Objective The aim of this study was to evaluate mortality and acute myocardial infarction (AMI) incidence among commercial and military flying personnel in Sweden.

Methods Flying personnel, employed at the Swedish part of Scandinavian Airlines and the Swedish Armed Forces at some point between 1957–1994, were included. The cohort 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 general Swedish population through standardized mortality ratios (SMR) and standardized incidence ratios (SIR) taking age, gender, and calendar year into account.

Results Swedish flying personnel, except male cabin crew, had a lower-than-expected all-cause mortality (SMR ranging from 0.57 among female cabin crew to 0.79 among navigators and mechanics; male cabin crew 0.89) and cardiovascular mortality (SMR from 0.31 among female cabin crew to 0.79 among navigators and mechanics). We observed an elevated mortality in aircraft accidents (SMR ranging from 23.87 among commercial pilots to 165.68 among military pilots). Male cabin attendants had a higher-than-expected mortality for alcohol-related death causes and acquired immunodeficiency syndrome (AIDS). AMI incidence was reduced in all groups and across the lifespan (SIR between 0.13 among female cabin crew and 0.61 among navigators and mechanics).

Conclusions Swedish flying personnel have a low all-cause mortality. This is mostly due to a reduced cardiovascular mortality reflecting a low AMI incidence during the working life as well as after retirement.

Key terms aircraft; aviation; commercial aircrew; flying personnel; military personnel; mortality; myocardial infarction; working career