Incidence of cancer among Nordic airline pilots over five decades: occupational cohort study.
OBJECTIVE
To assess the incidence of cancer among male airline pilots in the Nordic countries, with special reference to risk related to cosmic radiation.


METHODS
Retrospective cohort study, with follow up of cancer incidence through the national cancer registries.


METHODS
Denmark, Finland, Iceland, Norway, and Sweden.


METHODS
10 032 male airline pilots, with an average follow up of 17 years.


METHODS
Standardised incidence ratios, with expected numbers based on national cancer incidence rates; dose-response analysis using Poisson regression.


RESULTS
466 cases of cancer were diagnosed compared with 456 expected. The only significantly increased standardised incidence ratios were for skin cancer: melanoma 2.3 (95% confidence interval 1.7 to 3.0), non-melanoma 2.1 (1.7 to 2.8), basal cell carcinoma 2.5 (1.9 to 3.2). The relative risk of skin cancers increased with the estimated radiation dose. The relative risk of prostate cancer increased with increasing number of flight hours in long distance aircraft.


CONCLUSIONS
This study does not indicate a marked increase in cancer risk attributable to cosmic radiation, although some influence of cosmic radiation on skin cancer cannot be entirely excluded. The suggestion of an association between number of long distance flights (possibly related to circadian hormonal disturbances) and prostate cancer needs to be confirmed.
Pukkala
Eero
E
Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Liisankatu 21 B, FIN-00170 Helsinki, Finland. eero.pukkala@cancer.fi
Aspholm
Rafael
R
Auvinen
Anssi
A
Eliasch
Harald
H
Gundestrup
Maryanne
M
Haldorsen
Tor
T
Hammar
Niklas
N
Hrafnkelsson
Jón
J
Kyyrönen
Pentti
P
Linnersjö
Anette
A
Rafnsson
Vilhjálmur
V
Storm
Hans
H
Tveten
Ulf
U
D000328:Adult; D000368:Aged; D000401:Aircraft; D003359:Cosmic Radiation / Q000009:adverse effects*; D004812:Epidemiologic Methods; D005387:Finland; D006801:Humans; D007055:Iceland / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009381:Neoplasms, Radiation-Induced / Q000453:epidemiology* / Q000209:etiology; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology; D016273:Occupational Exposure / Q000009:adverse effects; D012537:Scandinavian and Nordic Countries / Q000453:epidemiology