Vietnam veterans had higher death rates after discharge than other veterans

09/27/04

CHICAGO Vietnam veterans had higher death rates in the first five years after discharge than veterans who did not serve in Vietnam, according to a 30-year follow-up study published in the September 27 issue of The Archives of Internal Medicine, one of the JAMA/Archives journals.

During the 1980s, the Centers for Disease Control and Prevention conducted the Vietnam Experience Study (VES) to look at the long-term health effects of military service in Vietnam. Serving in Vietnam exposed servicemen to several possible health factors, including exposure to psychological stress associated with war, infectious diseases prevalent in Vietnam, pesticides and herbicides, and drug and alcohol abuse. The original VES followed 18,313 US Army veterans from their date of discharge from active duty (1965-1977) through December 31, 1983. This study was somewhat limited by the young age of the participants (average age, 36.1 years) and the small number of deaths (446), the article states.

Tegan K. Catlin Boehmer, M.P.H., of the National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Ga., and colleagues followed up participants of the VES through 2000, for an average of 30 years of follow-up, and compared outcomes for Vietnam veterans (n=9,324) with veterans who served during the same period, but not in Vietnam (n=8,989).

Over 30 years of follow up, the researchers found that Vietnam veterans had a 7 percent higher death rate (838 deaths, 3.01 deaths per 1,000 person-years) compared to other veterans (746 deaths, 2.79 deaths per 1,000 person-years). This excess mortality among Vietnam veterans was limited to the first five years after discharge from active duty and resulted from an increase in external causes of death, including motor vehicle collision-related deaths, suicides, and homicides. Additionally, Vietnam veterans experienced higher mortality from unintentional poisoning deaths, and from drug-related deaths over the 30-year study period.

"Vietnam veterans continued to experience higher mortality than non-Vietnam veterans from unintentional poisonings and drug-related causes," the researchers write. "Death rates from disease-related chronic conditions, including cancers and circulatory system diseases, did not differ between Vietnam veterans and their peers, despite the increasing age of the cohort (average age, 53 years) and the longer follow up (average, 30 years)," write the authors.

(Arch Intern Med. 2004;164:1908-1916. Available post-embargo at archinternmed.com) Editor's Note: This study was supported by funding from the National Center for Environmental Health, Atlanta, Ga.

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