Although it's been long known that flight attendants are at higher risk of breast cancer and melanoma, new research has found an increase risk in the following additional cancers:

• non-melanoma (basal cell and squamous cell)
• thyroid
• cervical
• uterine
• gastrointestinal

Researchers from Harvard T. H. Chan School of Public Health, led by research associate, Irina Mordukhovich, surveyed over 5000 flight attendants as part of the Harvard Flight Attendant Health Study (FAHS) and found a four-fold risk in non-melanoma skin cancer, a two-fold risk in melanoma, and a 51% greater risk of breast cancer, among other malignancy risks.

Those flight attendants with three or more children had even a higher risk of breast cancer.

TIME Magazine reported the following:

“Flight attendants are considered a historically understudied occupational group, so there is a lot we don’t know about their health,” says Mordukhovich. “What we do know for sure is the exposures that both pilots and flight attendants have—the main one being high radiation levels because of cosmic radiation at altitude.” That exposure may not be concerning for people taking individual flights, but for people whose jobs involve flying, that risk may have a negative effect on their health, as the study results suggest.

A 2007 study found an increase risk of heart attacks, respiratory illness, poor sleep, depression and anxiety in cabin crew.

What’s surprising is the average flight attendant does not smoke and maintains a healthy weight, hence thought to live a healthier lifestyle, decreasing heart and cancer risk.  So….

Why are flight attendants at increased risk?

Multiple factors can affect those who work high in the skies. These include:

• cosmic ionizing radiation (radiation coming from outer space with higher levels in the upper earth’s atmosphere)
• solar radiation from sun flares
• disruption of their sleep cycle, circadian rhythm (long linked to cancer)
• exposure to chemicals such as jet fuel, flame retardants and other chemicals.
• constant exposure to pathogens and communicable diseases (link to cancer not yet determined)
• not being able to maintain regular hydration and diet

How can flight attendants protect themselves?

It’s difficult for those who staff airlines to alter their schedule, diet or uniform.  But what’s recommended is the following:

• wear sunscreen
• wear long sleeves and skirts/pants
• maintain good hydration and a regular diet
• try to ask for regular shifts that allow one to sleep regular cycles
• if at higher genetic risk for some cancers (BRCA1 and BRCA2 gene mutations) see your medical provider about recommended screening.

The CDC recommends the following:

• Try to reduce your time working on very long flights, flights at high latitudes, or flights which fly over the poles. These are flight conditions or locations that tend to increase the amount of cosmic radiation the crewmembers are exposed to. You can calculate your usual cosmic radiation exposures. The FAA’s CARI program website allows you to enter information to estimate your effective dose from galactic cosmic radiation (not solar particle events) for a flight.

• If you are pregnant or planning a pregnancy, it is important to consider your work exposures, including cosmic radiation. If you are pregnant and aware of an ongoing solar particle event when you are scheduled to fly you may want to consider trip-trading or other rescheduling actions if possible.

• For flight attendants, a NIOSH study found that exposure to 0.36 mSv or more of cosmic radiation in the first trimester may be linked to increased risk of miscarriage.

• Also, although flying through a solar particle event doesn’t happen often, a NIOSH and NASA study found that a pregnant flight attendant who flies through a solar particle event can receive more radiation than is recommended during pregnancy by national and international agencies.

• Regarding solar particle events:

• NIOSH has estimated that pilots fly through about 6 solar particle events in an average 28-year career.

• Avoiding exposure to solar particle events is difficult because they often happen with little warning. You can find out whether a solar particle event is currently active through these sources:

• The National Aeronautics and Space Administration (NASA) Nowcast of Atmospheric Ionizing Radiation System (NAIRAS) is being developed to report potentially harmful flight radiation levels to flight crews and passengers.

• NAIRAS: current radiation dose rate forecast.

• A space weather app for the iPhone offers current information on solar activity

• The National Oceanic and Atmospheric Administration (NOAA) Space Weather Prediction Center’s Aviation Community Dashboard includes a forecast for solar particle events.

Are travelers at risk?

Experts have suggested that those who are frequent fliers are still at low risk of being exposed to “too much radiation”.  Traveller.au.com writes: Overall, the amount “is really inconsequential,” said Dr. Edward Dauer, director of radiology at Florida Medical Center in Fort Lauderdale, adding that medical CT scans result in a much higher dose.

Read more:

Flight risk: how much radiation do planes expose you to?

Therefore medical professionals may suggest flying “in moderation” and checking in for regular check ups.

How can I check my radiation dose?

The American Nuclear Society provides a calculator, based on where one lives, how many x-rays, and how many hours one flies, here.

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Daliah Wachs is a guest contributor to GCN news. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.