Description:
<jats:sec><jats:title>Introduction</jats:title><jats:p>An update to the Porton Down Veterans Cohort study is planned for 2018–2021.</jats:p></jats:sec><jats:sec><jats:title>Background</jats:title><jats:p>Chemical warfare agents continue to be deployed by rogue states and terrorists, e.g. in Syria, Iraq, Tokyo, and Salisbury UK, yet their impact on long-term health is largely unknown. The Porton Down cohort comprises of 18 276 men who took part in the ‘human volunteer programme’ of chemical warfare agent research at Porton Down, UK, between 1941 to 1989, and a comparison group of 17 600 men who also served in the military. An original study linked veterans’ records to national registry data on cancer incidence and mortality up to 2004. By the end of 2004, 7306 of the Porton Down veterans and 6900 of the comparison cohort had died. The results showed Porton Down veterans had no overall excess of cancers (rate ratio (RR)=1.00, 95% CI 0.95–1.05) and a small (6%) excess of all-cause mortality (RR=1.06, 1.03–1.10) when compared with non-Porton Down veterans. Porton Down veterans had higher rates of certain cancers (e.g. ill-defined malignant neoplasms, and<jats:italic>in situ</jats:italic>neoplasms) and specific causes of death (e.g. genitourinary, circulatory and external causes).</jats:p></jats:sec><jats:sec><jats:title>Objectives</jats:title><jats:p>The updated study aims to replicate the original analyses but with an additional 15 years of follow-up – estimated to increase the number of deaths available for study to c 22 200. This will improve statistical power, allowing exposures and outcomes of interest from prior literature to be examined at a level of detail not possible in the original study, e.g. nerve agent antidotes, riot control agents, neurological mortality, and rarer cancers.</jats:p></jats:sec><jats:sec><jats:title>Implications</jats:title><jats:p>Greater understanding of the long-term risks associated with exposure to chemical agents could lead to raised awareness among policy makers and health care providers, leading to improved diagnosis and quality of care.</jats:p></jats:sec><jats:sec><jats:title>Conflict of interest</jats:title><jats:p>None</jats:p></jats:sec>