Mortality experience of US veterans following service as international peacekeepers in Bosnia/Kosovo theater, 1996–2002 |
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| Institution: | 1. Programa de Hematologia-Oncologia Pediátrica - PHOP, Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro, Brazil;2. Divisão de Vigilância e Análise de Situação, Coordenação de Prevenção e Vigilância, Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro, Brazil;3. Secretaria Estadual de Saúde da Paraíba, Registro de Câncer de Base Populacional de João Pessoa, Brazil;4. Secretaria Municipal de Saúde de Recife, Registro de Câncer de Base Populacional de Recife, Brazil;5. Secretaria de Saúde do Estado do Ceará, Registro de Câncer de Base Populacional de Fortaleza, Brazil;6. Secretaria Estadual de Saúde de Minas Gerais, Superintendência de Epidemiologia, Registro de Câncer de Base Populacional de Belo Horizonte, Brazil;7. Hospital de Câncer de Barretos, Fundação Pio XII, Registro de Câncer de Base Populacional de Barretos, Brazil;8. Coordenação Estadual de Atenção Oncológica, Secretaria Estadual de Saúde do Pará, Registro de Câncer de Base Populacional de Belém, Brazil;9. Secretaria Municipal de Saúde de Curitiba, Registro de Câncer de Base Populacional de Curitiba, Brazil;10. Secretaria Estadual de Saúde, Hospital Gov. João Alves Filho, Registro de Câncer de Base Populacional de Aracaju, Brazil;11. Fundação Centro de Controle de Oncologia, Registro de Câncer de Base Populacional de Manaus, Brazil;12. Associação de Combate ao Câncer de Goiás, Registro de Câncer de Base Populacional de Goiânia, Brazil;13. Secretaria Estadual de Saúde do Espírito Santo, Registro de Câncer de Base Populacional de Espírito Santo, Brazil;14. Faculdade de Saúde Pública da Universidade de São Paulo, Registro de Câncer de Base Populacional de São Paulo, Brazil;15. Secretaria Municipal de Saúde de Porto Alegre, Registro de Câncer de Base Populacional de Porto Alegre, Brazil;p. Secretaria de Estado de Saúde do Mato Grosso, Superintendência de Vigilância em Saúde, Registro de Câncer de Base Populacional de Cuiabá, Brazil;q. Fundação Hospital Amaral Carvalho, Registro de Câncer de Base Populacional de Jahu, Brazil;1. Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark;2. Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892-9778, USA;3. Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark;1. Universidad de Las Palmas de Gran Canaria, Calle Juan de Quesada 30, 35001 Las Palmas de Gran Canaria, Spain;2. Dermatology Department, Hospital Universitario de Gran Canaria Doctor Negrín, Barranco de la Ballena s/n, 35010 Las Palmas de Gran Canaria, Spain;3. Research Unit, Hospital Universitario de Gran Canaria Doctor Negrín, Barranco de la Ballena s/n, 35010 Las Palmas de Gran Canaria, Spain;1. Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China;2. Department of Medical Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & Affiliated Cancer Hospital of Nanjing Medical University, Nanjing China;3. State Key Laboratory of Pharmaceutical Biotechnology, Nanjing University, Nanjing 210023, China;4. State Key Laboratory of Bioelectronics, Southeast University, Nanjing, China;1. Department of Surgery, Division of Urology, Center for Integrated Research on Cancer and Lifestyle, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA;2. Duke Cancer Institute, Duke University School of Medicine, Durham, NC, USA;3. Surgery Section, Durham VA Health Care System, Durham, NC, USA;4. Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, CA, USA;5. Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA;6. Institute for Translational Epidemiology, and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA;7. Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA;1. Department of Medicine, University of Kentucky, Lexington, KY, United States;2. Department of Neurology, University of Kentucky, Lexington, KY, United States;3. Departments of Neurosurgery, University of Kentucky, Lexington, KY, United States;4. Departments of Pathology, Division of Neuropathology, University of Kentucky, Lexington, KY, United States;5. Markey Cancer Center, University of Kentucky, Lexington, KY, United States |
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| Abstract: | BackgroundBeginning 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.MethodsThis 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.ResultsThe 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.ConclusionIt 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. |
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| Keywords: | Veterans Leukemia Respiratory disease Epidemiology |
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