title: Mortality among Soviet and Russian cosmonauts: 1960-2013.
abstract: BACKGROUND
  Though the mortality of U.S. astronauts has been studied repeatedly in the last 20 yr, little is known about the long-term mortality trends of Soviet and Russian cosmonauts.
  
  
  METHODS
  Using data from 266 cosmonauts accepted into cosmonaut training from 1960 to 2013, we document the causes of death and crude death rates among cosmonauts. Using standardized mortality ratios (SMR), we compared cosmonauts to the general populations of Russia and Ukraine, and to 330 U.S. astronauts.
  
  
  RESULTS
  Cosmonauts experienced significantly lower all-cause mortality risk compared to the general population. However, cosmonauts were at almost double the risk of all-cause mortality in comparison to U.S. astronauts (SMR = 190, 95% C.I. 154-239). Cosmonauts were also at greater risk of circulatory disease (SMR = 364, 95% C.I. 225-557) and cancer (SMR = 177, 95% C.I. 108-274) compared to U.S. astronauts. Though not statistically significant, cosmonauts experienced fewer fatal accidents (SMR = 88, 95% C.I. = 54-136) than their U.S. counterparts.
  
  
  CONCLUSIONS
  Cosmonauts are at much lower risk of all-cause mortality than the general populations of Russia and Ukraine, yet are at greater risk for death by cardiovascular disease and cancer than are U.S. astronauts. This disparity may have common roots with decreases in life expectancy in Russia in recent decades. Further research is needed to understand these trends fully.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Reynolds
authors.forename: Steven M
authors.initials: SM
authors.lastname: Day
authors.forename: Zhannat Z
authors.initials: ZZ
authors.lastname: Nurgalieva
mesh_terms: D000059:Accidents / Q000401:mortality; D000328:Adult; D018480:Astronauts / Q000706:statistics & numerical data*; D002318:Cardiovascular Diseases / Q000401:mortality; D002423:Cause of Death / Q000639:trends*; D006801:Humans; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality; D012426:Russia / Q000453:epidemiology; D014586:USSR / Q000453:epidemiology; D014455:Ukraine / Q000453:epidemiology; D014481:United States / Q000453:epidemiology