The BOI noted deficiencies in the Occupational Health and Safety (OH&S) procedures as
well as inadequate reporting of incidents and hazards, and supported the conduct of an
epidemiological investigation into the health of F-111 DSRS workers. The investigation – the Study of Health Outcomes in Aircraft Maintenance Personnel (SHOAMP) – aimed to assess whether adverse health outcomes reported by DSRS personnel were associated with their involvement in DSRS programs or activities.

The SHOAMP was undertaken in three phases. The first phase involved a literature review of the evidence of possible associations between chemical exposure and health outcomes, a qualitative study of a sample of those involved in DSRS, and the development of a protocol for conducting a General Health and Medical Study. The second phase involved mortality and cancer incidence studies, the last of which estimated that on the balance of probabilities there was approximately a 50% increase in cancer in the F-111 DSRS group, which was of borderline statistical significance. The third phase is a General Health and Medical Study.

The SHOAMP was released to the government in October 2004 and the government made an announcement at that time and a further announcement in December 2004. Those announcements can be viewed in the next part here. The government also announced a lump sum ex-gratia payment in September 2005.

The Study of Health Outcomes in Aircraft Maintenance Personnel (SHOAMP) was commissioned by the Department of Defence to investigate the possible ill health effects on personnel undertaking specialised maintenance work (Deseal/Reseal) with the F-111 aircraft. The study was undertaken by a research consortium headed by The University of Newcastle Research Associates (TUNRA) and was managed by the Department of Veterans’ Affairs.

5 Volumes of work have been published and released to the public. These are:

• Volume 1 - (572Kb) Literature Review (Phase I) was an extensive review of the scientific literature for evidence of adverse health affects from occupational exposure.

• Volume 2 - (744Kb) Mortality and Cancer Incidence Study (Phase II) was a comparative statistical analysis using national databases for cancer and death. The results were inconclusive and a second study was recommended.

• Volume 3 - (391Kb) Qualitative Interviews were undertaken with a small number of participants to assist in the development of protocols for the main health study.

• Volume 4 - (1.3Mb) Final Mortality and Cancer Incidence Study – June 2004 was the second (repeated) statistical analysis using updated data. The study’s major conclusion was that, on the balance of probabilities, there was an increased risk of cancer associated with having participated in the F-111 Deseal/Reseal (DSRS) process. The study also reported an apparent decrease in death rates.

• Volume 5 - (3.13Mb) General Health and Medical Study (Phase III). Those persons identified as participating in the DSRS programs, and whose contact details were easily obtainable, were invited to take part in comprehensive health examinations by a nurse, doctor, and clinical psychologist, and were requested to complete a series of questionnaires. Information was gathered on many health indicators including general health and well being, cardiovascular and respiratory health, neurological abnormalities, skin and breast problems, sexual health, mood, cognition and memory. The appendix to Vol 5 is available here (13.29Mb).

Control groups from Amberley and Richmond RAAF bases were also invited to take part, the former being a group who represented the same base as the DSRS workers but a different job, and the latter representing those with similar jobs but from a different base. These two groups served as comparisons for the DSRS workers.

Overall, participation rates were 77%, 48% and 40% for the DSRS, Richmond and Amberley groups, yielding 659, 600 and 495 participants respectively.There were unavoidable uncertainties in the interpretation of the study results, due to factors such as: trying to identify all participants up to 30 years after the original programs, death of participants before the study started, and low participation rates. Despite these uncertainties, the results point to an association between involvement in the F-111 DSRS processes and a number of adverse health outcomes:

• lower physical and mental quality of life

• a 2.5 fold increase in erectile dysfunction for males

• twice as likely to have past or current depression

• twice as likely to have past or current anxiety

• an increase in self-reported memory problems.

There was also evidence, although less strong, of an association of DSRS with dermatitis, bronchitis and emphysema, and worse scores on some neuropsychological tests of memory and cognition.These associations appear to be consistent across Program 1 and Program 2 DSRS participants, and appear to be confined to DSRS and not to aircraft maintenance activities in general. However this study cannot by itself provide evidence as to which processes, work practices or chemical exposures might have been responsible for this increased risk. The full report contains a complete description and discussion of the results.