Cancer Incidence among Female Flight Attendants: A Meta-Analysis of Published Data

Abstract

Background: Flight attendants are exposed to cosmic ionizing radiation and other potential cancer risk factors, but only recently have epidemiological studies been performed to assess the risk of cancer among these workers. The aim of the present work was to evaluate the incidence of various types of cancer among female cabin attendants by combining cancer incidence estimates reported in published studies.Methods: All follow-up studies reporting standardized incidence ratio (SIR) for cancer among female flight attendants were obtained from online databases and analyzed. A metaanalysis was performed by applying Bayesian hierarchical models, which take into account studies that reported SIR ‫؍‬ 0 and natural heterogeneity of study-specific SIRs.Results: A total of seven published studies reporting SIR for several cancer types were extracted. Meta-analysis showed a significant excess of melanoma (meta-SIR 2.15, 95% posterior interval [PI] 1.56-2.88) and breast carcinoma (meta-SIR 1.40; PI 1.19-1.65) and a slight but not significant excess of cancer incidence across types (meta-SIR 1.11, PI 0.98-1.25).Conclusions: Although further studies are necessary to clarify the exact role of occupational exposure, all airlines should, as some companies do, estimate radiation dose, organize the schedules of crew members in order to reduce further exposure in highly exposed flight attendants, inform crew members about health risks, and give special protection to pregnant women.

Cohort study of cancer risk among male and female shift workers

“…These findings were confirmed in a recent meta-analysis that included both military and civilian pilots (25). Among female flight attendants, seven studies found elevated risks of breast cancer, and six studies reported a higher than expected malignant melanoma risk (20,26). Airline personnel, however, differ from other shift workers both with respect to their occupational exposures to cosmic radiation (21) and their greater opportunity for recreational solar exposure.…”

“…Airline personnel, however, differ from other shift workers both with respect to their occupational exposures to cosmic radiation (21) and their greater opportunity for recreational solar exposure. It is therefore difficult to know which factors are responsible for the observed excess cancer risks in this group of workers (20).…”

“…In a meta-analysis of 13 studies of female breast cancer among night workers (including airline workers), Megdal et al (19) found an aggregate fixed-effects standardized incidence ratio (SIR) of 1.48 [95% incidence ratio (95% CI 1.36-1.61]. Excluding the seven studies of airline workers (who clearly differ from other shift workers because of their potential exposures to ionizing radiation (20,21) ), the aggregate SIR for the remaining six studies of shift workers was 1.51 (95% CI 1.36-1.68). However, the studies included in this metaanalysis have different definitions of exposure or varying exposure duration, and some findings are of borderline statistical significance.…”

Breast cancer incidence among female flight attendants: exposure–response analyses

“…Studies suggest that flight attendants have an increased incidence of breast cancer compared to the general population (1,2). However, the reason is unclear.…”

Malignancies Associated with Radiation in Aerospace Personnel-A Review of Evidence and Studies

“…An example was that conducted by Buja et al [24]. Bayesian hierarchal models were applied to the results of 7 published studies after standardized incidence ratios (SIRs) were estimated.…”