BMJ 1995;311:649-652 (9 September)

Papers

Incidence of cancer among Finnish airline cabin attendants, 1967-92

Eero Pukkala, researcher,a Anssi Auvinen, senior scientist,b Gunilla Wahlberg, service chief c

a Finnish Cancer Registry, Liisankatu 21 B, FIN-00170 Helsinki, Finland, b Finnish Centre for Radiation Nuclear Safety, PO Box 14, FIN-00881 Helsinki, c Finnish Flight Attendants Association, Rautatielaisenkatu 6, FIN-00520 Helsinki

Correspondence to: Dr Pukkala.

Abstract

Objective: To assess whether occupational exposure among commercial airline cabin attendants are associated with risk of cancer.
Design: Record linkage study.
Setting: Finland.
Subjects: 1577 female and 187 male cabin attendants who had worked for the Finnish airline companies.
Main outcome measure: Standardised incidence ratio; expected number of cases based on national cancer incidences.
Results: A significant excess of breast cancer (standardised incidence ratio 1.87 (95% confidence interval 1.15 to 2.23)) and bone cancer (15.10 (1.82 to 54.40)) was found among female workers. The risk of breast cancer was most prominent 15 years after recruitment. Risks of leukaemia (3.57 (0.43 to 12.9)) and skin melanoma (2.11 (0.43 to 6.15) were not significantly raised. Among men, one lymphoma and one Kaposi's sarcoma were found (expected number of cases 1.6).
Conclusions: Although the lifestyle of cabin attendants is different from that of the reference population--for example, in terms of social status and parity--concentration of the excess risks to primary sites sensitive to radiation suggests that ionising radiation during flights may add to the cancer risk of all flight personnel. Otherwise the lifestyle of cabin attendants did not seem to affect their risks of cancer. Estimates of the effect of reproductive risk factors only partly explained the

Key messages

  • Key messages

  • The radiation dose of cabin attendants has been estimated as 2-3 mSv a year

  • Female cabin attendants had a significant 1.9-fold incidence of breast cancer and a 15-fold incidence of bone cancer compared with the national average

  • The excess of breast cancer can be partly explained by social class and reproductive factors, but even when these factors are taken into account a significant, an almost twofold risk remains in those who have worked for 15 or more years in their profession

  • Observed risk ratios are much higher than would be expected on the basis of present estimates of health hazards due to radiation (based on survivors of the atomic bomb and on people occupationally exposed to (gamma) radiation)


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