Breast Cancer Incidence in California Flight Attendants

Institution: Public Health Institute
Investigator(s): Peggy Reynolds, Ph.D. -
Award Cycle: 1997 (Cycle III) Grant #: 3IB-0049 Award: $56,922
Award Type: IDEA
Research Priorities
Etiology and Prevention>Etiology: the role of environment and lifestyle



Initial Award Abstract (1997)
Health problems faced by flight personnel have been of concern to workforce members for some time, but have been little studied by the scientific community. Particular concerns include increased exposures to radiation and ozone, exposures to hazardous components of jet exhaust and time zone and schedule changes. These exposures are consistent with both well-established and suspected risk factors for breast cancer, a disease demonstrated in one small European study to occur nearly twice as often among flight personnel as would be expected in the general population. California-based flight personnel are of particular potential interest in this regard, as they represent a mix of both major domestic and international carrier activities.

This proposal seeks to take advantage of the opportunity to link a large well-defined cohort of flight attendants with the state-of-the-art population-based statewide cancer reporting system maintained by the California Cancer Registry to see if the same risk relationship is evident. This preliminary effort will represent the largest such study to date. If risk associations for breast cancer, or other radiation-associated cancers, appear to be high in this preliminary study of flight attendants, it can serve as the basis for more in depth studies of cancer risk factors in flight personnel.


Final Report (1999)
Unusual exposure opportunities to flight crews from chemicals, cosmic radiation and electric and magnetic fields have made them the subject of considerable interest for certain health outcomes. To date, however, few studies have evaluated the cancer experience of people in these occupations. This project, a collaboration between the California Department of Health Services' environmental and occupational health programs and the Association of Flight Attendants (AFA), was designed to provide an initial evaluation of the incidence of cancers of the breast and other sites among California AFA members. With an average annual membership of nearly 6000 Californians during the study period, it is the largest such study of cabin crews to date.

AFA membership files were matched to California's statewide cancer registry to identify cancer diagnoses between 1988-1995. During this time a total of 175 newly diagnosed cancers occurred among AFA members with California residential histories: 149 among women and 26 among men. Of the total, 129 were invasive cancers and 46 were in situ. The two most common invasive cancer types in this group, female breast cancer (60 cases) and malignant melanoma of the skin (15 cases), also occurred substantially more frequently among flight attendants than would be expected from the general population. Breast cancer incidence was over 30% higher than expected, and melanoma incidence was roughly twice that expected. The observed elevations are not likely to be due to screening, as cohort members did not present at earlier stages of disease compared to the general population. Both of these are cancers that are associated with higher socioeconomic status and have been suggestively associated with various sources of radiation. Consistent with the results from a much smaller European study of cabin crews, these data suggest that follow-up investigations should focus on the potential relative contribution of workplace exposures and lifestyle characteristics to the higher rates of disease for these two cancers.

Cancer incidence in California flight attendants (United States)
Periodical:Cancer Causes Control
Index Medicus: Cancer Causes Contol
Authors: Peggy Reynolds, James Cone , Michael Layefsky, Debbie E. Goldberg, & Susan Hurley.
Yr: 2002 Vol: 13 Nbr: 4 Abs: Pg:317-24