Incidence of cancer among female flight attendants: a meta-analysis.
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AbstractBACKGROUND: Airline flight personnel work in a unique environment with exposure to known or suspected carcinogens and mutagens including ionizing cosmic radiation. A meta-analysis was conducted to study whether the occupational exposure of female flight attendants (FA) increased their relative risk of cancer incidence. METHODS: A bibliographical computer search from 1966 to 2005 of cancer incidence cohort studies of female FA was performed. Combined relative risks (RRc) in cancer incidence were calculated by means of meta-analysis. RESULTS: RRc and 95% confidence interval (CI) for malignant melanoma and breast cancer in female FA were 2.13 (95% CI: 1.58-2.88) and 1.41 (1.22-1.62) (p < 0.0001). Excess risk was not significant for all-site cancer with RRc of 1.10 (0.99-1.21). CONCLUSIONS: The meta-analysis confirmed the significantly increased risks for malignant melanoma and breast cancer in female FA. Increased exposure to cosmic radiation during flight has been suggested as a potential occupational risk factor. Ultraviolet radiation exposure on board seems an unlikely occupational risk, but nonoccupational leisure time sun exposure is a possible risk factor. The etiology of the observed increase in incidence of some cancers remains controversial because assessment of possible confounders, especially nonoccupational exposure factors, has thus far been limited.
CitationJ. Travel. Med. 13 (3):127-132
JournalJournal of travel medicine : official publication of the International Society of Travel Medicine and the Asia Pacific Travel Health Association
DescriptionCancer type: malignant melanoma; breast cancerStudy design: cohort study. Study size: 15433 individuals. Description of cohort(s) studied: Only cohort studies of cancer incidence in female commercial airline female flight attendants (FA), which compared each incidence with that of a national or state reference population data [ie, standardized incidence ratio (SIR)], were included.Exposure(s) evaluated: exposure to known or suspected carcinogens and mutagens such as ionizing radiation,ozone, jet engine emissions, electromagnetic fields, and cigarette smokeDose-response: RRc and 95% confidence interval (CI) for malignant melanoma and breast cancer in female FA were 2.13 (95% CI: 1.58-2.88) and 1.41 (1.22-1.62) (p < 0.0001). Excess risk was not significant for all-site cancer with RRc of 1.10 (0.99-1.21). CONCLUSIONS: The meta-analysis confirmed the significantly increased risks for malignant melanoma and breast cancer in female FA. KEYWORD CLASSIFICATION: Air Pollutants;Air Pollutants,Radioactive;analysis;Aviation;Breast Neoplasms;cancer epidemiology;Cosmic Radiation;epidemiology;etiology;Female;Humans;Hygiene;Incidence;Japan;manpower;Melanoma;Meta-Analysis;Middle Aged;Neoplasms,Radiation-Induced;Occupational Diseases;Occupational Exposure;Registries;Risk Factors;Skin Neoplasms;statistics & numerical data;Women's Health;Women,Working;