Compared to the general public, flight attendants have a much higher prevalence of many forms of cancer, according to recently published Harvard University research.
 
Between 2007 and 2015, researchers asked more than 5,000 U.S.-based flight attendants if they had ever been diagnosed with cancer. Researchers also asked more than 2,700 other adults with similar socioeconomic backgrounds if they’d been diagnosed.
 
The results published in the journal Environmental Health found flight attendants were 50 per cent more likely to develop breast cancer than adults in the general population. They were also twice as likely to develop melanoma and four times as likely to be diagnosed with other forms of skin cancer. In fact, every cancer examined, including uterine, cervical, gastrointestinal and thyroid, showed excess prevalence.
 
“Our findings of higher rates of several cancers among flight attendants is striking given the low rates of overweight and smoking in our study population, which highlights the question of what can be done to minimize the adverse exposures and cancers common among cabin crew,” said Irina Mordukhovich, study author and research fellow at Harvard University’s TH Chan School of Public Health.  

Potential causal factors

Though researchers did not seek to identify why flight attendants suffer higher cancer rates, they did point out they are “consistently exposed to several known and probable carcinogens in the cabin environment.”
 
This includes cosmic ionizing radiation. Researchers note cabin crews are exposed to the largest average annual effective dose relative to all other U.S. radiation workers. They also note this exposure can easily exceed guidelines established by the National Council on Radiation Protection and the International Commission on Radiological Protection.
 
Circadian rhythm disruption caused by work at night and poor sleeping patterns is another recognized carcinogen commonly experienced by flight attendants. They can also be exposed to cancer-causing chemicals in the cabin environment such as flame retardants, pesticides and second-hand smoke (for those exposed prior to 1988).
 
The timing of exposures may also be a factor. Although the researchers admit more investigation is required, they did find “somewhat stronger” associations for breast cancer in women working as flight attendants prior to age 45.  This finding is consistent with other cancer research, including a study of American nurses published in 2017 which found nurses exposed to shift work as young adults had a two-fold risk of developing breast cancer.  

Pursuing prevention

The researchers believe the findings support the need for more preventive actions to reduce the risk of cancer among flight attendants, such as monitoring radiation doses and organizing schedules to minimize radiation exposure and circadian rhythm disruption. They point out the European Union has already put in place criteria to manage cosmic radiation exposure.
 
Under Part II of the Canada Labour Code, employers, including Canadian air operators, are responsible for the health and safety of their workers. As a measure to help fulfill this obligation, Transport Canada recommends they develop a program to manage the cosmic radiation exposure. In fact, Transport Canada notes, “It is desirable that Canadian criteria correspond as closely as possible to those criteria accepted by the international community.”
 
According to Transport Canada, the manner in which this information is presented to workers should be agreed upon by the workplace health and safety committee.  

WHSC training and resources

Specific to the issue of shift work, irregular work schedules and circadian rhythm disruption, Workers Health & Safety Centre offers hours of work training along with fact sheets exploring hazards associated with work hours and shift work. These resources are designed to help workplace parties play a more informed role in seeking prevention solutions to these known hazards.
 
To learn more:
Visit:    www.whsc.on.ca 
Email:  contactus@whsc.on.ca
Call:     1-888-869-7950 and ask to speak to a training services representative.