Abstract
BackgroundFew studies have examined the broad health effects of occupational exposures in flight attendants apart from disease-specific morbidity and mortality studies. We describe the health status of flight attendants and compare it to the U.S. population. In addition, we explore whether the prevalence of major health conditions in flight attendants is associated with length of exposure to the aircraft environment using job tenure as a proxy.MethodsWe surveyed flight attendants from two domestic U.S. airlines in 2007 and compared the prevalence of their health conditions to contemporaneous cohorts in the National Health and Nutrition Survey (NHANES), 2005-2006 and 2007-2008. We weighted the prevalence of flight attendant conditions to match the age distribution in the NHANES and compared the two populations stratified by gender using the Standardized Prevalence Ratio (SPR). For leading health conditions in flight attendants, we analyzed the association between job tenure and health outcomes in logistic regression models.ResultsCompared to the NHANES population (n =5,713), flight attendants (n = 4,011) had about a 3-fold increase in the age-adjusted prevalence of chronic bronchitis despite considerably lower levels of smoking. In addition, the prevalence of cardiac disease in female flight attendants was 3.5 times greater than the general population while their prevalence of hypertension and being overweight was significantly lower. Flight attendants reported 2 to 5.7 times more sleep disorders, depression, and fatigue, than the general population. Female flight attendants reported 34% more reproductive cancers. Health conditions that increased with longer job tenure as a flight attendant were chronic bronchitis, heart disease in females, skin cancer, hearing loss, depression and anxiety, even after adjusting for age, gender, body mass index (BMI), education, and smoking.ConclusionsThis study found higher rates of specific diseases in flight attendants than the general population. Longer tenure appears to explain some of the higher disease prevalence. Conclusions are limited by the cross-sectional design and recall bias. Further study is needed to determine the source of risk and to elucidate specific exposure-disease relationships over time.
Highlights
Few studies have examined the broad health effects of occupational exposures in flight attendants apart from disease-specific morbidity and mortality studies
We found that, compared to the general population, flight attendants have an increased prevalence of a number of conditions, and some of the leading diagnoses are associated with longer job tenure, even after adjusting for other risk factors, such as age, smoking, education, and Body Mass Index [body mass index (BMI)]
This study has identified several significant health conditions in flight attendants compared to the general population and raises the important issue about what can be done to minimize risk
Summary
Few studies have examined the broad health effects of occupational exposures in flight attendants apart from disease-specific morbidity and mortality studies. We explore whether the prevalence of major health conditions in flight attendants is associated with length of exposure to the aircraft environment using job tenure as a proxy. Flight attendants are older and more diverse than in the past, and the job has changed dramatically [2,3]. Flight attendants exposed to tobacco smoke in the cabin were found to have higher rates of respiratory disease, only a few studies have followed respiratory outcomes much beyond the early years of the smoking ban, over a decade old [21,22,23,24,25,26]. There are no recent studies that profile the scope and severity of health conditions of flight attendants beyond a few survey studies limited by either nonrandom selection or low participation [9,21,27,28,29,30]
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