露（HR=1.25，95%可信区间 1.04 至 1.49）和较高剂量（空气>15mg.min/m）（HR=1.15，95%可信区间 1.02 至 1.30）。对于特定原因的死亡率，沙林暴露与“其他”循环系统疾病（不包括缺血性和脑血管疾病）（HR=1.41，95%可信区间 1.06 至 1.87）和酒精相关死亡（HR=2.66，95%可信区间 1.40 至 5.07）相关。沙林暴露与总体癌症发病率（HR=1.01，95%可信区间 0.93 至 1.10）无关，但与酒精相关肿瘤的发病率较高（HR=1.24，95%可信区间 1.01 至 1.51）。
在 50 年的随访中，接触沙林与死亡率升高有关。观察到的最强关联是归因于酒精和“其他”循环系统疾病的死亡。
