Mortality of Enlisted Men Who Served on Nuclear-Powered Submarines in the United States Navy

Objective: To describe the long-term mortality experience of a cohort of enlisted men who served on nuclear-powered submarines in the United States Navy and breathed recirculated filtered air for extended periods of time. Methods: In this historical cohort study we estimated standardized mortality ratios (SMRs) and used within-cohort Poisson regression analyses to address healthy worker biases. Results: Three thousand two hundred sixty three deaths occurred among 85,498 men during 1,926,875 person-years of follow-up from 1969 to 1995. SMRs were reduced for most cause-of-death categories, prostate cancer had a twofold elevation. In within-cohort comparisons, prostate cancer mortality did not increase with duration of submarine service, but ischemic heart disease mortality increased 26% per 5 years of submarine service. Conclusions: Long periods of submarine service do not increase mortality in most cause-of-death categories. Increased mortality from ischemic heart disease likely reflects the effects of tobacco smoke.

Automated summary

This study examines the long-term mortality experience of enlisted men who served on nuclear-powered submarines in the United States Navy. The findings suggest that long periods of submarine service do not increase mortality in most cause-of-death categories, but may result in an increased risk of ischemic heart disease, possibly due to tobacco smoke exposure.