{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T05:46:42Z","timestamp":1761198402449,"version":"3.37.3"},"reference-count":37,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T00:00:00Z","timestamp":1727654400000},"content-version":"unspecified","delay-in-days":29,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MRC (MR\/R002932\/1)"],"award-info":[{"award-number":["MRC (MR\/R002932\/1)"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Occup Environ Med"],"accepted":{"date-parts":[[2024,9,4]]},"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>We investigated whether UK military personnel exposed to sarin during the \u2018Service Volunteer Programme\u2019 at Porton Down had increased rates of mortality or cancer incidence over a 52-year follow-up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A historical cohort study assembled from UK military records, comprising male veterans exposed to sarin during the \u2018Service Volunteer Programme\u2019 at Porton Down, UK (n=2975) and a comparison group of similar veterans who did not attend (n=2919). Mortality and cancer incidence data were obtained from national registries up to December 2019. Analysis was conducted using Cox regression adjusted for age, year of birth and service characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Over a median follow-up of 52.2 years (range 2\u2009days to 74.6 years), 1598 (53.7%) sarin-exposed veterans and 1583 (54.3%) non-exposed veterans died. Adjusted HRs for all-cause mortality were raised for any sarin exposure (HR=1.08, 95% CI 1.01 to 1.16), two or more exposures (HR=1.25, 95% CI 1.04 to 1.49) and higher doses (air &gt;15\u2009mg.min\/m<jats:sup>3<\/jats:sup>) (HR=1.15, 95% CI 1.02 to 1.30). For cause-specific mortality, sarin exposure was associated with deaths from \u2018other\u2019 circulatory diseases (excludes ischaemic and cerebrovascular diseases) (HR=1.41, 95% CI 1.06 to 1.87) and alcohol-attributable deaths (HR=2.66, 95% CI 1.40 to 5.07). There was no association between sarin exposure and overall cancer incidence (HR=1.01, 95% CI 0.93 to 1.10), but cancer incidence was higher for alcohol-related neoplasms (HR=1.24, 95% CI 1.01 to 1.51).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Sarin exposure was associated with increased rates of mortality over a 50-year follow-up. The strongest associations were observed for deaths attributable to alcohol and \u2018other\u2019 circulatory diseases.<\/jats:p><\/jats:sec>","DOI":"10.1136\/oemed-2024-109525","type":"journal-article","created":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T17:20:39Z","timestamp":1727716839000},"page":"480-488","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Sarin exposure, mortality and cancer incidence in UK military veterans involved in human experiments at Porton Down: 52-year follow-up"],"prefix":"10.1136","volume":"81","author":[{"given":"Gemma","family":"Archer","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3691-953X","authenticated-orcid":false,"given":"Thomas","family":"Keegan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6743-9929","authenticated-orcid":false,"given":"Simon","family":"Wessely","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine M","family":"Venables","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5792-2925","authenticated-orcid":false,"given":"Nicola T","family":"Fear","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,9,30]]},"reference":[{"key":"2024100812502024000_81.9.480.1","doi-asserted-by":"publisher","DOI":"10.1080\/10408444.2020.1787330"},{"key":"2024100812502024000_81.9.480.2","unstructured":"Institute of Medicine . 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