Documenting health risks at 35,000 feet


3 min read

Alaska Airlines flight attendants began reporting symptoms such as itchy eyes, rashes, and shortness of breath soon after the company introduced new uniforms in 2011. Although the uniforms were replaced three years later, the company didn’t acknowledge a possible connection between the introduction of the uniforms and the spike in health complaints. The National Institute for Occupational Safety and Health (NIOSH) agreed, ruling that there wasn’t enough evidence to establish a link.

The case piqued the interest of researchers from Harvard T.H. Chan School of Public Health who had been studying the health effects of working in the airplane cabin environment as part of the Flight Attendant Health Study. The study is an ongoing effort to understand the risks faced by a group of workers who, because they work in the air, fall outside of standard health and safety protections.

The researchers analyzed survey data taken from 684 Alaska Airlines flight attendants before and after the uniforms were introduced in 2011 and published the results earlier this year in BMC Public Health. Their findings showed that respiratory, dermatological, and allergic symptoms increased following the introduction of the new uniforms, most significantly itchy skin and rash, itchy eyes and blurred vision, and sinus congestion.

Eileen McNeely, the study’s lead author, said that while just a few complaints about a consumer clothing item can prompt a fix, airlines have been slow to respond to flight attendants’ concerns. “That’s emblematic of the limited health and safety protection that flight attendants receive even from bodies such as the Occupation Safety and Health Administration,” she said. McNeely is co-director of SHINE, the School’s corporate health and sustainability program based in the Exposure, Epidemiology and Risk program.

American Airlines flight attendants filed a class action lawsuit last year over their uniforms, which were made by the same company as the Alaska Airlines uniforms, following more than 3,500 complaints.

While flight attendants are healthier overall than the general population, they have higher rates of certain diseases and conditions, including female reproductive cancers, sleep disorders, and depression, according to research by McNeely and colleagues. The findings were published March 23, 2018 in BMC Public Health.

McNeely began studying flight attendant health in 2007, when the School was chosen as one of the Centers of Excellence tasked with studying cabin air quality prior to the Federal Aviation Administration’s reauthorization by Congress. Once that was completed, funding to continue the Flight Attendant Health Study was provided by the Flight Attendant Medical Research Institute. Now on its third wave of recruitment, the study has already attracted more than 12,000 participants.

While flight attendants no longer have to work in smoke-filled cabins, they face other exposures, such as flame retardants on seat cushions and vulnerability to infectious respiratory diseases.

To obtain additional data, McNeely and her colleagues recently launched an app that was distributed along with wearable sensors to some study participants. It will track flight-related changes in measures that may affect health, and is available free in the Apple app store for use by anyone who flies.

Amy Roeder