Interplay Between Air Travel, Genome Integrity, and COVID-19 Risk vis-a-vis Flight Crew

Abstract

During air travel, flight crew (flight attendants, pilots) can be exposed to numerous flight-related environmental DNA damaging agents that may be at the root of an excess risk of cancer and other diseases. This already complex mix of exposures is now joined by SARS-CoV-2, the virus that causes COVID-19. The complex exposures experienced during air travel present a challenge to public health research, but also provide an opportunity to consider new strategies for understanding and countering their health effects. In this article, we focus on threats to genomic integrity that occur during air travel and discuss how these threats and our ability to respond to them may influence the risk of SARS-CoV-2 infection and the development of range of severity of the symptoms. We also discuss how the virus itself may lead to compromised genome integrity. We argue that dauntingly complex public health problems, such as the challenge of protecting flight crews from COVID-19, must be met with interdisciplinary research teams that include epidemiologists, engineers, and mechanistic biologists.

COVID-19 seroconversion in the aircrew from Turkey

“…This feature indicates the urgency and importance of preventing social transmission. The COVID-19 pandemic has touched every aspect of human life, affecting the global economy and many sectors, including the aviation industry [ 9 ]. Every year, 4.1 billion people use airlines in the worldwide and only 140 thousand pilots and 120 thousand flight attendants work in the United States [ 15 , 16 ].…”

“…During the flight, the aircrew is exposed to environmental factors that may cause cancer and other diseases by damaging deoxyribonucleic acid (DNA). Exposures such as air pressure change, vibration, prolonged immobility, circadian rhythm disturbances and cosmic ionizing radiation are the leading environmental factors [ 9 , 19 ]. DNA repair plays a central role in immunity, and DNA repair capacity affects severe COVID-19 development.…”

“…DNA repair plays a central role in immunity, and DNA repair capacity affects severe COVID-19 development. Failure to provide social distance in airplanes or time to flight increase the risk of COVID-19 exposure for the aircrew [ 9 ]. It is known that 50% of COVID-19 cases are asymptomatic who increase transmission of viruses.…”

“…COVID-19 has affected all areas of our lives and has had a heavy impact on the aviation industry [ 8 ]. Measures such as personal protective equipment and social distance are taken into an account in air travel to reduce the risk of COVID-19 exposure and spread [ 9 ]. Infection contamination during flights may be caused by direct contact with blood, skin or other body fluids.…”

Cancer risks from cosmic radiation exposure in flight: A review

“…Chemical exposures in the aircraft include jet fuel and engine oil combustion products, ozone, flame retardants, pesticides, and disinfectants ( 1 ). Infectious biological agents pose a significant concern with today's global travel as seen in the recent SARS-CoV-2 pandemic ( 2 , 3 ). In addition to these exposures, aircrew perform physically and psychologically demanding work that includes circadian rhythm disruption due to shift work and crossing time zones as well as potentially stressful interaction with passengers ( 1 , 4 ).…”