Abstract
BackgroundFlight attendants are an understudied occupational group, despite undergoing a wide and unique range of adverse job-related exposures. In our study, we aimed to characterize the health profile of cabin crew relative to the U.S. general population.MethodsIn 2014–2015, we surveyed participants of the Harvard Flight Attendant Health Study. We compared the prevalence of their health conditions to a contemporaneous cohort in the National Health and Nutrition Examination Survey (NHANES 2013–2014) using age-weighted standardized prevalence ratios (SPRs). We also analyzed associations between job tenure and selected health outcomes, using logistic regression and adjusting for potential confounders.ResultsCompared to the NHANES population (n = 2729), flight attendants (n = 5366) had a higher prevalence of female reproductive cancers (SPR = 1.66, 95% CI: 1.18–2.33), cancers at all sites (SPR = 2.15, 95% CI: 1.73–2.67 among females), as well as sleep disorders, fatigue, and depression, with SPRs ranging between 1.98 and 5.57 depending on gender and the specific condition examined. In contrast, we observed a decreased prevalence of cardiac and respiratory outcomes among flight crew relative to NHANES. Health conditions that increased with longer job tenure were sleep disorders, anxiety/depression, alcohol abuse, any cancer, peripheral artery disease, sinusitis, foot surgery, infertility, and several perinatal outcomes.ConclusionsWe observed higher rates of specific adverse health outcomes in U.S. flight attendants compared to the general population, as well as associations between longer tenure and health conditions, which should be interpreted in light of recall bias and a cross-sectional design. Future longitudinal studies should evaluate specific exposure-disease associations among flight crew.
Highlights
Flight attendants are an understudied occupational group, despite undergoing a wide and unique range of adverse job-related exposures
This study reported elevated rates of reproductive cancers, respiratory and cardiovascular outcomes, and sleep and mental health conditions in flight attendants, some of which were related to job tenure [14]
For the 2014–2015 wave of the Flight Attendant Health Study (FAHS) reported in this manuscript, we recruited both new and returning flight attendants to participate through several channels, including a hard copy survey mailed to the 2007 participants and distributed at airport terminals between December 2014 and June 2015, and an online survey launched in December 2014
Summary
Flight attendants are an understudied occupational group, despite undergoing a wide and unique range of adverse job-related exposures. Flight attendants are an understudied occupational cohort, despite undergoing a wide and unique range of adverse job-related exposures. These workers are consistently exposed to cosmic ionizing radiation, circadian rhythm disruption due to night shift work and frequently crossing time zones, poor cabin air quality, elevated ozone levels, Flight crew have historically been excluded from the Occupational Safety and Health Administration protections granted to most U.S workers. Et al BMC Public Health (2018) 18:346 attendants’ exposure to ionizing radiation is not monitored, despite the National Council on Radiation Protection (NCRP) reporting that flight crew have the largest average annual effective dose of all U.S radiation workers [7, 8]. But overall point towards associations between in-flight exposures or job tenure and reduced respiratory health [9], increased rates of breast and skin cancers [10], adverse reproductive and perinatal outcomes [11], musculoskeletal injuries [2], health effects from contaminated cabin air [12], and higher rates of mental health conditions [1, 13]
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