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Radiation-induced acute myeloid leukaemia and other cancers in commercial jet cockpit crew: a population-based cohort study
Maryanne Gundestrup, Hans H Storm
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Institute of Cancer Epidemiology, Danish Cancer Society, Strandboulevarden 49, DK 2100 Copenhagen (M Gundestrup MD, H H Storm MD) and National Clinic of Aviation Medicine, University Hospital Copenhagen (Rigshospitalet), Copenhagen, Denmark (M Gundestrup)
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Correspondence to: Dr Hans H Storm (e-mail:
[email protected])
Background Cockpit crews receive cosmic radiation during flight operations. The increasing total accumulated dose over the years might be expected to cause increased frequency of radiation-induced cancer. The rate should increase with number of flight hours per year, number of years of flying, and higher flight altitude. If the cumulative radiation exposure during flights is of concern, we would expect an increased cancer risk to be present among those crew members flying jets.
Methods Cockpit-crew medical records (pilots and flight engineers) from 1946 onwards, holding information on the individual, flight hours, aircraft type, and date of commercial certification and decertification, were linked to the population-based Danish Cancer Registry, the central population registry, and the National Death Index.
Findings Altogether 3877 cockpit crew members could be traced for follow-up, accruing 61095 person-years at risk in 3790 men and 661 in 87 women. The total number of cancers observed was 169 whereas 153·1 were expected (standardised incidence ratio 1·1 [95% CI 0·94-1·28]). Significantly increased risks of acute myeloid leukaemia (5·1 [1·03-14·91]), skin cancer, excluding melanoma (3·0 [2·12-4·23]), and total cancer (1·2 [1·00-1·53]) were observed among Danish male jet cockpit crew members flying more than 5000 h. Increased risk of malignant melanoma irrespective of aircraft type was also found among those flying more than 5000 h.
Interpretation Both malignant melanoma and skin cancer were found in excess in cockpit crew members with a long flying history, probably attributable to sun exposure during leisure time at holiday destinations. We cannot confirm previously reported increased risk of brain and rectal cancers in pilots. The study shows that male cockpit crew members in jets flying more than 5000 h have significantly increased frequency of acute myeloid leukaemia.
Lancet 1999; 354: 2029-31
more good news:
Anthony R Mawson
A high rate of breast cancer is present among Finnish female flight attendants after a mean of 13·9 years at work (standard incidence ratio 1·87 [95% CI 1·15!2·23]). The risk is most prominent 15 years after recruitment.1 This increase may be due to melatonin deficiency, resulting from work-associated interruptions in sleep-waking cycles (jetlag). Chronic disturbances in circadian rhythm are thought to lead to many of the health problems reported by shift workers, and because flight attendants commonly work at night and travel across many time zones, they are exposed to chronic interruptions in circadian rhythms.2