Introduction Several studies have shown higher mortality and morbidity ratios in seafarers when compared to land-based occupations. Hence, we conducted a cohort study in more recent time.

Methods All persons included in the Swedish Registry of Seafarers 1985–2013 with registered work periods were included in the cohort. They (n = 85 862) were followed up for death from 1985 or first work period to emigration, dead or 2013. Standardised mortality ratio (SMR) were analysed with 95% confidence intervals (CI) stratified for ship types, gender and age (<65 or ≥65 years) in relation to the Swedish population. Mean follow up time was 17 years.

Results There overall mortality was normal. For seafarers working only at passenger ships there was no excess mortality. Both male and female seafarers less than 65 years and working at other kind of ships had an increased mortality. This was most pronounced among those being seafarers for 10–20 years.

Passenger ships only:

• male <65 (n = 22,382, deaths = 698) SMR 97.0 (95% CI: 90–104)

• male ≥65 (n = 3,025, deaths = 533) SMR 75.3 (69–82)

• female <65 (n = 24,549, deaths = 325) SMR 86.9 (78–97)

• female ≥65 (n = 1,739, deaths = 200) SMR 68.5 (59–79)

• Other kind of ships:

• male <65 (n = 32,350, deaths = 1,988) SMR 127.7 (122–„133)

• male ≥65 (n = 7,040, deaths = 1,450) SMR 86.7 (82–91)

• female <65 (n = 6,292, deaths = 146) SMR 121.0 (102–142)

• female ≥65 (n = 646, deaths = 100) SMR 68.5 (56–83)

Conclusions Seafarers in working ages still are at risk for early death if they not are working at passenger ships only. If not stratified for ship type and age this would be unrevealed.