Army bomb disposal veterans may have a significantly increased risk of developing bladder cancer compared with the general public, according to research.

A research letter published in the medical journal BJU International and at the European Association of Urology Annual Congress in Madrid has suggested that the incidence of bladder cancer among British Army veteran bomb disposal officers aged under 70 may be five times higher than among the general public.

This is “raising urgent concerns” about occupational exposure to hazardous substances, the research team has argued.

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The study was conducted by a team from the University of Wales Trinity Saint David (UWTSD), University of Birmingham, King’s College London, University of Glasgow, and South Wales NHS Trust.

It identified a disproportionately high rate of bladder cancer among the cohort of former bomb disposal operatives following a survey of around 30% (688 out of 2,300) of veterans serving in explosive ordnance disposal since 1970.

Dr Gareth Collett, an executive director at UWTSD’s Wales Institute for Science and Art (WISA) and the study’s lead author, said: “This research isn’t about blame; it’s about raising awareness amongst veterans and general practitioners, protecting those still serving, and ensuring that lessons are learned.

“Our findings suggest that there is a significant link between exposure to certain explosives encountered by ammunition technicians during their careers and bladder cancer, and a definitive study based on these findings could lead to real change that saves lives.”

The findings provide a strong signal that there is a considerably increased risk of bladder cancer among members of the ammunition technician profession who are exposed to certain explosives on a regular basis.

Professor Rik Bryan, director of the Bladder Cancer Research Centre at the University of Birmingham and a co-author of the study, said: “Despite the relatively small size of this initial study, the findings provide a strong signal that there is a considerably increased risk of bladder cancer amongst members of the ammunition technician profession who are exposed to certain explosives on a regular basis.

“This risk is significant enough to warrant urgent further investigation and a definitive study working with as many veterans as possible.”

The research was inspired by the personal experience of Dr Collett, a retired British Army brigadier and former head of UK bomb disposal.

After being diagnosed with bladder cancer in November 2023, Dr Collett shared his diagnosis in a private social media group for retired and serving ammunition technicians.

Within days, other members of that group reported similar diagnoses, leading Dr Collett and a team of urologists, epidemiologists, and scientists to investigate whether there is a higher incidence among the population, as the lifetime incidence of bladder cancer in the general population is below 1%.

Dr Collett said: “I was diagnosed with bladder cancer at the age of 56. I had been an ammunition technical officer for 33 years, seeing operational service in Northern Ireland, the Balkans, Iraq, Afghanistan and in less publicised operations globally.

“The immediate supposition by medical professionals was that it was a heavy smoker’s disease. This was not the case at all for me, leading to the possibility that it could be occupational related given my service history and frequent visits to the regimental medical officer with bouts of overactive bladder for over a decade.

“Anecdotal evidence was already being amassed by the ammunition technical profession, raising concerns of the link between explosives and urological cancers. However, there was very little epidemiological evidence available for the MOD [Ministry of Defence] to consider this a matter of concern.

“As such I decided to gather factual and preliminary evidence, speaking with service charities, learned professors of urology and trade professionals to formulate an initial epidemiological survey. This survey led to the standard incidence ratios and confidence intervals reported in the paper, and the necessity for further action,” Dr Collett added.

The study’s authors are calling for further large-scale research into the long-term health impacts of explosive exposure.

They are also arguing for changes in military safety regulations regarding the disposal and handling of explosives, regular screening programmes for at-risk individuals, using low-cost urinalysis tests for early detection of bladder cancer, and for raised awareness among GPs when dealing with veterans exposed to explosives during their careers, particularly if they are aged below 70 and are experiencing blood in their urine.

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