Melanoma incidence in Norway is closely related to local levels of UVB radiation independently of other factors suggesting that local exposures carry significant risk. Risks would probably increase if ozone depletion led to enhanced UVB flux (estimated as 1.6% rise in incidence for each 1% increase in UVB). By the end of the study period income was no longer a significant factor but holidays abroad had started to have a detectable effect on melanoma incidence.
Objective -This study aimed to examine regional urban-rural differences in mortality from ischaemic heart disease, including sudden death of unknown cause (IHDISUD) it was 8% (95% CI 2%,13%) higher in rural than in urban areas. The mortality rates for women were equal for both these aggregates. For men the results indicate that IHDISUD mortality peaked first in urban municipalities and then, but at a lower level, in rural areas. For women there was a substantial decline in IHDISUD mortality between 1966 and 1989, but an actual peak could not be demonstrated in any of the three aggregates during the period. The decline in IHD/SUD mortality among women was steepest in urban municipalities and least noticeable in rural municipalities, but the decline tapered off towards the end of the study period. Conclusion -The results confirm a phaseshifted peak in IHDISUD mortality, which began in towns and ended in rural areas, and provides clues to the main underlying factors in the IHD epidemic at the population level. (J Epidemiol Community Health 1995;49:271-276) The changes in mortality from ischaemic heart disease (IHD) in the western world during recent decades have not been regionally homogenous. Mortality time trend differences have been shown both between and within coun-
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