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TUESDAY, June 26, 2018 (HealthDay News) – Flight attendants can face higher risks than average breast and skin cancer, a new study concludes – although the reasons are not yet clear.
Harvard researchers found that, compared to women in the general population of the United States, air hostesses had a 51 percent higher rate of breast cancer. Meanwhile, their melanoma and non-melanoma skin cancer rates were approximately two to four times higher, respectively.
The study, which included more than 5,300 US flight attendants, is not the first to detect increased cancer risks among airline crews.
According to Eileen McNeely, senior researcher, she is one of the most important and comprehensive on the subject.
What is still not clear, that is why the pattern is seen. And because this is what is called an observational study, it can not prove the cause and the effect.
According to McNeely, an environmental health instructor at the Harvard School of Public Health, flight crews have a number of shows likely to play a role.
"There has been a lot of speculation about exposure to cosmic ionizing radiation," she said.
This refers to the radiation coming from the space. At flying altitudes, people are exposed to higher levels. The US National Institute for Occupational Safety and Health (NIOSH) reports that among all US workers exposed to radiation, crews have the highest average levels.
But no one knows for sure if cosmic radiation is to blame for the higher risks of cancer flight attendants, McNeely said.
Crews can also come in contact with a number of chemicals, she noted. And before smoking bans came into effect, they usually breathed second-hand smoke.
In addition, said McNeely, flight crews face constant time zone changes and irregular sleep schedules – which means many disruptions to the body's circadian rhythm, or "internal clock".
Circadian disruptions of shift work have been linked to increased risks of obesity and diseases such as diabetes and heart disease.
"It's hard to determine which of these factors could be more important than others, or whether it's a combination of all of these factors," McNeely said.
However, it is also possible that there are factors unrelated to flight attendant jobs, said Dr. Paolo Boffetta, professor of oncology and environmental medicine at the medical school. Icahn of Mount Sinai, New York.
"For example, they may have more UV [sun] exposure because of their opportunity to travel, "said Boffetta, who was not involved in the study.
In addition, he added, women who are crew members may not have children or have fewer children compared to other women. And reproductive factors like this are associated with the risk of breast cancer.
Yet, McNeely said, his team found evidence that the more flight attendants had been at work, the higher their risk of cancer. In women, the risk of melanoma-free skin cancer has increased along with occupational seniority.
This supports the theory that occupational exposures are the culprits, McNeely said.
The results, published on June 25 in the journal Environmental health, are based on 5,366 flight attendants who were part of an ongoing Harvard study started in 2007.
They were asked about their health in 2014-2015, when they were on average 52 years old. The McNeely team compared cancer rates with a nationally representative sample of 2,729 adults with similar demographic characteristics.
Overall, 3.4% of women were diagnosed with breast cancer compared to 2.3% of other US women. Meanwhile, 2.2% had been diagnosed with melanoma, compared to just under 1% of other women.
The biggest difference was observed in non-melanoma skin cancer rates – which are highly curable. More than 7% of flight attendants were diagnosed with cancer, compared to just under 2% of other women.
Male flight attendants had higher rates of skin cancer than other men. But the differences were not significant in statistical terms.
According to McNeely, the conclusions will be "not news" for crews. They have long known that their profession could be linked to increased cancer risk.
The question is, if the causes are unclear, what can be done? McNeely noted that the European Union has already taken action – requiring air crews to be monitored for radiation exposure. If she reaches a certain level, their work schedules are adjusted.
According to NIOSH, there is no official radiation limit for US crews.
Boffetta said that for whatever reason, the higher rates of skin and breast cancer among flight attendants point to one important point: they should be screened for cancer.
The potential risks to flight crews raise another question: what about frequent flyers?
McNeely said that it's not clear if they are facing health risks. "We study workers first because they are the most exposed," she said. "They are like the canary in the coal mine."
More information
US Centers for Disease Control and Prevention have increased reliance on air travel.
SOURCES: Eileen McNeely, Ph.D., instructor and co-director, SHINE Initiative, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston; Paolo Boffetta, M.D., M.P.H., Professor, Medicine, Hematology and Medical Oncology, and Environmental Medicine and Public Health, Icahn School of Medicine, Mount Sinai, New York; June 25, 2018, Environmental Health, online
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