PubMed · 992235
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C Montgomery. 1976. Post-mortem on a disaster.. https://pubmed.ncbi.nlm.nih.gov/992235/
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Airline cabin attendants are exposed to several potential occupational hazards, including cosmic radiation. Little is known about the mortality pattern and cancer risk of these persons. The authors conducted a historical cohort study among cabin attendants who had been employed by two German airlines in 1953 or later. Mortality follow-up was completed through December 31, 1997. The authors computed standardized mortality ratios (SMRs) for specific causes of death using German population rates. The effect of duration of employment was evaluated with Poisson regression. The cohort included 16,014 women and 4,537 men (approximately 250,000 person-years of follow-up). Among women, the total number of deaths (n = 141) was lower than expected (SMR = 0.79, 95% confidence interval (CI): 0.67, 0.94). The SMR for all cancers (n = 44) was 0.79 (95% CI: 0.54, 1.17), and the SMR for breast cancer (n = 19) was 1.28 (95% CI: 0.72, 2.20). The SMR did not increase with duration of employment. Among men, 170 deaths were observed (SMR = 1.10, 95% CI: 0.94, 1.28). The SMR for all cancers (n = 21) was 0.71 (95% CI: 0.41, 1.18). The authors found a high number of deaths from acquired immunodeficiency syndrome (SMR = 40; 95% CI: 28.9, 55.8) and from aircraft accidents among the men. In this cohort, ionizing radiation probably contributed less to the small excess in breast cancer mortality than reproductive risk factors. Occupational causes seem not to contribute strongly to the mortality of airline cabin attendants.
Despite its large geographic area, Alaska has only 12,200 miles of public roads, and 90% of the state's communities are not connected to a highway system. Commuter and air-taxi flights are essential for transportation of passengers and delivery of goods, services, and mail to outlying communities (Figure 1). Because of the substantial progress in decreasing fatalities in the fishing and logging industries, aviation crashes are the leading cause of occupational death in Alaska. During 1990-1999, aircraft crashes in Alaska caused 107 deaths among workers classified as civilian pilots. This is equivalent to 410 fatalities per 100,000 pilots each year, approximately five times the death rate for all U.S. pilots and approximately 100 times the death rate for all U.S. workers. As part of a collaborative aviation safety initiative that CDC's National Institute for Occupational Safety and Health (NIOSH) is implementing with the Federal Aviation Administration (FAA), the National Transportation Safety Board (NTSB), and the National Weather Service, CDC analyzed data from NTSB crash reports to determine factors associated with pilot fatalities in work-related aviation crashes in Alaska. This report summarizes the result of this analysis, which found that the following factors were associated with pilot fatalities: crashes involving a post-crash fire, flights in darkness or weather conditions requiring instrument use, crashes occurring away from an airport, and crashes in which the pilot was not using a shoulder restraint. Additional pilot training, improved fuel systems that are less likely to ignite in crashes, and company policies that discourage flying in poor weather conditions might help decrease pilot fatalities. More detailed analyses of crash data, collaborations with aircraft operators to improve safety, and evaluation of new technologies are needed.
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