Suchergebnisse

Background: Depleted uranium (DU) use has been implicated in the poor health of many service personnel who have served in the Gulf and the Balkans. Although the health related risks are thought to be small the UK government has offered to set up a voluntary screening programme for service personnel. This study aimed to find out the characteristics and possible exposures to DU for those personnel who desire DU screening.

Method: Cross sectional postal survey of three cohorts of United Kingdom military personnel comprising Gulf veterans (n=3531), those who had served in Bosnia (n=2050), and those serving during the Gulf war but not deployed there (Era cohort, n=2614).

Introduction: There are higher levels of alcohol misuse in the military compared to the general population. Yet there is a dearth of research in military populations on the longitudinal patterns of alcohol use. This study aims to identify group trajectories of alcohol consumption in the UK military and to identify associations with childhood adversity, deployment history and mental disorder. Methods: Data on weekly alcohol consumption across an eight year period and three phases of a UK military cohort study (n = 667) were examined using growth mixture modelling. Results: Five alcohol trajectory classes were identified: mid-average drinkers (55%), abstainers (4%), low level drinkers (19%), decreasing drinkers (3%) and heavy drinkers (19%). Alcohol consumption remained stable over the three periods in all classes, other than in the small decreasing trajectory class. Individuals in the heavy drinking class were more likely to have deployed to Iraq. Abstainers and heavy drinkers were more likely to report post-traumatic stress disorders at baseline compared to average drinkers. Conclusions: Heavy drinkers in the UK military did not change their drinking pattern over a period of eight years. This highlights the need to develop effective preventive programmes to lessen the physical and psychological consequences of long-term heavy alcohol use. Individuals with a mental health problem appeared more likely to either be drinking at a high level or to be abstaining from use.

Background There has been concern about the impact of tour length on the mental health of the UK Armed Forces. In 2007 we reported that cumulative length of deployment was associated with mental illnesses among military personnel. This gave empirical evidence to support the UK advisory policy on tour length, known as Harmony Guidelines. If fully implemented, the guidelines would be expected to be a tool to prevent mental illnesses. This study re-evaluates the relationship between cumulative length of deployment and number of deployments over three years, and mental illnesses in the UK forces. Methods We assessed 3,982 UK regulars, from a representative study of the military, who had deployed during the three years prior to completing a questionnaire between November 2007 and September 2009. The outcomes of the study were posttraumatic stress disorder checklist (PCL), General Health Questionnaire (GHQ-12), multiple physical symptoms (MPS), Alcohol Use Disorders Identification Test (AUDIT), and problems at home during and post-deployment. The key independent factors were deployment for 13 or more months and number of deployments in the last three years. Findings Deployment for longer than 13 months decreased from 22% in our previous study to 12% now. Cumulative length of deployment as a continuous variable was associated with all outcomes. 13 or more months of deployment was associated with MPS, PCL (score 40 or more), problems at home, but not PCL (score 50 or more), GHQ-12 (score four or more) and AUDIT (score 16 or more). Number of deployments was not associated with worse mental illness status or problems at home. Interpretation The Harmony Guidelines have been shown to prevent mental illness in the UK Armed Forces and its introduction has decreased the number deploying in excess of its recommendations since 2006. Monitoring cumulative length of deployment is effective in reducing mental illness in the UK military. Key words: Alcohol misuse, physical symptoms, population study, posttraumatic stress disorder (PTSD), psychological distress, problems at home

OBJECTIVES—To study the association between occupational factors specific to the Armed Forces (rank, functional roles, Service, regular or reservist status and deployment factors) and symptomatic health problems in Gulf veterans, after sociodemographic and lifestyle factors have been accounted for. DESIGN—A postal cross sectional survey of randomly selected UK Gulf veterans was conducted six to seven years after the Gulf conflict. Physical ill health was measured using the Fatigue Questionnaire and a measure of the Centers for Disease Control and Prevention (CDC) multi-symptom syndrome. Psychological ill health was measured using the General Health Questionnaire and a post-traumatic stress measure. SETTING—Population of servicemen who were serving in the UK Armed Forces during the Gulf conflict between 1 September 1990 and 30 June 1991. PARTICIPANTS—3297 Gulf veterans. MAIN RESULTS—In multivariate logistic regression, there was an inverse relation between higher rank and psychological and physical ill health (test of trend: General Health Questionnaire, p=0.004 ; post-traumatic stress, p=0.002; fatigue, p=0.015; CDC case, p=0.002). Having left the Armed Forces was associated with a two to three times increase in reporting ill health. Of the deployment factors, there was a weak association between being deployed as an individual reinforcement in a combat role and post-traumatic stress but there was no association between receiving pre-deployment training or post-deployment leave and ill health. Marital status and smoking were associated with psychological and physical ill health. CONCLUSIONS—Rank was the main occupational factor associated with both psychological and physical ill health in Gulf veterans. This may parallel the associations between socioeconomic status and morbidity in civilian populations. Ill health seems to be greater in those who return to civilian life. Sociodemographic factors also seem to be important in ill health in Gulf veterans. Keywords: military; Gulf veterans; rank