Michalek J E, Ketchum N S, Akhtar F Z
Air Force Research Laboratory, Brooks Air Force Base, TX 78235-5250, USA.
Am J Epidemiol. 1998 Oct 15;148(8):786-92. doi: 10.1093/oxfordjournals.aje.a009699.
The US Air Force continues to assess the mortality of veterans of Operation Ranch Hand, the unit responsible for aerially spraying herbicides in Vietnam. The authors of this study found that the cumulative all-cause mortality experience of these veterans was not different from that expected (standardized mortality ratio (SMR) = 1.0). Overall, cause-specific mortality did not differ from that expected regarding deaths from accidents, cancer, or circulatory system diseases, but the authors found that there was an increased number of deaths due to digestive diseases (SMR = 1.7, 95% confidence interval (CI) 0.9-3.2). When analyzing by military occupation, they found an increase in the number of deaths caused by circulatory system diseases (SMR = 1.5, 95% CI 1.0-2.2) among enlisted ground personnel, the subgroup with the highest dioxin levels. Most of the increase in the number of deaths from digestive diseases was caused by chronic liver disease and cirrhosis, and more than half of the increase in the number of deaths from circulatory system diseases was a result of atherosclerotic heart disease. In the subgroup of Ranch Hand veterans who had survived more than 20 years since their military service in Southeast Asia, the authors found no significant increase in the risk of death due to cancer at all sites (SMR = 1.1) and a nonsignificant increase in the number of deaths due to cancers of the bronchus and lung (SMR = 1.3).
美国空军继续评估“牧场工人行动”退伍军人的死亡率,该部队负责在越南进行空中喷洒除草剂作业。这项研究的作者发现,这些退伍军人的全因累积死亡率与预期死亡率没有差异(标准化死亡率(SMR)=1.0)。总体而言,在事故、癌症或循环系统疾病导致的死亡方面,特定病因死亡率与预期死亡率没有差异,但作者发现消化系统疾病导致的死亡人数有所增加(SMR=1.7,95%置信区间(CI)0.9 - 3.2)。在按军事职业进行分析时,他们发现地面应征人员(二噁英水平最高的亚组)中循环系统疾病导致的死亡人数有所增加(SMR=1.5,95%CI 1.0 - 2.2)。消化系统疾病死亡人数的增加主要由慢性肝病和肝硬化引起,循环系统疾病死亡人数增加的一半以上是由动脉粥样硬化性心脏病导致的。在自东南亚服役后存活超过20年的“牧场工人行动”退伍军人亚组中,作者发现所有部位癌症导致的死亡风险没有显著增加(SMR=1.1),支气管和肺癌导致的死亡人数有不显著增加(SMR=1.3)。