Objective To investigate external-cause mortality among 21 609 Norwegian male military peacekeepers deployed to Lebanon during 1978–1998.
Methods The cohort was followed from the 1st day of deployment through 2013, and mortality during deployment and post discharge was assessed using SMRs calculated from national rates in Norway. Poisson regression was used to see the effect of high-conflict versus low-conflict exposure.
Results For the total cohort, external-cause mortality was within expected values during deployment (SMR=0.80) and post discharge (SMR=1.05). In the low-conflict exposure group, a lower mortality from all external causes (SMR=0.77), transport accidents (SMR=0.55) and accidental poisoning (SMR=0.53) was seen. The high-conflict exposure group showed an elevated mortality from all external causes (SMR=1.20), transport accidents (SMR=1.51) and suicide (SMR=1.30), but these risks were elevated only during the first 5 years after discharge. This group also showed elevated mortality from all external causes (rate ratio, RR=1.49), and for transport accidents (RR=3.30) when compared with the low-conflict exposure group.
Conclusions Overall external-cause mortality among our peacekeepers was equal to national rates during deployment and post discharge. High-conflict exposure was associated with elevated mortality from all external causes, transport accidents and suicide during the first 5 years after discharge from service.
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Contributors Study concepts and design: LAS, EKB;
Data acquisition: LAS, EKB, JIM;
Quality control of data and algorithms: JIM, LAS;
Data analysis and interpretation: JIM, LAS, EKB, EAF;
Statistical analysis: JIM;
Manuscript preparation LAS, EKB;
Manuscript editing and review: LAS, EKB, JIM, EAF.
Funding This study was funded by the Norwegian Armed Forces Medical Services. No outside financial support was received for this project.
Competing interests None declared.
Ethics approval Regional Committees for Medical and Health Research Ethics of Southern Norway.
Provenance and peer review Not commissioned; externally peer reviewed.
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