Abstract
BackgroundFlight attendants at Alaska Airlines reported health symptoms after the introduction of new uniforms in 2011. The airline replaced the uniforms in 2014 without acknowledging harm. To understand possible uniform-related health effects, we analyzed self-reported health symptoms in crew who participated in the Harvard Flight Attendant Health Study between 2007 and 2015, the period before, during, and after the introduction of new uniforms.MethodsWe calculated a standardized prevalence of respiratory, dermatological and allergic symptoms at baseline, as well as during and after uniform changes in 684 flight attendants with a varying number of surveys completed across each time point. We used Generalized Estimating Equations (GEE) to model the association between symptoms at baseline versus the exposure period after adjusting for age, gender and smoking status and weighting respondents for the likelihood of attrition over the course of the study period.ResultsWe found the following symptom prevalence (per 100) increased after the introduction of new uniforms: multiple chemical sensitivity (10 vs 5), itchy/irritated skin (25 vs 13), rash/hives (23 vs 13), itchy eyes (24 vs 14), blurred vision (14 vs 6), sinus congestion (28 vs 24), ear pain (15 vs 12), sore throat (9 vs 5), cough (17 vs 7), hoarseness/loss of voice (12 vs 3), and shortness of breath (8 vs 3). The odds of several symptoms significantly increased compared to baseline after adjusting for potential confounders.ConclusionThis study found a relationship between health complaints and the introduction of new uniforms in this longitudinal occupational cohort.
Highlights
Flight attendants at Alaska Airlines reported health symptoms after the introduction of new uniforms in 2011
We found significantly increased prevalence of symptoms after the introduction of new uniforms including eye pain/dry eyes/itchy eyes, blurred vision, combined EENT, cough, hoarseness/loss of voice combined lower respiratory, itchy/irritated skin, and rash/hives
The National Safety and Health Administration (NIOSH) conducted a Health Hazard Review (HHE) and found that the uniforms were unlikely to be related to the health complaints because of a lack of scientific evidence for chemical toxicity according to the quantities in the material and because the prevalence rates of dermatitis in the flight attendants were not dissimilar to the general population [5]
Summary
Flight attendants at Alaska Airlines reported health symptoms after the introduction of new uniforms in 2011. According to the employee union health and safety website for the Association of Flight Attendants-CWA, the airline and the manufacturer conducted separate laboratory tests of the materials, testing for tributyl phosphate, but found low quantities that were not expected to cause reactions [2]. The National Safety and Health Administration (NIOSH) conducted a Health Hazard Review (HHE) and found that the uniforms were unlikely to be related to the health complaints because of a lack of scientific evidence for chemical toxicity according to the quantities in the material and because the prevalence rates of dermatitis in the flight attendants were not dissimilar to the general population [5]. Gauging the health consequences of the new uniforms was complicated by limited data about reactions to textile chemicals in the general population and limited data about the onset and scope of reactions in the flight attendant population
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