Mortality among women Vietnam veterans, 1973-1987

A retrospective cohort mortality study was conducted to examine health effects of US military service in Vietnam on women veterans who served there between July 4, 1965 and March 28, 1973. About 4,600 women Vietnam veterans and 5,300 women veterans who had never served in Vietnam were identified from military records and followed for vital status on December 31, 1987. Mortality rates for all causes of death combined and for all cancers among Vietnam veterans were similar to those among non-Vietnam veterans (relative risk (RR) = 0.93). There was a slight excess of mortality from external causes among women Vietnam veterans compared with non-Vietnam veterans (RR = 1.33), primarily due to an excess of motor vehicle accidents (RR = 3.19). Suicide rates were nearly the same in both cohorts (RR = 0.96). Vietnam veterans had twofold increases in mortality from cancers of the pancreas and uterine corpus compared with non-Vietnam veterans. Women Vietnam veterans and non-Vietnam veterans had lower-than-expected mortality from all causes of death combined (standardized mortality ratio (SMR) = 0.82 and 0.88, respectively), based on rates for US women, due to significant deficits of deaths from circulatory diseases. Compared with rates for US women, mortality from cancers of the pancreas (five deaths, SMR = 3.27) and uterine corpus (four deaths, SMR = 4.05) was significantly elevated among Vietnam veteran nurses.     

Mortality patterns among women Vietnam-era veterans: results of a retrospective cohort study

PURPOSE: This research compiled and analyzed the data of two cohorts of women veterans who either served in Vietnam ("Vietnam veteran" cohort, n = 4586) or served elsewhere during the Vietnam War ("non-Vietnam veteran" cohort, n = 5325). All cause and cause-specific mortality were compared between Vietnam and non-Vietnam veteran cohorts, to the U.S. population, and to earlier research. Similar analyses were performed for nurses only. METHODS: Vital status was determined through December 31, 2004, using primarily the U.S. Department of Veterans Affairs beneficiary file and the Social Security Administration Death Master File. Selected data were submitted to the National Center for Health Statistics for merging with the National Death Index to obtain cause of death. Cox proportional hazard analysis modeling was used to obtain adjusted relative risks (ARR). SEER( *)Stat software was used to compute standardized mortality ratios (SMR) for comparisons to the U.S. population. RESULTS: Women Vietnam veterans showed a significant deficit (ARR = 0.78, 95% confidence interval [CI] 0.62-0.98) in circulatory system disease relative to non-Vietnam veterans, but significant deficits also were observed when the Vietnam and non-Vietnam cohorts were each compared with women in the U.S. population (SMR = 0.65, 95% CI 0.54-0.77; SMR=0.82, 95% CI 0.73-0.93, respectively). Vietnam veterans had significantly lower mortality than women in the U.S. population for all causes (SMR = 0.87, 95% CI 0.80-0.94). Vietnam veterans were at significantly greater risk of mortality from motor vehicle accidents than non-Vietnam veterans (ARR = 2.60, 95% CI 1.22-5.55) and this appeared to be specific to service in Vietnam based on comparisons to the U.S. population. Patterns did not differ greatly for the analysis on nurse veterans or to earlier mortality studies of these cohorts. CONCLUSION: Mortality from motor vehicle accidents was significantly associated with service in Vietnam. Mortality patterns generally resembled those reported on in the past.     

Non-Hodgkin's lymphoma in a cohort of Vietnam veterans.

We examined the incidence of non-Hodgkin's lymphoma (NHL) in a cohort of 18,313 United States Army veterans from the Vietnam era. Diagnoses were confirmed through a review of hospital records. Among veterans who had died after discharge or who had participated in a telephone interview (8,170 Vietnam veterans and 7,564 non-Vietnam veterans), seven Vietnam veterans and one non-Vietnam veteran had developed non-Hodgkin's lymphoma (p = 0.07). As none of the NHL cases had military job titles which suggest that they were occupationally exposed to herbicides while in Vietnam, the reasons for the excess are unclear.     

Prevalence of gynecologic cancers among female Vietnam veterans

The possibility of a gender-specific health problem associated with the Vietnam War has been a concern since the war. We targeted 4140 female Vietnam veterans and 4140 veteran controls to complete a structured telephone interview that included questions regarding any history of gynecologic cancer. As a measure of association between the risk of cancer and military service in Vietnam, odds ratios and 95% confidence intervals were calculated using multiple logistic regression models that yielded estimates of potential cofounders. Although 8% of Vietnam veterans and 7.1% of non-Vietnam veterans reported a history of gynecologic cancers, namely, breast, ovary, uterus, or cervix, the difference was not statistically significant either for the individual site or for the gynecologic cancers as a group. Female Vietnam veterans have not experienced a higher prevalence of gynecologic cancer in the 30 years since the conflict.     

Health status of Army Chemical Corps Vietnam veterans who sprayed defoliant in Vietnam

BACKGROUND: U.S. Army Chemical Corps veterans handled and sprayed herbicides in Vietnam resulting in exposure to Agent Orange and its contaminant 2,3,7, 8-tetrachlorodibenzo-p-dioxin (TCDD or dioxin). This study examined the long-term health effects associated with herbicide exposure among these Vietnam veterans. METHODS: A health survey of these 1,499 Vietnam veterans and a group of 1,428 non-Vietnam veterans assigned to chemical operations jobs was conducted using a computer-assisted telephone interview (CATI) system. Exposure to herbicides was assessed by analyzing serum specimens from a sample of 897 veterans for dioxin. Logistic regression analyses were used to estimate the risk of selected medical outcomes associated with herbicide exposure. RESULTS: Odds ratios for diabetes, heart disease, hypertension, and chronic respiratory disease were elevated, but not significantly (P>0.05) for those who served in Vietnam. However, they were significantly elevated among those Vietnam veterans who sprayed herbicides: diabetes, odds ratio (OR)=1.50 (95% confidence interval [95%CI]=1.15-1.95); heart disease, OR=1.52 (1.18-1.94); hypertension, OR=1.32 (1.08-1.61); and chronic respiratory condition, OR=1.62 (1.28-2.05). Hepatitis was associated with Vietnam service, but not with herbicide application. CONCLUSIONS: Vietnam veterans who were occupationally exposed to herbicide experienced a higher risk of several chronic medical conditions relative to other non-Vietnam veterans. A potential selection bias is of concern. However, there were relatively high participation rates in both the Vietnam and non-Vietnam veteran groups, and the prevalence rates of some of these medical conditions among non-Vietnam veterans were comparable to general populations. Therefore, self-selection factors are considered unlikely to have biased the study results.     

Cancer mortality among the highest exposed US atmospheric nuclear test participants

Of the estimated 205,000 military personnel who participated in the US atmospheric nuclear weapons testing program from 1945 to 1962, less than 1% had ionizing radiation doses that met or exceeded the current federal occupational guideline for dose of 5 rem (roentgen equivalents in humans) in a 12-month period. The objective of this study was to determine whether veterans who received the highest gamma radiation doses (n = 1010) have experienced increased cancer mortality compared with a group of Navy veterans who received a minimal radiation dose as participants of HARDTACK I (n = 2870). Mortality from all causes of death (relative risk, 1.22; 95% confidence interval, 1.04 to 1.44) and from all lymphopoietic cancers (relative risk, 3.72; 95% confidence interval, 1.28 to 10.83) was significantly elevated among the 5-rem cohort compared with the Navy controls. The lack of statistically significant excesses in deaths from many of the known radiogenic cancers suggests that the observed excess mortality may be the result of many factors, of which radiation exposure was only one.     

Cancer mortality risk among military participants of a 1958 atmospheric nuclear weapons test.

OBJECTIVES. This study was undertaken to determine if Navy veterans who participated in an atmospheric nuclear test in 1958 were at increased risk of death from certain cancers. METHODS. Cancer mortality risk of 8554 Navy veterans who participated in an atmospheric nuclear test in the Pacific was compared with that of 14,625 Navy veterans who did not participate in any test. Radiation dosage information was obtained from film badges for 88% of the test participants. RESULTS. The median radiation dose for the test participants was 388 mrem (3.88 millisieverts [mSv]). Among participants who received the highest radiation dose (> 1000 mrem, or 10 mSv), an increased mortality risk for all causes (relative risk [RR] = 1.23; 95% confidence interval [CI] = 1.04, 1.45), all cancers (RR = 1.42; 95% CI = 1.03, 1.96), and liver cancer (RR = 6.42; 95% CI = 1.17, 35.3) was observed. The risk for cancer of the digestive organs was elevated among test participants (rate ratio = 1.47; 95% CI = 1.06, 2.04) but with no significant dose-response trend. Many of the cancers of a priori interest were not significantly elevated in the overall test participant group or in the group that received the highest radiation dose. CONCLUSIONS. Most of the cancers suspected of being radiogenic were not significantly elevated among the test participants. Nevertheless, increased risks for certain cancers cannot be ruled out at this time. Veterans who participated in the nuclear weapons tests should continue to be monitored.     

Paternal military service in Vietnam and the risk of late adverse pregnancy outcomes.

To investigate the relationship between paternal military service in Vietnam and the risk of late adverse pregnancy outcomes, we conducted a case-control study of women who delivered infants from August 1977 until March 1980 at Boston Hospital for Women. Paternal military service history among 857 congenital anomaly cases, 61 stillbirth cases, and 48 neonatal death cases were compared with that of 998 normal controls. Military service veterans were identified by crossmatching identifying information from obstetric records with state and national military records. After controlling for confounding variables, we found that the Vietnam veterans' relative risk of fathering an infant with one or more major malformations was 1.7 (95% CI = 0.8, 3.5) compared to non-Vietnam veterans. The increased risk was present in several organ systems and did not seem to be related to a particular type of defect. No associations or highly unstable associations were found between paternal military service in Vietnam and the occurrence of congenital anomalies overall, minor malformations, normal variants, stillbirths, and neonatal deaths. These findings should be viewed with caution since maternal and delivery characteristics appear to have contributed to the etiology of several of the major malformations among the Vietnam veterans' children.