{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T02:16:25Z","timestamp":1792289785921,"version":"4.4.0"},"reference-count":12,"publisher":"BMJ","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2013,7,11]]},"published-print":{"date-parts":[[2013,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The aim was to observe the patterns of mortality and cancer incidence in New Zealand Vietnam\u00a0veterans. The objectives were to assess whether the patterns of disease observed were consistent with those associated with military service in Vietnam, and similar to the patterns identified in other groups of Vietnam veterans.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A historical cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Veterans, identified from service records, with Vietnam service between 1964 and 1972.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Of the 3322 survivors of Vietnam service, we followed up 2783 (84%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>Standardised mortality and incidence ratios (SMRs and SIRs, respectively) were calculated based on the number of deaths and cancer registrations observed, those expected being based on New Zealand national rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All cause mortality was significantly reduced (SMR 0.85, 95% CI 0.77 to 0.94) and cancer incidence non-significantly increased (SIR 1.06, 95% CI 0.97 to 1.16). The risk of mortality from cancers of the head and neck (SMR 2.20, 95% CI 1.09 to 3.93); oral cavity pharynx and larynx (SMR 2.13, 95% CI 1.06 to 3.81) and the incidence of chronic lymphatic leukaemia (CLL) (SIR 1.91, 95% CI 1.04 to 3.20) were, however, significantly increased. Other lymphohaematopoietic disorders, specifically multiple myeloma and Hodgkin disease, showed non-significant mortality excesses, reflected by a similar increase in incidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Service in the Vietnam war was associated with defoliant herbicide exposure, including 2,4,5-trichlorophenoxyacetic acid, 2,4-dichlorophenoxyacetic acid, picloram and cacodylic acid. Subsequent reviews of mechanistic, animal and epidemiological evidence led to certain conditions being deemed compensable. The pattern of mortality and cancer incidence is not at odds with the list of compensable conditions and consistent with that found in Australian veterans serving in the same area of Vietnam, but also consistent with smoking and the healthy soldier effect. In common with the Australian experience, this is the only veterans group to show a significant excess of CLL.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2013-003379","type":"journal-article","created":{"date-parts":[[2013,9,3]],"date-time":"2013-09-03T20:14:31Z","timestamp":1378239271000},"page":"e003379","source":"Crossref","is-referenced-by-count":28,"title":["The mortality and cancer experience of New Zealand Vietnam war veterans: a cohort study"],"prefix":"10.1136","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5531-7687","authenticated-orcid":false,"given":"David","family":"McBride","sequence":"first","affiliation":[{"name":"Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand"},{"name":"Centre for Military and Veterans Health, University of Queensland, Herston, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Cox","sequence":"additional","affiliation":[{"name":"Hugh Adam Cancer Epidemiology Unit, University of Otago, Dunedin, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Broughton","sequence":"additional","affiliation":[{"name":"Ngai Tahu M\u0101ori Health Research Unit, University of Otago, Dunedin, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darryl","family":"Tong","sequence":"additional","affiliation":[{"name":"Department of Oral Diagnostic and Surgical Sciences, University of Otago, Dunedin, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2013,9,2]]},"reference":[{"key":"2025121400094050000_3.9.e003379.1","doi-asserted-by":"publisher","DOI":"10.1038\/nature01537"},{"key":"2025121400094050000_3.9.e003379.2","unstructured":"Committee to Review the Health Effects in Vietnam Veterans of Exposure to Herbicides. Veterans and Agent Orange: Update 2010. Washington, DC: The National Academies Press, 2012."},{"key":"2025121400094050000_3.9.e003379.3","unstructured":"Committee to Review the Health Effects in Vietnam Veterans of Exposure to Herbicides. Veterans and Agent Orange: Update 1994. Washington, DC: The National Academies Press, 1994."},{"key":"2025121400094050000_3.9.e003379.4","unstructured":"Breslow NE Day NE . Statistical methods in cancer research volume II\u2014the design and analysis of cohort studies. Lyon: International Agency for Research on Cancer, 1987."},{"key":"2025121400094050000_3.9.e003379.5","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2004.040907"},{"key":"2025121400094050000_3.9.e003379.6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1478-7954-9-7","article-title":"Changes over time in the healthy soldier effect","volume":"9","author":"Waller","year":"2011","journal-title":"Popul Health Metrics"},{"key":"2025121400094050000_3.9.e003379.7","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1987.03390060080028"},{"key":"2025121400094050000_3.9.e003379.8","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1093\/oxfordjournals.aje.a009699","article-title":"Postservice mortality of us air force veterans occupationally exposed to herbicides in Vietnam: 15-year follow-up","volume":"148","author":"Michalek","year":"1998","journal-title":"Am J Epidemiol"},{"key":"2025121400094050000_3.9.e003379.9","doi-asserted-by":"crossref","first-page":"406","DOI":"10.7205\/MILMED.170.5.406","article-title":"Postservice mortality of Air Force veterans occupationally exposed to herbicides during the Vietnam War: 20-Year follow-up results","volume":"170","author":"Ketchum","year":"2005","journal-title":"Mil Med"},{"key":"2025121400094050000_3.9.e003379.10","unstructured":"Wilson EJ Horsley KW Van der Hoek R . The Third Australian Vietnam Veterans Mortality Study 2005. Canberra: Department of Veteran's Affairs, 2005."},{"key":"2025121400094050000_3.9.e003379.11","unstructured":"Wilson EJ Horsley KW Van der Hoek R . Cancer Incidence in Australian Vietnam Veterans Study 2005. Canberra: Department of Veteran's Affairs, 2005."},{"key":"2025121400094050000_3.9.e003379.12","unstructured":"Committee to Review the Health Effects in Vietnam Veterans of Exposure to Herbicides. Veterans and Agent Orange: update 2002. Washington, DC: The National Academies Press, 2003."}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2013-003379","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T08:09:46Z","timestamp":1765699786000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2013-003379"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,8]]},"references-count":12,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2013,9,2]]},"published-print":{"date-parts":[[2013,8]]}},"alternative-id":["10.1136\/bmjopen-2013-003379"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2013-003379","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,8]]}}}