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 four of DASA Health Information's annual National Statistics publications are summarised in this chapter, along with a range of other key outputs.

There are nine sections in this chapter covering:

Deaths in the UK Armed Forces (Tables 3.1 to 3.4) - Numbers and rates of deaths in the UK Armed Forces covering a 10 year time series broken down by Service, year of death and cause. Comparison with deaths in the UK population.

Suicides in the UK Armed Forces (Tables 3.5 and 3.6) - Numbers, age standardised rates and standardised mortality ratios are reported for a 25 year time series, broken down by Service, gender and age. Comparison with suicides in the UK population.

UK Gulf Veterans Mortality (Table 3.7) - 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 1991-2008 by cause of death and are compared to mortality rates in the UK general population.

Operational Fatalities and Casualties (Table 3.8 and 3.9) - Numbers of UK military and civilian fatalities on operations in Afghanistan, Iraq and the Balkans. Numbers of very seriously injured and seriously injured UK military and civilian casualties on operations in Afghanistan, Iraq and the Balkans.

Psychiatric Morbidity (Tables 3.10 to 3.12) - Numbers and rates of new attendances to the Ministry of Defence's Departments of Community Mental Health in 2007 and 2008 broken down by demographics, deployment and mental disorder groupings. Rate ratios comparing those who have deployed to the Iraq and Afghanistan theatres of operation with those who have not deployed there.

Medical Discharges (Tables 3.13 to 3.15) - Numbers of medical discharges of Army, RAF and Naval Service staff in each year from 2004 to 2008 broken down by discharge cause.

Health and Safety (Tables 3.16 to 3.19) - Numbers of UK Military and civilian work related fatalities for the last 10 years broken down by year and cause. Numbers and rates of major and serious injuries and illnesses (RIDDOR) for UK military and civilian personnel for the last 10 years broken down by Service.

Civilian Personnel Sickness Absence (Table 3.20) - Numbers of working days lost per year due to sickness by cause.

War Pensions and Armed Forces Compensation Scheme (Tables 3.21 to 3.24) - Number of War Pensions in payment under the War Pensions Scheme by type. Number and outcomes of claims registered as well as tariff of injury table information for lump sum awards under the Armed Forces Compensation Scheme.

Key Points and Trends

• In 2008, a total of 137 deaths occurred among the UK regular Armed Forces (see Table 3.1). During the 10-year period 1999-2008, 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 UK regular Armed Forces as a whole, the annual SMR was statistically significantly lower than the UK population, except in 2006 and 2007 when it was not significantly different from the UK population. In 2008 the UK regular Armed Forces were at a 44% decreased risk of dying compared to the UK general population.



• For the 25-year period 1984-2008, 718 suicides and open verdict deaths among UK regular Armed Forces personnel: 700 among males (see Table 3.5), 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 1984-2008 this group had a statistically significantly increased risk of approximately 50% (see Table 3.6).



• Between 1 April 1991 and 31 December 2008 there were 997 deaths among the Gulf 1 veterans and 1041 deaths among the Era comparison group (see Table 3.7). 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 2008, there have been 137 UK fatalities on Operations in Afghanistan and 178 on Operations in Iraq (see Table 3.8).



• Since reporting began in 2001 until the end of 2008, there have been 169 very seriously injured and seriously injured casualties on Operations in Afghanistan and 221 on Operations in Iraq (see Table 3.9).



• During 2008, 3,189 new cases of mental disorder were identified within UK Armed Forces personnel, representing a rate of 16.2 per 1,000 strength. Rates for Royal Marines were lower than for other Services; rates for females were higher than for males; rates for other ranks were higher than for officers (see Table 3.10). There were no differences in the overall rates of mental disorder among those deployed to the Iraq or Afghanistan theatres of operation compared with those who had not deployed there.



• During the 5-year period 2004-2008 there were 1,814 medical discharges from the Naval Service (see Table 3.13), 4,982 from the Army (see Table 3.14) and 1,071 from the RAF (see Table 3.15). Musculoskeletal disorders and injuries were the most common cause of discharge for each Service.



• Between 1 January 1999 and 31 December 2008 there have been 499 work related fatalities of which 249 were in hostile action, 82 were on-duty road traffic accidents and 168 were work place incidents (see Table 3.16).



• The number of major injuries and illnesses (RIDDOR) reported increased in 2008 to 1,495 from 215 in 1999, an increase of 595%. The rate of major injury and illnesses increased over the ten years from 67 per 100,000 MOD personnel in 1999 to 548 per 100,000 in 2008 (see Table 3.18). Changes in reporting mechanisms are thought to be responsible for this increase.



• The number of claims cleared under the AFCS since the scheme began have continued to increase year on year (see Table 3.23). This is due to an increasing awareness of the scheme, as well as increasing numbers who are eligible to claim, i.e. Service related injury/illness with an incident/onset date on or after 6 April 2005.

Ethical and Confidentiality Issues

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

• Information relating to deaths is publicly available.
• As only aggregated data are presented, individuals cannot be identified.

Links to Websites

Further information on coding 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/