Department of Environmental Health, Harvard T.H. Chan School of Public Health, Landmark Center, 401 Park Dr, Boston, MA, 02215, USA.
Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Environ Health. 2018 Jun 26;17(1):49. doi: 10.1186/s12940-018-0396-8.
Flight attendants are an understudied occupational group, despite undergoing a wide range of adverse job-related exposures, including to known carcinogens. In our study, we aimed to characterize the prevalence of cancer diagnoses among U.S. cabin crew relative to the general population.
In 2014-2015, we surveyed participants of the Harvard Flight Attendant Health Study. We compared the prevalence of their self-reported cancer diagnoses to a contemporaneous cohort in the National Health and Nutrition Examination Survey (NHANES 2013-2014) using age-weighted standardized prevalence ratios (SPRs). We also analyzed associations between job tenure and the prevalence of selected cancers, using logistic regression and adjusting for potential confounders.
Compared to NHANES participants with a similar socioeconomic status (n = 2729), flight attendants (n = 5366) had a higher prevalence of every cancer we examined, especially breast cancer, melanoma, and non-melanoma skin cancer among females. SPR for these conditions were 1.51 (95% CI: 1.02, 2.24), 2.27 (95% CI: 1.27, 4.06), and 4.09 (95% CI: 2.70, 6.20), respectively. Job tenure was positively related to non-melanoma skin cancer among females, with borderline associations for melanoma and non-melanoma skin cancers among males. Consistent with previous studies, we observed associations between job tenure and breast cancer among women who had three or more children.
We observed higher rates of specific cancers in flight attendants compared the general population, some of which were related to job tenure. Our results should be interpreted in light of self-reported health information and a cross-sectional study design. Future longitudinal studies should evaluate associations between specific exposures and cancers among cabin crew.
空乘人员是一个研究不足的职业群体，尽管他们经历了广泛的与工作相关的不良暴露，包括已知的致癌物质。在我们的研究中，我们旨在描述美国客舱机组人员与一般人群相比癌症诊断的患病率。
在 2014-2015 年，我们调查了哈佛空乘人员健康研究的参与者。我们使用年龄加权标准化患病率比（SPR），将他们自我报告的癌症诊断患病率与同期国家健康和营养检查调查（NHANES 2013-2014）中的一个队列进行比较。我们还使用逻辑回归分析了工作年限与特定癌症患病率之间的关系，并调整了潜在的混杂因素。
与具有相似社会经济地位的 NHANES 参与者（n=2729）相比，空乘人员（n=5366）患有我们检查的每种癌症的患病率更高，尤其是女性中的乳腺癌、黑色素瘤和非黑色素瘤皮肤癌。这些疾病的 SPR 分别为 1.51（95%CI：1.02，2.24）、2.27（95%CI：1.27，4.06）和 4.09（95%CI：2.70，6.20）。工作年限与女性非黑色素瘤皮肤癌呈正相关，男性黑色素瘤和非黑色素瘤皮肤癌的相关性也存在边界。与以前的研究一致，我们观察到在生育三个或更多孩子的女性中，工作年限与乳腺癌之间存在关联。
与一般人群相比，我们观察到空乘人员中某些特定癌症的发病率较高，其中一些与工作年限有关。我们的研究结果应根据自我报告的健康信息和横断面研究设计进行解释。未来的纵向研究应评估机舱人员中特定暴露与癌症之间的关联。
