Study Finds Pilots and Flight Attendants Face Higher Radiation-Related Cancer Mortality
Analysis of U.S. death certificates shows pilots and flight attendants have the highest proportions of deaths from cancers linked to ionizing radiation, prompting calls for better occupational exposure monitoring.
A study published in JAMA Internal Medicine examined nearly 13 million U.S. death certificates from 2020-2024 and identified pilots and flight attendants as having the highest percentages of deaths from cancers associated with ionizing radiation, including breast, prostate, central nervous system cancers, melanoma and, for pilots, leukemia. The research covered 503 occupations, with about 14 000 pilots and 7 000 flight attendants represented.
"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.
Dr. Nathan Goodyear of the Williams Cancer Institute said the odds of radiation-related cancer deaths were 50 % higher for flight attendants and 36 % higher for pilots compared with other occupations. He noted that similar risks were not observed among ground-based aviation workers.
Experts cautioned that the findings show association, not causation. Dr. Goodyear highlighted missing data on flight hours, routes, altitude, solar events, sleep disruption, UV exposure, body weight and lifestyle factors, which prevents definitive conclusions about cause and effect. Dr. Brian Honeyman emphasized that cancer mortality, not just incidence, was measured and that regular health screenings and overall healthier profiles of aircrew could complicate the analysis.
Dr. Ayesha Bryant described the results as an occupational health warning, noting that flight attendants were 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 UV-A exposure may also contribute.
The authors and commentators suggested that the study supports enhanced tracking of cumulative radiation exposure for crew members, especially those on long-haul or polar routes, rather than immediate changes to cancer-screening guidelines. Existing FAA dose estimates and CDC information on higher exposure during certain flights were cited as tools for monitoring occupational doses.