Verhoogde sterfte onder Nederlandse ontwikkelingswerkers in de periode 1984-1994

To compare the death rates of Dutch development workers in the period 1984-1994 with the death rate of the general Dutch population.

Design

Retrospective and comparative study.

Setting

HealthNet International and Royal Tropical Institute, the Netherlands.

Methods

Records were reviewed of three Dutch organisations sending out development workers. Mortality among these workers was compared with that of the general Dutch population, adjusted for age and sex.

Results

In the study period > 6,500 development workers and spouses for whom records were retrieved spent 15,144 person-years abroad. A total of 32 deaths were observed, while only 16.8 were expected, giving a standardised mortality ratio (SMR) of 1.9 (95 confidence interval: 1.3-2.7). The SMR among women (3.3) was higher than that among men (1.4), mainly because of different SMRs for traffic accidents: 35.0 among women and 4.5 among men. Traffic accidents caused 11 (34) out of 32 deaths. After adjustment for a healthy cohort effect, higher educational level, and increased mortality after end of contract because of HIV infection, the SMR increased further.

Conclusion

Dutch development workers had an increased mortality compared with the general Dutch population, in particular because of traffic accidents.