Introduction

This chapter provides summaries and analyses of health-related information on UK Armed Forces personnel and Health & Safety for UK Armed Forces personnel and MOD Civilians. The key findings of three of DASA Health Information's annual National Statistics publications are summarised in this chapter, along with a range of other key outputs.

A summary of the numbers and rates of deaths in the UK Armed Forces is provided in Tables 3.1 and 3.2. The figures cover a 10 year time series and are broken down by Service, year of death and cause. Prior to the introduction of the Health chapter in this year's edition, in UKDS 2007 and in previous years the corresponding tables appeared as Tables 2.24 and 2.25.

The numbers of suicides and open verdict deaths in the UK Armed Forces are broken down further in Tables 3.3 and 3.4. Numbers, age standardised rates and standardised mortality ratios are reported for a 24 year time series, broken down by Service, gender and age.

Table 3.5 presents the number of deaths of UK Gulf 1 veterans and for a UK Military comparison group who did not deploy to the Gulf. Figures and mortality rate ratios are presented from 1991-2007 by cause of death and are compared to mortality rates in the UK general population.

The numbers of fatalities of UK Armed Forces personnel on operations in Afghanistan and Iraq are reported in Table 3.6. The numbers of very seriously injured and seriously injured casualties on operations in Afghanistan, Iraq and the Balkans are presented in Table 3.7.

The numbers of UK Military and civilian work related fatalities are presented for the last 10 years in Tables 3.8 and 3.9. Figures are provided by year and are broken down by cause.

Tables 3.10 and 3.11 report numbers and rates of major and serious injuries and illnesses for UK military and civilian personnel. Figures are provided for the last 10 years and are broken down by Service.

Table 3.12, in this year's edition of UKDS, regarding sickness absence, corresponds to Table 2.36 in previous years' editions.

Key Points and Trends

• In 2007, a total of 201 deaths occurred among the UK regular Armed Forces (see Table 3.1), of which 27 were serving in the Naval Service, 143 in the Army, and 31 in the RAF.



• During the 10-year period 1998-2007, the overall Armed Forces age and gender standardised mortality rates fluctuated between a low of 66 per 100,000 in 1999 to a high of 105 per 100,000 in 2007 (see Table 3.1).



• For the 24-year period 1984-2007, 712 suicides occurred among UK regular Armed Forces personnel: 694 among males (see Table 3.3), and 18 among females.



• Overall, male suicide rates in the UK Armed Forces were statistically significantly lower than the general UK population, with the exception of Army males aged under 20. Over the period 1984-2007 this group had a statistically significantly increased risk of approximately 50%.



• Between 1 April 1991 and 31 December 2007 there were 918 deaths among the Gulf 1 veterans and 958 deaths among the Era comparison group (see Table 3.5). There were no statistically significant differences in the total number of deaths or for any of the main groups of cause of death.



• Since reporting began in 2001 until the end of 2007, there were 86 UK fatalities on Operations in Afghanistan and 174 on Operations in Iraq (see Table 3.6).



• Since reporting began in 2001 until the end of 2007, there were 104 very seriously injured and seriously injured casualties on Operations in Afghanistan and 212 on Operations in Iraq (see Table 3.7).



• Between 1 January 1998 and 31 December 2007 there were 461 work related fatalities of which 192 were in hostile action, 97 were on-duty road traffic accidents and 172 were work place incidents (see Table 3.8).



• The number of major injuries and illnesses reported on the Central Health and Safety Project (CHASP) system increased in 2006 to 430 from 85 in 1997, an increase of 406% (see Table 3.10). The rate of major injury and illnesses increased over the nine years from 26 per 100,000 MOD personnel to 153 per 100,000.



• The number of serious injuries and illnesses recorded on the CHASP system increased in 2006 to 1,550 from 530 in 1997, an increase of 192% (see Table 3.11). The rate of serious injury and illnesses reported on CHASP increased over the nine years from 162 per 100,000 MOD personnel in 1997 to 550 per 100,000 in 2006.



• The increases in the rates of major and serious injuries and illnesses are thought to be due to the introduction of single Service notification cells and increasing health and safety awareness in general.



• There has been a decline in the average number of working days lost per year amongst industrial civilian personnel since 2005. For non-industrial civilian personnel, the rate is at its lowest point in the past four years (See Table 3.12).

Denominator Data

Annual strength data for UK Regular Armed Forces personnel were obtained for the period 1984-2005 from AFPAA. Strength data for 2006 were obtained from both the Armed Forces Personnel Administration Agency (AFPAA) and Joint Personnel Administration (JPA).

Data on the size of the UK general population and the numbers of deaths by age, gender and year were obtained for the 22 year period 1984-2005 from the ONS, GROS and NISRA. Data for 2006 were not available at the time of publication; therefore the figures from 2005 were used as an estimate for 2006 as the year on year variation in the UK population figures is unlikely to affect the findings.

Gulf Veterans Definitions

Gulf veterans consist of Service personnel deployed to any Gulf state between 1 September 1990 and 30 June 1991 and for the Navy afloat, all personnel aboard a ship east of the Suez canal during that period. The data do not include civilian personnel employed by the MoD (including the Royal Fleet Auxiliary, the NAAFI, MoD civil servants), by other Government Departments, or civilians working for Defence Contractors, the media or charitable and humanitarian organisations.

The "Era" comparison group comprises 53,143 personnel, randomly sampled from all UK Armed Forces personnel in service on 1 January 1991 and who did not deploy to the Gulf. This group is stratified according to the 53,409 Gulf veterans to reflect the socio-demographic and military composition of the Gulf cohort in terms of age, gender, Service (Naval Service, Army, Royal Air Force), officer/other rank status, regular/reservist status, and a proxy measure for fitness.

Ethical and Confidentiality Issues

The information presented in this publication does not present any ethical issues because:

• Information relating to deaths is publicly available.
• No medical information is presented detailing the injuries sustained.
• As only aggregated data are presented, individuals cannot be identified.

Links to Websites

Further information on deaths in the UK Armed Forces, including cause of death breakdowns for each Service, can be found in the latest National Statistic Publication published in March 2008:

http://www.dasa.mod.uk/natstats/deaths/pdfs/deaths01mar08.pdf

Further information on suicides in the UK Armed Forces is provided in the March 2008 National statistic publication:

http://www.dasa.mod.uk/publications/pdfs/suicide/suicideMar08.pdf

The March 2008 publication of the Gulf 1 Veterans Mortality National Statistic gives further information on the methodology used and provides a breakdown of deaths due to neoplasms (cancers):

http://www.dasa.mod.uk/natstats/gulf/pdfs/gulf0108.pdf

The operational casualty and fatality tables are available on the MOD website, where further information on field hospital admissions and aero-medical evacuations is also available for operations in Afghanistan and Iraq:

http://www.mod.uk/DefenceInternet/FactSheets/OperationsFactsheets/OperationsInIraqBritishCasualties.htm

http://www.mod.uk/DefenceInternet/FactSheets/OperationsFactsheets/OperationsInAfghanistanBritishCasualties.htm

http://www.mod.uk/DefenceInternet/AboutDefence/CorporatePublications/
DoctrineOperationsandDiplomacyPublications/OperationsinTheBalkans/TheBalkanCasualtyTable.htm

Further information on coding of deaths to ICD10, including a full breakdown of codes, can be found on the World Health Organisation website:

http://www.who.int/classifications/apps/icd/icd10online/