The self-reported health of U.S. flight attendants compared to the general population
Open accessAbstract
BACKGROUND: Few studies have examined the broad health effects of occupational exposures in flight attendants apart from disease-specific morbidity and mortality studies. We describe the health status of flight attendants and compare it to the U.S. population. In addition, we explore whether the prevalence of major health conditions in flight attendants is associated with length of exposure to the aircraft environment using job tenure as a proxy. METHODS: We surveyed flight attendants from two domestic U.S. airlines in 2007 and compared the prevalence of their health conditions to contemporaneous cohorts in the National Health and Nutrition Survey (NHANES), 2005-2006 and 2007-2008. We weighted the prevalence of flight attendant conditions to match the age distribution in the NHANES and compared the two populations stratified by gender using the Standardized Prevalence Ratio (SPR). For leading health conditions in flight attendants, we analyzed the association between job tenure and health outcomes in logistic regression models. RESULTS: Compared to the NHANES population (n =5,713), flight attendants (n = 4,011) had about a 3-fold increase in the age-adjusted prevalence of chronic bronchitis despite considerably lower levels of smoking. In addition, the prevalence of cardiac disease in female flight attendants was 3.5 times greater than the general population while their prevalence of hypertension and being overweight was significantly lower. Flight attendants reported 2 to 5.7 times more sleep disorders, depression, and fatigue, than the general population. Female flight attendants reported 34% more reproductive cancers. Health conditions that increased with longer job tenure as a flight attendant were chronic bronchitis, heart disease in females, skin cancer, hearing loss, depression and anxiety, even after adjusting for age, gender, body mass index (BMI), education, and smoking. CONCLUSIONS: This study found higher rates of specific diseases in flight attendants than the general population. Longer tenure appears to explain some of the higher disease prevalence. Conclusions are limited by the cross-sectional design and recall bias. Further study is needed to determine the source of risk and to elucidate specific exposure-disease relationships over time.
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A survey of ~4,000 flight attendants found that, compared with the general population, flight attendants are 2-5.7-fold more likely to have sleep disorders, depression, anxiety and/or fatigue.
“A survey of ~4,000 flight attendants as part of the US National Health and Nutrition Survey (NHANES) found that, compared with the general population, flight attendants are 2–5.7-fold more likely to have sleep disorders, depression, anxiety and/or fatigue230.”
From Rhythms of life: circadian disruption and brain disorders across the lifespan (2019) · cites this paper as [230]
Female flight attendants have a higher prevalence of reproductive cancers, skin cancers and other conditions such as chronic bronchitis and heart disease.
“Female flight attendants also have a higher prevalence of reproductive cancers, skin cancers and other conditions such as chronic bronchitis and heart disease230,231”
From Rhythms of life: circadian disruption and brain disorders across the lifespan (2019) · cites this paper as [230]
There are increased rates of cardiac disease, depression and anxiety, sleep disturbances, skin and reproductive cancers, and hearing loss in this population.
“There are also increased rates of cardiac disease, depression and anxiety (Pinkerton et al., 2012), sleep disturbances, skin and reproductive cancers and hearing loss (Czura, 2005; McNeely et al., 2014).”
From Effectiveness of a Novel Qigong Meditative Movement Practice for Impaired Health in Flight Attendants Exposed to Second-Hand Cigarette Smoke (2017) · cites this paper as McNeely et al., 2014
Recent studies demonstrate significant rates of abnormal pulmonary function in this population, including air trapping, reduced flow at mid-volume, reduced exercise tolerance, and elevated rates of chronic bronchitis and sinusitis.
“Recent studies (Whelan et al., 2003; Arjomandi et al., 2009, 2012; McNeely et al., 2014) demonstrate significant rates of abnormal pulmonary function in this population: air trapping, reduced flow at mid-volume, reduced exercise tolerance, and significantly elevated rates of chronic bronchitis and sinusitis.”
From Effectiveness of a Novel Qigong Meditative Movement Practice for Impaired Health in Flight Attendants Exposed to Second-Hand Cigarette Smoke (2017) · cites this paper as McNeely et al., 2014
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References 47 · Cited by 104
- Authors
- McNeely, E., Gale, S., Tager, I., Kincl, L., Bradley, J., Coull, B., & Hecker, S.
- Affiliations
- Harvard University (US)
- University of California, Berkeley (US)
- Oregon State University (US)
- University of Oregon (US)
- Corresponding author
- McNeely, Eileen
- Venue
- Environmental Health
- Published
- 2014-03-10
- Volume
- 13
- Issue
- 1
- Pages
- 13-13
- ISSN
- 1476-069X (ISSN-L)
- PMC
- PMC4007523
- OpenAlex
- W2129520824
- Cited by
- 104
- References
- 47
- Citations by year
- 2026: 8 · 2025: 3 · 2024: 17 · 2023: 8 · 2022: 15 · 2021: 6 · 2020: 10 · 2019: 5 · 2018: 11 · 2017: 7 · 2016: 7 · 2015: 6 · 2014: 1
- FWCI
- 21.80
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Environmental Health (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- Funders
- National Institute of Environmental Health Sciences (P30ES000002)
- Topics
- Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Performance
- Health Sciences › Health Professions › General Health Professions › Workplace Health and Well-being
- Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Safety in Workplaces
- Keywords
- flight attendants, occupational health, aircraft cabin environment, chronic bronchitis, cardiovascular disease, hypertension, sleep disorders, depression, fatigue, reproductive cancers, skin cancer, hearing loss, job tenure, exposure duration, sex differences
- MeSH terms
- Adolescent, Adult, Aerospace Medicine, Anxiety, Bronchitis, Depression, Female, Health Status, Health Surveys, Heart Diseases, Humans, Male, Middle Aged, Nutrition Surveys, Occupational Diseases, Skin Neoplasms, Sleep Wake Disorders, United States, Prevalence, Hearing Loss, Young Adult, Self Report
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