G. A. Archer, King’s College London, UK

Objective:

To investigate whether veterans involved in chemical warfare agent research at Porton Down have increased rates of mortality or cancer incidence.

Methods:

Our sample comprised male UK veterans who attended Porton Down between 1941-1989 (n=18,069) and a comparison group of similar ‘Non-Porton Down’ veterans who did not attend (n=17,588). Veterans were identified from historical records and military personnel files. Mortality and cancer incidence data were obtained from national registries up to December 2019. Associations between Porton Down attendance and health outcomes were examined using Cox regression.

Results:

Over a median follow-up of 48.1 years, 10,889 Porton Down veterans (60.3%) and 10,657 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 7% higher rate of all-cause mortality compared to non-Porton Down veterans (hazard ratio=1.07, 95% confidence interval 1.04-1.10). For cause-specific mortality, Porton Down veterans had higher rates of death from infectious and parasitic (1.43, 1.05 to 1.94), genitourinary (1.45, 1.12-1.87) and external causes (1.23, 1.07-1.43), and deaths attributable to alcohol (1.48, 1.09-2.02). Associations with all-cause mortality were stronger for veterans who attended Porton Down between 1960 and 1964 (1.36, 1.20-1.54), compared to other periods; likelihood-ratio test, p=0.006. There was no association between attendance at Porton Down and overall cancer incidence (0.99, 0.95-1.03)

Conclusions:

Overall, mortality rates were slightly higher in Porton Down veterans, but there was no difference in cancer incidence. Associations were stronger in Porton Down veterans who attended in the early 1960’s.

References

Archer, G., Keegan, T.J., Venables, K.M., Carpenter, L.M., Fear, N.T., (2022). Cohort Profile: The Porton Down Veterans cohort study. Int. J. Epidemiol. dyac006. https://doi.org/10.1093/ije/dyac006

Bullman, T., Kang, H., (2000). A Fifty Year Mortality Follow-up Study of Veterans Exposed to Low Level Chemical Warfare Agent, Mustard Gas. Ann. Epidemiol. 10, 333–338. https://doi.org/10.1016/S1047-2797(00)00060-0

Carpenter, L.M., Linsell, L., Brooks, C., Keegan, T.J., Langdon, T., Doyle, P., Maconochie, N.E.S., Fletcher, T., Nieuwenhuijsen, M.J., Beral, V., Venables, K.M., (2009). Cancer morbidity in British military veterans included in chemical warfare agent experiments at Porton Down: cohort study. BMJ 338, b655. https://doi.org/10.1136/bmj.b655

Institute of Medicine (US) Committee on the Survey of the Health Effects of Mustard Gas and Lewisite, (1993). Veterans at Risk: The Health Effects of Mustard Gas and Lewisite. National Academies Press (US), Washington (DC).

Venables, K.M., Brooks, C., Linsell, L., Keegan, T.J., Langdon, T., Fletcher, T., Nieuwenhuijsen, M.J., Maconochie, N.E.S., Doyle, P., Beral, V., Carpenter, L.M., (2009). Mortality in British military participants in human experimental research into chemical warfare agents at Porton Down: cohort study. BMJ 338, b613. https://doi.org/10.1136/bmj.b613