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Temporal trends in the healthy soldier effect in a cohort of Royal Norwegian Navy servicemen followed for 67 years
- Source :
- Occupational and Environmental Medicine. 77:775-781
- Publication Year :
- 2020
- Publisher :
- BMJ, 2020.
-
Abstract
- ObjectivesTo investigate temporal trends in the ‘healthy soldier effect’ (HSE) among 28 300 Royal Norwegian Navy servicemen who served during 1950–2004.MethodsStandardised mortality ratios (SMRs) for all causes, diseases and external causes were calculated from national rates for the entire study period (1951–2017), and for seven successive follow-up periods after the first recorded day of Naval service, for the overall cohort and for two subgroups: land-based personnel and vessel crews. Poisson regression, expressed as rate ratios, was used to compare all-cause mortality between the subgroups.ResultsIn the overall cohort, SMRs for all-cause mortality increased steadily during the first six 10-year follow-up periods, from 0.52 to 0.94, which was still lower than national rates. After 60 years, the lower mortality compared with national rates was no longer statistically significant (SMR=0.93). Low non-neoplastic disease mortality contributed most to the longevity of the HSE. For neoplastic diseases, there was a mortality deficit only for the first and third 10-year follow-up periods. External-cause mortality rose to national rates after 40 years. An HSE was present among vessel crews, but their total mortality rate was 24% higher than that among land-based personnel, who also showed a longer-lasting HSE.ConclusionsThe HSE eroded gradually over time but was still present at 60 years of follow-up for all-cause mortality. The effect was strongest and most long-lived for non-neoplastic disease, lasted up to 40 years for external causes, and was relatively short for cancers. Land-based personnel showed stronger and longer-lasting HSE than vessel crews.
- Subjects :
- Adult
Male
medicine.medical_specialty
Adolescent
Health Status
Longevity
Norwegian
Young Adult
03 medical and health sciences
symbols.namesake
0302 clinical medicine
Epidemiology
Humans
Medicine
030212 general & internal medicine
Poisson regression
Mortality
Naval Medicine
Aged
Norway
business.industry
Disease mortality
Public health
Public Health, Environmental and Occupational Health
Middle Aged
030210 environmental & occupational health
language.human_language
Navy
Military Personnel
Cohort
symbols
language
Female
business
Lower mortality
Demography
Subjects
Details
- ISSN :
- 14707926 and 13510711
- Volume :
- 77
- Database :
- OpenAIRE
- Journal :
- Occupational and Environmental Medicine
- Accession number :
- edsair.doi.dedup.....3a587626c4c4adab2d5bbce4baa6dc91