Chapter 3 - Health
                       
Table 3.7 Deaths among UK Gulf 1 Veterans by cause, numbers and rate ratios, 1 April 1991 - 31                     December 2008
There were no statistically significant differences in the total number of deaths between the Gulf veterans and the Era comparison group, or for any of the main groups of cause of death. The 997 deaths among Gulf veterans compare with approximately 1,609 deaths which would have been expected in a similar sized cohort taken from the general population of the UK with the same age and gender profile.

The main cause of disease-related deaths amongst both Gulf veterans and the age-adjusted Era comparison group were neoplasms: 237 deaths in Gulf veterans and an estimate of 236 amongst the age-adjusted Era comparison group. There were 172 deaths due to diseases of the circulatory system (including ischaemic heart disease and cerebrovascular disease) among Gulf veterans compared with an estimate of 199 in the age-adjusted Era comparison group. There were more deaths due to external causes among Gulf veterans than the age-adjusted Era comparison group, but this was not statistically significant: 457 deaths compared with an estimate of 421. The largest group of deaths due to external causes were transport accidents: 194 deaths among Gulf veterans compared with an estimate of 167 among the age-adjusted Era comparison group. Of these, land transport accidents accounted for 161 Gulf Veterans' deaths compared to an estimate of 140. There were 169 deaths due to intentional self-harm and events of undetermined intent (suicides and open verdict deaths) among Gulf veterans compared with an estimate of 148 among the age-adjusted Era comparison group, but this was not statistically significant.
    Number   Crude
Mortality
Rate Ratio		 Adjusted2
Mortality
Rate Ratio		   Adjusted2
95% Confidence
Interval
    Gulf Era Adjusted
Era		 2  
ICD Chapter1 Cause of death    
  All deaths 997 1 041 1 008   0.95 0.99  
(0.90
-
 1.08)
                       
  All cause coded deaths 981 1 030 998   0.95 0.98  
(0.90
-
1.07)
                       
I - XVIII Disease-related causes 524 607 577   0.86 0.91  
(0.81
-
1.02)
I       Certain infectious and parasitic diseases 9 6 4   1.49 1.87  
(0.60
-
5.87)
II       Neoplasms 237 251 236   0.94 1.00  
(0.84
-
1.20)
V       Mental and behavioural disorders 16 25 23   0.64 0.70  
(0.37
-
1.34)
VI       Diseases of the nervous system 16 25 24   0.64 0.68  
(0.36
-
1.27)
IX       Diseases of the circulatory system 172 204 199   0.84 0.87  
(0.71
-
1.06)
X       Diseases of the respiratory system 17 14 13   1.21 1.25  
(0.60
-
2.62)
XI       Diseases of the digestive system 40 54 53   0.74 0.75  
(0.50
-
1.14)
III, IV, XII - XVIII       All other disease related causes3 17 28 25   0.60 0.66  
(0.35
-
1.25)
                       
XX External causes of mortality 457 423 421   1.07 1.08  
(0.95
-
1.24)
     Transport accidents: 194 165 167   1.17 1.16  
(0.94
-
1.43)
           Land transport accident: 161 139 140   1.15 1.14  
(0.91
-
1.44)
                 Pedestrian 17 7 7   2.42 2.27  
(0.94
-
5.51)
                 Motorcycle rider 49 42 42   1.16 1.16  
(0.76
-
1.76)
                 Car occupant 47 40 40   1.17 1.16  
(0.75
-
1.77)
                 Other4 48 50 50   0.95 0.95  
(0.63
-
1.42)
           Water transport 5 3 4   1.66 1.50  
(0.38
-
6.02)
           Air and space transport 28 23 24   1.21 1.21  
(0.70
-
2.09)
     Other external causes of accidental injury: 75 78 76   0.96 0.97  
(0.70
-
1.34)
           Falls 9 12 12   0.75 0.81  
(0.35
-
1.88)
           Exposure to inanimate mechanical forces 16 18 19   0.88 0.82  
(0.41
-
1.63)
           Accidental drowning and submersion and
         other accidental threats to breathing		 10 11 10   0.90 0.89  
(0.36
-
2.19)
           Accidental poisoning by and exposure to
         noxious substances		 16 17 16   0.94 0.97  
(0.48
-
1.96)
           Accidental exposure to other and
         unspecified factors		 18 13 13   1.38 1.47  
(0.71
-
3.04)
           Other 6 7 6   0.85 0.91  
(0.29
-
2.80)
     Intentional self-harm and events of
   undetermined intent5		 169 150 148   1.12 1.14  
(0.91
-
1.42)
     Assault 5 10 10   0.50 0.46  
(0.15
-
1.38)
     Legal intervention and operations of war 6 10 11   0.60 0.63  
(0.23
-
1.73)
     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 4 *   * *  
*
  
*
  Overseas deaths for which cause data are not available 15 7 *   * *  
*
  
*
Source: DASA (Health Information)
1. Causes have been coded to the World Health Organisation's International Statistical Classification of Diseases and Related Health Problems, 10th revision
    (ICD-10), 1992
2. 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.
3. Includes cases with insufficient information on the death certificate to provide a known cause of death.
4. 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 38 of these deaths among Gulf veterans compared to 35 in the Era group.
5. Includes both coroner-confirmed suicides and open verdict deaths in line with the definition used by the Office for National Statistics (ONS).