In a large study of U.S. workers, flight attendants and pilots had the highest proportions of occupational radiation-related cancer deaths, researchers say.
Even nuclear medicine technologists, who are routinely exposed to radiation, had lower mortality rates from these cancers than flight and cabin crews, the researchers reported in JAMA Internal Medicine.
They used the National Vital Statistics System to analyze death certificates collected between 2020 and 2024 from nearly 13 million decedents across 503 occupations, including roughly 14,000 pilots and 7,000 flight attendants.
They looked for deaths due to radiation-related cancers of the breast, central nervous system, blood, thyroid, prostate and skin.
After accounting for individual risk factors, the researchers found that pilots and flight attendants had statistically significantly higher rates of death from breast, central nervous system, and prostate cancers and melanoma.
Pilots also had a higher rate of leukemia deaths.
In all, about 6.9% of deaths among flight attendants and 6.7% of deaths among pilots were from radiation-related cancers, the researchers found.
Flight crew members were not at higher risk for non–radiation-related cancer deaths.
Pilots and flight attendants accrue an estimated 3 to 6 millisieverts per year of cosmic radiation, greatly exceeding the 0.4 millisieverts received by an air traveler taking 10 cross-country round-trip flights per year, according to the report.
While the U.S. Federal Aviation Administration formally recognizes these workers as occupationally exposed to ionizing radiation, they are not subject to federal dose limits or monitoring requirements — unlike other U.S. radiation-exposed workers or aircrew in other countries, the researchers noted.
The findings “…warrant attention from policymakers, regulators, airlines, and the clinicians who care for those who spend their working lives at altitude,” researchers not involved in the study wrote in an editorial.
In the meantime, the editorial advises, doctors should have “a heightened index of suspicion” when evaluating aircrew whose symptoms might be cancer-related.
