Pilots and flight attendants have highest mortality from radiation-linked cancers, study shows

A study published in JAMA Internal Medicine examined over 12 million U.S. death certificates that listed occupations and cause of death. Researchers identified deaths from 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, flight attendants had the highest proportion of radiation-related cancer deaths, with pilots ranking second.

The analysis showed flight attendants had about a 50 % higher odds of dying from a radiation-related cancer compared with the general working population, while pilots had roughly a 36 % increase. In absolute terms, 6.9 % of flight-attendant deaths and 6.7 % of pilot deaths were attributed to these cancers, versus 5 % for other workers.

"You can't manage an exposure you've decided not to measure," said Dr. Vishal Patel, the study's lead author, in an email response.

"The risk is known, but crew are not educated or informed. And, no one is taking responsibility," said Sara Nelson, president of the Association of Flight Attendants-CWA.

Commentary by radiation experts Catherine Olsen and Ken Karipidis noted that the elevated mortality was specific to radiation-linked cancers, suggesting occupational exposure rather than lifestyle factors as the driver. They recommended regular skin examinations for airline crew and earlier or more frequent mammograms for women in these roles, and urged physicians to maintain a heightened suspicion for cancer in this population.

The Federal Aviation Administration acknowledges that aircrew are exposed to ionizing radiation but does not set federal dose limits or require routine monitoring. The study authors cautioned that individual exposure levels were not measured and that occupational misclassification on death certificates could affect results.