Flight Attendants and Pilots Face Highest Mortality from Radiation-Linked Cancers, Study Finds

A new study published in JAMA Internal Medicine reveals that flight attendants and pilots are at the greatest risk of dying from radiation-related cancers compared to workers in other occupations, including those handling radioactive materials.

Cosmic radiation, originating from space, is minimal at the Earth’s surface but intensifies at high altitudes. While previous small studies hinted at increased cancer mortality among frequent flyers, particularly flight crews, this latest research provides substantial evidence. “This study brings important new evidence to bear on this question,” noted two Australian radiation experts in an accompanying commentary.

The research analyzed over 12 million death certificates with occupational data, focusing on cancers linked to radiation exposure, such as leukemia, lymphoma, multiple myeloma, and cancers of the skin, breast, thyroid, prostate, and central nervous system.

Among more than 500 occupations examined, flight attendants had the highest proportion of deaths from radiation-related cancers, followed by pilots. Both groups showed significantly elevated odds for each type of radiation-linked cancer. Notably, neither group exhibited increased mortality from non-radiation-related cancers, supporting the hypothesis that occupational radiation exposure—rather than lifestyle or socioeconomic factors—drives the excess, according to commentary authors Catherine Olsen, PhD, and Ken Karipidis, PhD.

Flight attendants faced approximately 50% higher odds of dying from radiation-related cancers than the general working population, while pilots had about 36% higher odds. In absolute terms, 6.9% of flight attendant deaths and 6.7% of pilot deaths were attributed to these cancers, compared to 5% for the general workforce, reported study first author Vishal Patel, MD, MPH, of Harvard Medical School.

The authors noted limitations, including unknown radiation exposure levels for individuals and potential misclassification of occupations on death certificates. Additionally, they could not account for circadian rhythm disruptions from jet lag and irregular schedules, which may independently elevate cancer risk.

The Federal Aviation Administration acknowledges ionizing radiation exposure for aircrews but does not establish federal dose limits or mandate monitoring. “You can’t manage an exposure you’ve decided not to measure,” Patel emphasized.

Sara Nelson, president of the Association of Flight Attendants-CWA representing 55,000 flight attendants, stated the report underscores the need for serious attention to radiation exposure, a concern the union has raised for years. “The risk is known, but crew are not educated or informed. And, no one is taking responsibility,” Nelson said.

The commentary authors recommend annual skin examinations for high-altitude flight crews and suggest women in these roles consider earlier or more frequent mammograms. Additionally, healthcare providers evaluating pilots and flight attendants should maintain a “heightened index of suspicion” for cancer.

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