Cancer incidence among Nordic airline cabin crew

• Published in: International journal of cancer Vol. 131; no. 12; pp. 2886 - 2897
• Main Authors: Pukkala, Eero, Helminen, Mika, Haldorsen, Tor, Hammar, Niklas, Kojo, Katja, Linnersjö, Anette, Rafnsson, Vilhjálmur, Tulinius, Hrafn, Tveten, Ulf, Auvinen, Anssi
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 15-12-2012; Wiley-Blackwell; Wiley Subscription Services, Inc
• Subjects: Airlines; Aviation - manpower; Biological and medical sciences; Cancer; Case-Control Studies; circadian disruptions; Circadian rhythm; Cohort Studies; cohort study; cosmic radiation; Epidemiology; Female; Health risk assessment; Hematologic and hematopoietic diseases; Humans; Incidence; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Male; Medical research; Medical sciences; Medicin och hälsovetenskap; neoplasms; Neoplasms - epidemiology; Occupational diseases; occupational exposure; Radiation; record linkage; registries; Scandinavian and Nordic Countries - epidemiology; Tumors; Sweden; Norway; Atlantic Ocean Islands; Europe; Iceland; Finland; Scandinavian and Nordic Countries; ANE, Atlantic, Iceland; Crew; record linkage; circadian disruptions; Leukemia; cosmic radiation; Malignant hemopathy; Biological rhythm; Case control study; Circadian rhythm; Malignant tumor; registries; Occupational exposure; Epidemiology; Cosmic irradiation; Incidence; Biological clock; Cancerology; Cohort study; neoplasms; Public health; Cancer
• ISSN: 0020-7136; 1097-0215; 1097-0215
• DOI: 10.1002/ijc.27551

Airline cabin crew are occupationally exposed to cosmic radiation and jet lag with potential disruption of circadian rhythms. This study assesses the influence of work‐related factors in cancer incidence of cabin crew members. A cohort of 8,507 female and 1,559 male airline cabin attendants from Finland, Iceland, Norway and Sweden was followed for cancer incidence for a mean follow‐up time of 23.6 years through the national cancer registries. Standardized incidence ratios (SIRs) were defined as ratios of observed and expected numbers of cases. A case‐control study nested in the cohort (excluding Norway) was conducted to assess the relation between the estimated cumulative cosmic radiation dose and cumulative number of flights crossing six time zones (indicator of circadian disruption) and cancer risk. Analysis of breast cancer was adjusted for parity and age at first live birth. Among female cabin crew, a significantly increased incidence was observed for breast cancer [SIR 1.50, 95% confidence interval (95% CI) 1.32–1.69], leukemia (1.89, 95% CI 1.03–3.17) and skin melanoma (1.85, 95% CI 1.41–2.38). Among men, significant excesses in skin melanoma (3.00, 95% CI 1.78–4.74), nonmelanoma skin cancer (2.47, 95% CI 1.18–4.53), Kaposi sarcoma (86.0, 95% CI 41.2–158) and alcohol‐related cancers (combined SIR 3.12, 95% CI 1.95–4.72) were found. This large study with complete follow‐up and comprehensive cancer incidence data shows an increased incidence of several cancers, but according to the case‐control analysis, excesses appear not to be related to the cosmic radiation or circadian disruptions from crossing multiple time zones.