American flight attendants have a higher prevalence of several forms of cancer, including breast, uterine, gastrointestinal, thyroid, and cervical cancers, when compared with the general public, according to new research from the Harvard T.H. Chan School of Public Health.
The analysis, one of the largest studies of cancer among cabin crew members to date, is the first to show that U.S. flight attendants also have an elevated rate of non-melanoma skin cancer.
The findings are “striking given the low rates of overweight and smoking in our study population, which highlights the question of what can be done to minimize the adverse exposures and cancers common among cabin crew,” said Irina Mordukhovich, a research fellow at Harvard Chan School and the corresponding author of the paper.
The study was published online in Environmental Health on Monday.
Flight attendants are exposed to several known and probable cancer risks, including cosmic ionizing radiation, disrupted sleep cycles and circadian rhythms, and chemical contaminants. Moreover, cabin crews are exposed to the largest effective annual ionizing radiation dose relative to all other U.S. radiation workers because of both their exposure to and lack of protection from cosmic radiation.
Despite these known risks, flight attendants have historically been excluded from Occupational Safety and Health Administration protections typically granted to U.S. workers. Protections instituted in 2014 are limited.
The Harvard researchers began studying flight attendants’ health more than a decade ago, launching the Harvard Flight Attendant Health Study. The new findings are based on a 2014–15 survey in which 5,366 U.S. flight attendants were asked about health outcomes and symptoms, work experience, personal characteristics, and employment history. The researchers compared the prevalence of cancers among the flight attendants with similar information from the National Health and Nutrition Examination Survey, an annual study of approximately 5,000 citizens that is conducted by the Centers for Disease Control and Prevention.
Flight attendants had a higher prevalence of every cancer that was examined, especially breast cancer, melanoma, and non-melanoma skin cancer among women, echoing multiple U.S. and European studies. Job tenure was linked to non-melanoma skin cancer among women, with borderline associations for melanoma and non-melanoma skin cancer among men.
The findings suggest that additional efforts should be made in the U.S. to minimize the risk of cancer among flight attendants, including monitoring radiation doses and organizing schedules to minimize radiation exposure and circadian rhythm disruption, according to the researchers.
“The E.U. already evaluates radiation exposure among flight attendants, which our findings show may be an important step toward lowering cancer risk among this work population,” said study author Eileen McNeely.
Other Harvard Chan School authors were Brent Coull, Sara Gale, Steven Staffa, and Samuel Tideman. Funding for the study came from the Flight Attendant Medical Research Institute.