Abstract
BackgroundMany epidemiological studies point to an increased risk of breast cancer among female airline cabin crew. Possible causes include occupational factors (e.g. cosmic radiation exposure, chronodisruption), as well as lifestyle and reproductive factors.AimsTo investigate the frequency of various risk factors in German flight attendants which are recognised to be associated with breast cancer.Methods2708 current and former female cabin crew were randomly selected by a flight attendants’ union and mailed a questionnaire; 1311 responded (48% response). Descriptive statistics were used to compare the distribution of breast cancer risk factors with general German population data.ResultsOn average, cabin crew were 3.0 cm (95% CI 2.7-3.3) taller than the comparison group, while their body mass index was 2.5 kg/m2 (95% CI 2.4-2.6) lower. We found less use of hormone replacement therapy, but longer average use of oral contraceptives. Nulliparity among respondents aged 45+ was 57% (95% CI 54%-60%) compared to 16%. Average age at first birth was 32.1 years (95% CI 31.7-32.4) vs. 25.5 years. The birth rate was 0.62 (95% CI 0.58-0.67), less than half the population average of 1.34. Alcohol consumption was considerably higher, whereas cabin crew tended to smoke less and performed more physical exercise.ConclusionWe found important differences in terms of anthropometric, gynaecological, reproductive and lifestyle factors. Some of these differences (e.g. higher nulliparity, alcohol consumption, taller size) could contribute to a higher breast cancer risk, whereas others could lead to a reduction (e.g. increased physical exercise, lower BMI, less HRT use).
Highlights
Breast cancer is currently the most frequently diagnosed form of cancer in women in Germany, accounting for 31% of incident cancer cases in 2010 [1]
We found important differences in terms of anthropometric, gynaecological, reproductive and lifestyle factors. Some of these differences could contribute to a higher breast cancer risk, whereas others could lead to a reduction
Use of oral contraceptives (OC) was widespread among cabin crew; 96% of respondents indicated that they had ever used OC, for an average duration of 11.1 years, which is 2.0 years longer than the population average
Summary
Breast cancer is currently the most frequently diagnosed form of cancer in women in Germany, accounting for 31% of incident cancer cases in 2010 [1]. A significant increase of breast cancer incidence among female flight attendants has been found in several countries, as shown by studies from Finland, Denmark, Iceland and the USA [2,3,4,5,6]. An Icelandic study indicates that occupational factors may be an important cause of breast cancer among cabin attendants [13]. No association between occupational factors and breast cancer, has been found by studies from Sweden and Finland [7,14] In these studies the increased incidence was explained by risk factors that can be found in the general population. Many epidemiological studies point to an increased risk of breast cancer among female airline cabin crew. Possible causes include occupational factors (e.g. cosmic radiation exposure, chronodisruption), as well as lifestyle and reproductive factors
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