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  • Total and cause-specific mortality of Finnish military personnel following service in international peacekeeping operations 1990–2010: a comprehensive register-based cohort study

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Epidemiology
Research
Total and cause-specific mortality of Finnish military personnel following service in international peacekeeping operations 1990–2010: a comprehensive register-based cohort study
  1. T Laukkala1,
  2. K Parkkola2,
  3. M Henriksson3,4,
  4. S Pirkola5,
  5. N Kaikkonen4,
  6. E Pukkala6,
  7. P Jousilahti7
  1. 1Centre for Military Medicine, Finnish Defence Forces, Helsinki, Finland
  2. 2School of Medicine, University of Tampere, Tampere, Finland
  3. 3National Supervisory Authority for Welfare and Health, Helsinki, Finland
  4. 4Centre for Military Medicine, Finnish Defence Forces, Helsinki, Finland
  5. 5School of Health Sciences, University of Tampere, and Tampere University Hospital, Tampere, Finland
  6. 6School of Health Sciences, University of Tampere, Tampere Finland and the Finnish Cancer Registry, Helsinki, Finland
  7. 7National Institute for Health and Welfare, Helsinki, Finland
  1. Correspondence to Dr Tanja Laukkala; tanja.laukkala{at}kela.fi

Abstract

Objectives To estimate total and cause-specific mortality after international peacekeeping deployments among the Finnish military peacekeeping personnel in comparison to the general population of similar age and sex.

Design A register-based study of a cohort of military peacekeeping personnel in 1990–2010 followed for mortality until the end of 2013. Causes of death were obtained from the national Causes of Death Register. The standardised mortality ratio (SMR) for total and cause-specific mortality was calculated as the ratio of observed and expected number of deaths.

Setting Finland (peacekeeping operations in different countries in Africa, Asia and in an area of former Yugoslavia in Europe).

Participants 14 584 men and 418 women who had participated in international military peacekeeping operations ending between 1990 and 2010.

Interventions Participation in military peacekeeping operations.

Main outcome Total and cause-specific mortality.

Results 209 men and 3 women died after their peacekeeping service. The SMR for all-cause mortality was 0.55 (95% CI 0.48 to 0.62). For the male peacekeeping personnel, the SMR for all diseases was 0.44 (95% CI 0.35 to 0.53) and for accidental and violent deaths 0.69 (95% CI 0.57 to 0.82). The SMR for suicides was 0.71 (95% CI 0.53 to 0.92).

Conclusions Even though military peacekeeping personnel are working in unique and often stressful conditions, their mortality after their service is lower compared with the general population. Military peacekeeping personnel appear to be a selected population group with low general mortality and no excess risk of any cause of death after peacekeeping service.

  • Peacekeeper
  • All-cause mortality
  • Cause-specific mortality
  • Finland

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2016-012146

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    Footnotes

    • EP and PJ contributed equally.

    • Contributors TL planned the study design, participated in the data collection, interpreted the results and wrote the manuscript. KP, MH, SP and NK participated in the study planning and read and critically commented on the manuscript. KP and MH provided organisation support. EP participated in the design of the study, performed the statistical analysis and read and critically commented on the manuscript. PJ participated in study planning, interpreting the results, manuscript writing and critical assessment of the results.

    • Funding This study was supported by the Finnish Psychiatric Association.

    • Competing interests None declared.

    • Ethics approval The study was approved by the Ethics Committee of Helsinki University Hospital. Permissions to conduct the study were received from the Defence Command of the Finnish Defence Forces and from Statistics Finland (causes of death).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Separate data on upper age groups are available from the authors on request.