Mortality from cancer and other causes in commercial airline crews: a joint analysis of cohorts from 10 countries

Hammer, GP; Auvinen, A; de Stavola, BL; Grajewski, B; Gundestrup, M; Haldorsen, T; Hammar, N; Lagorio, S; Linnersjo, A; Pinkerton, L; Pukkala, E; Rafnsson, V; Dos-Santos-Silva, I; Storm, HH; Strand, T.-, E; Tzonou, A; Zeeb, H; Blettner, M; (2014) Mortality from cancer and other causes in commercial airline crews: a joint analysis of cohorts from 10 countries. Occupational and environmental medicine, 71 (5). pp. 313-322. ISSN 1351-0711 DOI:

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Background Commercial airline crew is one of the occupational groups with the highest exposures to ionising radiation. Crew members are also exposed to other physical risk factors and subject to potential disruption of circadian rhythms. Methods This study analyses mortality in a pooled cohort of 93771 crew members from 10 countries. The cohort was followed for a mean of 21.7years (2.0 million person-years), during which 5508 deaths occurred. Results The overall mortality was strongly reduced in male cockpit (SMR 0.56) and female cabin crews (SMR 0.73). The mortality from radiation-related cancers was also reduced in male cockpit crew (SMR 0.73), but not in female or male cabin crews (SMR 1.01 and 1.00, respectively). The mortality from female breast cancer (SMR 1.06), leukaemia and brain cancer was similar to that of the general population. The mortality from malignant melanoma was elevated, and significantly so in male cockpit crew (SMR 1.57). The mortality from cardiovascular diseases was strongly reduced (SMR 0.46). On the other hand, the mortality from aircraft accidents was exceedingly high (SMR 33.9), as was that from AIDS in male cabin crew (SMR 14.0). Conclusions This large study with highly complete follow-up shows a reduced overall mortality in male cockpit and female cabin crews, an increased mortality of aircraft accidents and an increased mortality in malignant skin melanoma in cockpit crew. Further analysis after longer follow-up is recommended.

Item Type: Article
Keywords: Accidents, Aviation, mortality, Acquired Immunodeficiency Syndrome, etiology, mortality, Aircraft, Brain Neoplasms, etiology, mortality, Breast Neoplasms, etiology, mortality, Cardiovascular Diseases, etiology, mortality, Cause of Death, Circadian Rhythm, Cohort Studies, Cosmic Radiation, adverse effects, Europe, epidemiology, Female, Humans, Leukemia, etiology, mortality, Male, Melanoma, etiology, mortality, Middle Aged, Neoplasms, etiology, mortality, Neoplasms, Radiation-Induced, etiology, mortality, Occupational Diseases, etiology, mortality, Occupational Exposure, adverse effects, Occupations, Risk Factors, Sex Factors, United States, epidemiology
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Non-Communicable Disease Epidemiology
Faculty of Epidemiology and Population Health > Dept of Medical Statistics
PubMed ID: 24389960
Web of Science ID: 334397500004


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