title: Mortality patterns among women Vietnam-era veterans: results of a retrospective cohort study.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  Mortality from motor vehicle accidents was significantly associated with service in Vietnam. Mortality patterns generally resembled those reported on in the past.
authors.affiliation: War-Related Illness and Injury Study Center, Environmental Epidemiology Service (135), Department of Veterans Affairs, 810 Vermont Avenue, NW, Washington, DC 20420, USA. yasmin.cypel@va.gov <yasmin.cypel@va.gov>
authors.forename: Yasmin
authors.initials: Y
authors.lastname: Cypel
authors.forename: Han
authors.initials: H
authors.lastname: Kang
mesh_terms: D000368:Aged; D002423:Cause of Death; D005260:Female; D006801:Humans; D008875:Middle Aged; D009026:Mortality; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States; D014728:Veterans / Q000706:statistics & numerical data*; D014744:Vietnam; D014857:Warfare; D014931:Women, Working / Q000706:statistics & numerical data*