Chapter 3 - Health


                       
Table 3.5 Deaths among UK Gulf 1 Veterans1 1 April 1991 - 31 December 2007
This section provides summary statistics on the causes of deaths that occurred among the UK veterans of the 1990/91 Gulf Conflict between 1 April 1991 and 31 December 2007. The mortality rates were analysed alongside those of a comparison group, the Era cohort, who were not deployed to the Gulf.

Mortality rate ratios were calculated to compare deaths in the Gulf and Era cohorts. The rate ratios provided here were calculated using as denominator the total person-years at risk (the length of time each person has been in the study), taking into account deaths and emigrations from the UK. People who had left the Services and subsequently emigrated were deemed to be lost to follow up because we had no means of knowing if and when they may have died. The mortality rate ratios given here differ marginally from the crude deaths ratio owing to some small differences in the number of person years at risk between the Gulf and Era comparison groups.

The single year age distribution among those aged 40 and over has been found to show differences, with those in this age-group deployed to the Gulf generally younger than those in the Era group. Therefore, age adjusted estimates for the Era comparison group have been created by calculating the mortality rate for each single year of age at 1 January 1991 in each calendar year since 1991. This rate was applied to the equivalent numbers in each single year of age at 1 January 1991 and year of death in the Gulf population, from which deaths and emigrations from the UK were subtracted, to calculate the estimated total for each calendar year. These estimated numbers by calendar year were divided by the Gulf population, from which deaths and emigrations from the UK were subtracted, to produce adjusted rates.

    Number   Crude
Mortality
Rate Ratio		 Adjusted3
Mortality
Rate Ratio		 Adjusted3
95% Confidence
Interval
    Gulf Era Adjusted
Era		 3  
ICD Chapter2 Cause of death    
  All deaths 918 958 936   0.95 0.98  
(0.89
-
1.07)
                 
  All cause coded deaths 905 951 931   0.94 0.97  
(0.89
-
1.07)
                 
I - XVIII Disease-related causes 463 550 528   0.83 0.88  
(0.78
-
1.00)
I       Certain infectious and parasitic diseases 7 3 3   2.31 2.51  
(0.60
-
10.56)
II       Neoplasms 212 232 219   0.90 0.97  
(0.80
-
1.17)
V       Mental and behavioural disorders 14 24 22   0.58 0.65  
(0.33
-
1.27)
VI       Diseases of the nervous system 15 22 23   0.67 0.70  
(0.37
-
1.33)
IX       Diseases of the circulatory system 154 183 179   0.83 0.87  
(0.70
-
1.07)
X       Diseases of the respiratory system 13 12 12   1.07 1.06  
(0.47
-
2.39)
XI       Diseases of the digestive system 34 49 48   0.69 0.71  
(0.46
-
1.11)
III,IV,XII,XVIII       All other disease related causes4 14 25 22   0.55 0.63  
(0.31
-
1.25)
                 
XX External causes of mortality 442 401 403   1.09 1.09  
(0.95
-
1.25)
  Transport accidents: 190 159 162   1.18 1.17  
(0.94
-
1.45)
        Land transport accident: 157 134 136   1.16 1.14  
(0.91
-
1.45)
              Pedestrian 17 7 8   2.40 2.26  
(0.93
-
5.47)
              Motorcycle rider 47 40 40   1.16 1.16  
(0.76
-
1.78)
              Car occupant 46 37 38   1.23 1.21  
(0.78
-
1.87)
              Other5 47 50 50   0.93 0.92  
(0.61
-
1.38)
        Water transport 5 2 2   2.47 2.43  
(0.46
-
12.78)
        Air and space transport 28 23 24   1.20 1.20  
(0.69
-
2.08)
  Other external causes of accidental injury: 71 68 67   1.03 1.04  
(0.74
-
1.45)
        Falls 9 11 11   0.81 0.87  
(0.37
-
2.06)
        Exposure to inanimate mechanical forces 14 18 19   0.77 0.70  
(0.34
-
1.43)
        Accidental drowning and submersion and other       accidental threats to breathing 10 8 8   1.24 1.16  
(0.45
-
3.03)
        Accidental poisoning by and exposure to       noxious substances 15 13 11   1.14 1.23  
(0.56
-
2.69)
        Accidental exposure to other and unspecified       factors 17 11 11   1.53 1.54  
(0.72
-
3.31)
        Other 6 7 6   0.85 0.90  
(0.29
-
2.78)
  Intentional self-harm and events of undetermined intent6 162 144 144   1.11 1.12  
(0.89
-
1.40)
  Assault 5 10 10   0.49 0.46  
(0.15
-
1.37)
  Legal intervention and operations of war 6 10 11   0.59 0.63  
(0.23
-
1.72)
  Sequelae of external causes of morbidity and mortality - 2 1   - -        
  Deaths where the inquest has been adjourned 8 8 *   * *   *         *
  Other deaths for which cause data are not yet available 1 2 *   * *   *         *
  Overseas deaths for which cause data are not available 12 5 *   * *   *         *
Source: DASA (Health Information)
1.    Service and Ex-Service personnel only.

2.    Causes have been coded to the World Health Organisation's International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10), 1992.
3.    Adjusted for the single years of age structure of the Gulf cohort at 1 January 1991. The numbers may not add up to the totals shown due to rounding.
4.    Includes cases with insufficient information on the death certificate to provide a known cause of death.

5.    Under ICD-10 coding if the death certificate does not specifically mention the type of vehicle that was involved in the accident, the death is coded to "motor or nonmotor vehicle accident, type of vehicle unspecified". There were 37 of these deaths among Gulf veterans compared to 35 in the Era group.
6.    Includes both coroner-confirmed suicides and open verdict deaths in line with the definition used by the Office for National Statistics (ONS).
The main sources of deaths information are the NHS Information Centre's Central Register, the General Register Office for Scotland and the Northern Ireland Statistics and Research Agency.