Mortality from cancer and other causes among male airline cockpit crew in Europe

Abstract

Airline pilots and flight engineers are exposed to ionizing radiation of cosmic origin and other occupational and lifestyle factors that may influence their health status and mortality. In a cohort study in 9 European countries we studied the mortality of this occupational group. Cockpit crew cohorts were identified and followed-up in Denmark, Finland, Germany, Great Britain, Greece, Iceland, Italy, Norway and Sweden, including a total of 28,000 persons. Observed and expected deaths for the period 1960 -97 were compared based on national mortality rates. The influence of period and duration of employment was analyzed in stratified and Poisson regression analyses. The study comprised 547,564 person-years at risk, and 2,244 deaths were recorded in male cockpit crew (standardized mortality ratio [SMR] ‫؍‬ 0.64, 95% confidence interval [CI] ‫؍‬ 0.61-0.67). Overall cancer mortality was decreased (SMR ‫؍‬ 0.68; 95% CI ‫؍‬ 0.63-0.74). We found an increased mortality from malignant melanoma (SMR ‫؍‬ 1.78, 95% CI ‫؍‬ 1.15-2.67) and a reduced mortality from lung cancer (SMR ‫؍‬ 0.53, 95% CI ‫؍‬ 0.44 -0.62). No consistent association between employment period or duration and cancer mortality was observed. A low cardiovascular mortality and an increased mortality caused by aviation accidents were noted. Our study shows that cockpit crew have a low overall mortality. The results are consistent with previous reports of an increased risk of malignant melanoma in airline pilots. Occupational risk factors apart from aircraft accidents seem to be of limited influence with regard to the mortality of cockpit crew in Europe.

Malignancies Associated with Radiation in Aerospace Personnel-A Review of Evidence and Studies

“…pilots and flight engineers) from 9 European countries showed that there was increased mortality from malignant melanoma [12]. These results were consistent at least up to the time of publication, with findings that malignant skin melanoma did occur in pilots, owing to the effects of radiation exposure.…”

Low mortality and myocardial infarction incidence among flying personnel during working career and beyond

“…Several studies have reported a lower-than-expected cardiovascular mortality among flying personnel compared to the general population (1)(2)(3)(4)(5)(6)(7)(8)(9). This has many possible explanations including individual as well as occupation-related factors.…”

Cosmic radiation in commercial aviation

“…Both the Blettner et al paper (8), which looked at 28,000 flight deck crew with 547,564 person years at risk, and the Pukkala et al paper (39), comprising 177,000 person years at risk from 10,211 pilots, concluded that occupational risk factors were of limited influence on the findings. There was consistency though in the mortality study showing an excess of malignant melanoma.…”

“…In Europe two large mortality cohort studies, one amongst flight deck crew (8) and one amongst cabin crew (56), together with a large cancer incidence study amongst Nordic pilots (39) have been recently published. They are based on data from many of the individual studies in the literature but contain additional data, providing increased statistical power in looking at small excesses, allow measures of consistency between studies to be determined, and provide the basis for dose-response assessments.…”