Medical reports from 885 Fleet Ballistic Missile (FBM) submarine patrols (7,650,000 man-days) were analyzed. The data were categorized and compared with data obtained by medical personnel from surface fleet personnel (1,215,918 man-days) during a continuous 7--8 months' deployment of surface vessels in 1973. Surface fleet personnel had a higher illness rate in the categories of respiratory, traumatic, gastrointestinal, dermal, infections, and miscellaneous illness, and a lower rate in genitourinary, systemic (including mononucleosis), cranial, and neuropsychiatric illness compared to submarine personnel. Because of improved atmosphere control, a sharp decline in the level of submarine contaminants occurred between 1965--67. Reports from the 1968--73 period showed a decrease in: 1) respiratory; 2) ear, nose, and throat; 3) gastrointestinal; 4) cardiovascular; 5) urologic; and 6) general medical illness categories; the number of general surgery, orthopedics, dental, and eye illness cases was not affected. Neurologic and psychiatric disease showed the only increases in incidence for this period. The overall decrease in illness can be attributed mainly to the fall in the incidence of respiratory disease, known to be affected by reduced air pollution, and the decline in gastrointestinal illness. This decline occurred in a period during which the incidence of both classes of illness went up in the general population, according to the Health Interview Survey published by DHEW. The improvement of atmosphere control in submarines caused a substantial reduction in contaminants (a decline in tobacco smoking also occurred in this period), which led to a decrease in incidence of illness, particularly respiratory disease. No direct causal relationship between reduction in air pollution and reduction in the incidence of disease could be proven within the framework of this study, however.