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Background In 1988, a cardiovascular prevention program which combined an individual and a population-based strategy was launched within primary health-care in Sollentuna, a municipality in Stockholm County. The aim of this study was to investigate time trends in the incidence of and mortality from acute myocardial infarction and all-cause mortality in Sollentuna compared with the rest of Stockholm County during a period of two decades following the implementation of a cardiovascular prevention program. Materials and Methods The average population in Sollentuna was 56,589 (49% men) and in Stockholm County (Sollentuna included) 1,795,504 (49% men) during the study period of 1987-2010. Cases of hospitalized acute myocardial infarction and death were obtained for the population of Sollentuna and the rest of Stockholm County using national registries of hospital discharges and deaths. Acute myocardial infarction incidence and mortality were estimated using the average population of Sollentuna and Stockholm in 1987-2010. Results During the observation period, the incidence of acute myocardial infarction decreased more in Sollentuna compared with the rest of Stockholm County in women (-22% vs. -7%; for difference in slope <0.05). There was a trend towards a greater decline in Sollentuna compared to the rest of Stockholm County in the incidence of acute myocardial infarction (in men), acute myocardial mortality, and all-cause mortality but the differences were not significant. Conclusion During a period of steep decline in acute myocardial infarction incidence and mortality in Stockholm County the municipality of Sollentuna showed a stronger trend in women possibly compatible with favorable influence of a cardiovascular prevention program.

Aim: Flying personnel are exposed to several factors in the work environment that can potentially increase their cancer incidence, mortality and acute myocardial infarction (AMI) incidence. The aim of this licentiate thesis is to study cancer incidence among Swedish cabin crew in relation to exposures in the work environment and to study mortality and AMI incidence in Swedish airline and military flying personnel. Methods: Cancer incidence among cabin crew at the Swedish Scandinavian Airlines (SAS) was determined from the Swedish National Cancer Register. Their cancer incidence was compared with that of the general Swedish population by comparing observed and expected number of cases. To study exposure of total flight hours and exposure to “high altitude, long distance” flights a nested case-control study was performed, including cancer cases diagnosed after 1979 and four controls per case. A cohort of flying personnel employed at the Swedish part of SAS or the Swedish Air Force was followed regarding mortality and AMI incidence using national registers of hospital discharges and deaths. The observed mortality and AMI incidence was compared with the expected rate in the Swedish population. Results: Swedish cabin crew had an overall cancer incidence similar to that of the general population. An increased incidence of malignant skin melanoma in both male and females and non-melanoma skin cancer among men may be associated with exposure to UV radiation, either at work or outside work. An increased risk of breast cancer in female cabin crew is consistent with our results and may in part be due to differences in reproductive history. No clear associations were found between length of employment or cumulative block hours and cancer incidence. Swedish flying personnel, except male cabin crew, had lower-than-expected all-cause mortality mostly due to a reduced cardiovascular mortality reflecting a low AMI incidence during the working life as well as after retirement. Conclu