The mortality of Royal Naval submariners 1960-1989.

The mortality pattern of 15,318 Royal Naval submariners has been examined to asses the long term effects on health of serving in submarines. The main outcome measures used were standardised mortality ratios (SMRs) which present the submariners' mortality rates as a percentage of those for men in England and Wales. The SMR for all causes of death combined was low at 86, this being comparable to findings in other studies of Armed Forces personnel. Cancer mortality was particularly low with an SMR of 69 and there was no particular cancer site which showed an excess. Raised mortality from digestive diseases was seen: the excess was attributable to cirrhosis of the liver which gave rise to an SMR of 221 based on 12 deaths, alcohol being a contributory factor in eight. This excess mortality from cirrhosis was concentrated in the period 1970-79 and occurred in men who had left the Royal Navy. Deaths from accidents and violence were also higher than expected with an SMR of 115, but this was due to high levels of accidents occurring after discharge from the Navy.