title: Mortality in British military participants in human experimental research into chemical warfare agents at Porton Down: cohort study.
abstract: OBJECTIVE
  To investigate any long term effects on mortality in participants in experimental research related to chemical warfare agents from 1941 to 1989.
  
  
  METHODS
  Historical cohort study. Data sources Archive of UK government research facility at Porton Down, UK military personnel records, and national death and cancer records. Participants 18,276 male members of the UK armed forces who had spent one or more short periods (median 4 days between first and last test) at Porton Down and a comparison group of 17,600 non-Porton Down veterans followed to 31 December 2004.
  
  
  METHODS
  Mortality rate ratio of Porton Down compared with non-Porton Down veterans and standardised mortality ratio of each veteran group compared with the general population. Both ratios adjusted for age group and calendar period.
  
  
  RESULTS
  Porton Down veterans were similar to non-Porton Down veterans in year of enlistment (median 1951) but had longer military service (median 6.2 v 5.0 years). After a median follow-up of 43 years, 40% (7306) of Porton Down and 39% (6900) of non-Porton Down veterans had died. All cause mortality was slightly greater in Porton Down veterans (rate ratio 1.06, 95% confidence interval 1.03 to 1.10, P<0.001), more so for deaths outside the UK (1.26, 1.09 to 1.46). Of 12 cause specific groups examined, rate ratios in Porton Down veterans were increased for deaths attributed to infectious and parasitic (1.57, 1.07 to 2.29), genitourinary (1.46, 1.04 to 2.04), circulatory (1.07, 1.01 to 1.12), and external (non-medical) (1.17, 1.00 to 1.37) causes and decreased for deaths attributed to in situ, benign, and unspecified neoplasms (0.60, 0.37 to 0.99). There was no clear relation between type of chemical exposure and cause specific mortality. The mortality in both groups of veterans was lower than that in the general population (standardised mortality ratio 0.88, 0.85 to 0.90; 0.82, 0.80 to 0.84).
  
  
  CONCLUSIONS
  Mortality was slightly higher in Porton Down than non-Porton Down veterans. With lack of information on other important factors, such as smoking or service overseas, it is not possible to attribute the small excess mortality to chemical exposures at Porton Down.
authors.affiliation: Department of Public Health, University of Oxford, Oxford OX3 7LF. kate.venables@dphpc.ox.ac.uk
authors.forename: K M
authors.initials: KM
authors.lastname: Venables
authors.forename: C
authors.initials: C
authors.lastname: Brooks
authors.forename: L
authors.initials: L
authors.lastname: Linsell
authors.forename: T J
authors.initials: TJ
authors.lastname: Keegan
authors.forename: T
authors.initials: T
authors.lastname: Langdon
authors.forename: T
authors.initials: T
authors.lastname: Fletcher
authors.forename: M J
authors.initials: MJ
authors.lastname: Nieuwenhuijsen
authors.forename: N E S
authors.initials: NE
authors.lastname: Maconochie
authors.forename: P
authors.initials: P
authors.lastname: Doyle
authors.forename: V
authors.initials: V
authors.lastname: Beral
authors.forename: L M
authors.initials: LM
authors.lastname: Carpenter