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Gulf War Veterans: Mortality Figures

Lord Williams of Elvel asked Her Majesty's Government:

What are the latest figures for deaths of 1990–91 UK Gulf War veterans. [HL4080]

Lord Bach: Mortality figures for the United Kingdom veterans of the 1990–91 Gulf conflict from 1 April 1991 to 31 December 2002 were published on 9 January 2003 (Official Report, cols. WA 158– WA 160). The latest data, as at 30 June 2003, are shown in Table 1 below. As before, the data for Gulf veterans are compared to that of a control group, known as the era cohort, which is made up of Armed Forces personnel of a similar size, age, gender, service, regular/reservist status and rank who were not deployed. Table 2 provides a detailed breakdown of deaths from cancer (neoplasm) by anatomical site.

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On 24 July 2002 (WA 81–83) it was announced that the Ministry of Defence was discussing with the University of Manchester a detailed study of the factors underlying the figures for road traffic accident deaths. There are indications that the excess of motor vehicle accident deaths among Gulf veterans occurred principally during the first six years after the cessation of hostilities (to 31 March 1997) and that this trend has reversed in the following six years to 31 March 2003.

Furthermore, the numbers of incidents are relatively small, the information on each accident is insufficiently detailed to allow meaningful analysis and a considerable amount of time has elapsed since 1 April 1991. Therefore, following the advice of the experts that have been consulted, we have decided not to commission the proposed study.

Table 1

Deaths to UK Gulf veterans (Note: 1) 1 April 1991–30 June 2003 Causes (coded to ICD-9) (Note: 2)

ICD Chapter	Cause of death	Gulf	Era(13)	Mortality Rate Ratio(14)
	All deaths	600	613	0.97
	All cause coded deaths	586	599	0.97
I–XVI	Disease-related causes	243	300	0.81
I	Infectious and parasitic diseases	4	2	1.99
II	Cancers	105	124	0.84
III	Endocrine and immune disorders	1	6	0.20
V	Mental orders	13	15	0.86
VI	Diseases of the nervous system and sense organs (Note 5)	10	11	0.90
VII	Diseases of the circulatory system	82	106	0.77
VIII	Diseases of the respiratory system	11	6	1.82
IX	Diseases of the digestive system	15	18	0.83
IV, X–XVI	All other disease-related causes (Note 6)	2	12	0.17
EXVII	External causes of injury and poisoning	343	299	1.14
	Railway accidents	4	1	3.98
	Motor vehicle accidents	118	100	1.17
	Water transport accidents	5	1	4.98
	Air and space accidents	25	19	1.31
	Other vehicle accidents	0	1	0.00
	Accidental poisoning	14	15	0.93
	Accidental falls	8	8	1.00
	Accidents due to fire/flames	0	2	0.00
	Accidents due to natural environmental factors	2	2	1.00
	Accidents due to submersion/suffocation/foreign bodies	17	7	2.42
	Otheraccidents	31	29	1.06
	Late effects of accident/injury	0	2	0.00
	Suicide and injury undetermined whether	110	103	1.06
	accidentally or purposely inflicted Homicide	6	5	1.19
	Injury resulting from the operations of war	3	4	0.75
	Other deaths for which coded cause data are not yet available	11	10
	Overseas deaths for which cause data are not available	3	4




Notes:

1. Service and ex-Service personnel only.

2. World Health Organisation's International Classification of Diseases 9th revision, 1997.

3. The Era group comprises 53,143 personnel, randomly sampled from all UK Armed Forces personnel in service on 1 January 1991 and who did not deploy to the Gulf. This group is matched to the 53,409 Gulf veterans to reflect the socio-demographic and military composition of the Gulf cohort in terms of age, gender, Service (Army, Royal Navy, Royal Air Force), officer/other rank status, regular/reservist status, and a proxy measure for fitness.

4. Mortality rate ratios differ marginally from the crude deaths ratio owing to some small differences between the Gulf and Era cohorts.

5. These figures include four deaths from motor neurone disease amongst the Gulf cohort and three in the Era group.

6. Includes cases with insufficient information on the death certificate to provide a known cause of death.

Table 2

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Deaths due to neoplasms among UK veterans: 1 April 1991–30 June 2003

Major anatomical sites (coded to ICD–9) ¹

ICD 9	Site	Gulf	Era
140–239	All neoplasms	105	124
140–149	Malignant neoplasm of lip, oral cavity and pharynx	6	4
150–159	Malignant neoplasm of digestive organs and peritoncum	22	30
160–165	Malignant neoplasm of respiratory and intrathoracic organs	17	25
170–175	Malignant neoplasm of bone, connective tissue, skin and breast	14	13
179–189	Malignant neoplasm of genitourinary organs	3	7
190–199	Malignant neoplasm of other and unspecified site	21	29
200–208	Malignant neoplasm of lymphatic and haematopoietic tissue	19	14
239	Unspecified nature	3	2




(11) World Health Organisation's International Classification of Diseases 9th revision, Geneva, 1997.

Local Authority Funding

Lord Orme asked Her Majesty's Government:

When there will be public consultation on the current review of the balance of funding for English local authorities. [HL4070]

The Minister of State, Office of the Deputy Prime Minister (Lord Rooker): Following a commitment in the 2001 local government White Paper, we are carrying out a wide-ranging review of the balance between central and local sources of funding for local government in England. This review is being steered by a high level group, chaired by my right honourable friend the Member for Greenwich and Woolwich in the other place, which includes senior representatives of central and local government as well as business, the unions, the academic world and the accountancy profession.

To inform the work of the group my right honourable friend the Member for Greenwich and Woolwich is today issuing an invitation to all those interested to submit comments by 30 September 2003. Copies of the invitation letter will be available in the Libraries of the House, the Printed Paper Office and on the website of the Office of the Deputy Prime Minister.

Consanguinity

Lord Lucas asked Her Majesty's Government:

Whether the average degrees of consanguinity between brother and half-sister, and that between blood uncle and niece, are identical. [HL3471]

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The Parliamentary Under-Secretary of State, Department of Health (Lord Warner): The average degree of consanguinity between brother and half-sister is equivalent to that between blood uncle and niece. In both cases, on average the two related individuals will have one quarter of their genes in common.

Food Supplements

Earl Howe asked Her Majesty's Government:

What recent representations they have received from the National Association of Health Stores in relation to the provisions of the Food Supplements Directive and the Food Supplements (England) Regulations; and what response they have made to those representations.[HL3481]

Lord Warner: Ministers have received a number of recent written representations from, and on behalf of, the National Association of Health Stores (NAHS) expressing NAHS's concerns over the impact of the Food Supplements Directive and the implementing regulations. In particular, NAHS voice particular concerns over the current composition of the lists of permitted substances in the annexes to the directive and asked that the United Kingdom seek an amendment to the directive.

Ministers have responded recognising those concerns and setting out the Government's view that there was no possibility of negotiations on the directive being reopened. Many member states wanted a much more restrictive regime.

No aspect of the directive needs to be implemented by the industry until 1 August 2005 and the Food Supplements (England) Regulations 2003 make use of flexibility in the directive that means marketing of some products may not be affected until 1 January 2010.

Food supplements containing vitamins and minerals and their sources missing from the positive lists that were on the market when the directive came into force may continue to be marketed beyond 1 August 2005 provided that dossiers to support their addition to the positive lists have been submitted to the European Commission before 12 July 2005 and provided that the European Food Safety Authority has not given a negative opinion on such use.

Earl Howe asked Her Majesty's Government:

What assessment they have made of the impact upon consumer choice and the United Kingdom food supplements industry of the possible setting by the European Union of maximum permitted levels for nutrients in food supplements at levels substantially lower than those which are currently permitted in the United Kingdom.[HL3484]

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Lord Warner: The Government's firm position is that safety should be the primary concern, and that maximum limits should be set at levels that are based on scientific risk assessments and not limited by considerations of nutritional need, thus protecting public health without unnecessarily limiting consumer choice or unduly restricting trade.

Article 5 of Directive 2002/46/EC on food supplements sets out principles for setting EU maximum limits for vitamins and minerals in food supplements, although no specific figures have yet been set. Discussion on maximum limits at EU level will follow publication of advice from the European Food Safety Authority. We do not expect the European Commission to issue its proposal on maximum limits before the end of this year.

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