Study Finds Pilots and Flight Attendants Face Higher Odds of Radiation-Related Cancer Deaths
Analysis of U.S. death certificates from 2020-2024 shows pilots and flight attendants have the highest proportions of deaths from cancers linked to ionizing radiation among more than 500 occupations.
A study published in JAMA Internal Medicine examined nearly 13 million U.S. death certificates spanning 503 occupations and identified pilots and flight attendants as having the highest percentages of deaths from cancers associated with ionizing radiation, such as breast, prostate, central nervous system cancers, melanoma and, for pilots, leukemia. The research, led by Dr. Vishal Patel of Harvard Medical School, used data from the National Vital Statistics System covering 2020-2024.
"Aircrew members receive the largest mean annual effective dose of ionizing radiation of any occupational group in the US, primarily due to cosmic rays encountered at commercial flight altitudes," the authors wrote.
Co-author Dr. Nathan Goodyear of the Williams Cancer Institute noted that flight crews showed a 50 % higher adjusted odds of radiation-related cancer deaths for flight attendants and a 36 % increase for pilots compared with other occupations. He emphasized that the analysis could not account for variables such as cumulative flight hours, specific radiation dose measurements, flight routes, altitude, solar events, sleep disruption, ultraviolet exposure, body weight or lifestyle factors, limiting causal inference.
"Without the inclusion of these additional variables, we cannot extrapolate association to cause and effect," Goodyear said.
Dr. Brian Honeyman, a hospice and internal medicine physician, cautioned that the study reports mortality rather than incidence and that regular health screenings and overall fitness of aircrew may influence outcomes. He reiterated that while ionizing radiation is a known carcinogen, dose variations based on flight characteristics prevent definitive conclusions about causality.
Physician Ayesha Bryant highlighted the findings as an occupational health signal, indicating that flight attendants are about 1.5 times and pilots about 1.36 times more likely to die from radiation-linked cancers than the general workforce. She added that circadian disruption and ultraviolet-A exposure in cockpits may also contribute, and called for better tracking of cumulative radiation exposure rather than changes to existing cancer-screening guidelines.
Experts suggested that regulators and airlines should consider monitoring cumulative occupational radiation doses, especially for long-haul and polar routes, using existing FAA flight-dose estimates, to inform future protective measures.