title: Mortality among pilots and cabin crew in Greece, 1960-1997.
abstract: BACKGROUND
  Specific health hazards, among them radiation of cosmic origin, have caused some concern among aircrew in civil aviation in recent years. Several cohort studies in Northern countries have investigated mortality and cancer incidence among aircrew. Our goal was to study the pattern of mortality among Greek commercial airline cockpit and cabin crew.
  
  
  METHODS
  We performed a retrospective cohort study including 843 Olympic Airways cockpit crew and 1835 cabin attendants. Standardized mortality ratios (SMR) were calculated based on death rates of the Greek population. Duration of employment as a proxy for occupational exposure was used to stratify the cohort.
  
  
  RESULTS
  For cockpit crew, the overall SMR was 0.7 (n = 65, 95% CI: 0.5-0.9). The SMR for all cancers was also significantly decreased (n = 17; SMR = 0.6; 95% CI: 0.3-0.9). Most of this reduction was due to a large deficit in lung cancer deaths (SMR = 0.1; 95% CI: 0.0-0.5). Slight but non-significant increases were noted for brain and liver cancer. The SMR for cardiovascular death was close to unity. Among female cabin attendants the SMR for all causes was 0.8 (95% CI: 0.4-1.3). The SMR for all cancers was 0.8 (95% CI: 0.3-1.7). Mortality from breast cancer was not increased. Among male cabin crew, SMR for all causes was 0.5 (95% CI: 0.3-0.9). Analyses according to duration of employment showed no pattern.
  
  
  CONCLUSIONS
  In this first-ever occupational cohort study in Greece, Greek aircrew had a low overall and cancer mortality. Due to the small number of events, the strength of our study is limited. The Greek data will be included in a pooled analysis of European studies.
authors.affiliation: Department of Epidemiology, Medical School, University of Athens, 75 M. Asias St, 115 27, Athens, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Paridou
authors.forename: E
authors.initials: E
authors.lastname: Velonakis
authors.forename: I
authors.initials: I
authors.lastname: Langner
authors.forename: H
authors.initials: H
authors.lastname: Zeeb
authors.forename: M
authors.initials: M
authors.lastname: Blettner
authors.forename: A
authors.initials: A
authors.lastname: Tzonou
mesh_terms: D000337:Aerospace Medicine; D000401:Aircraft; D002423:Cause of Death; D015331:Cohort Studies; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D008297:Male; D009784:Occupational Diseases / Q000401:mortality*; D012189:Retrospective Studies; D015996:Survival Rate