title: Incidence of cancer among female flight attendants: a meta-analysis.
abstract: BACKGROUND
  Airline flight personnel work in a unique environment with exposure to known or suspected carcinogens and mutagens including ionizing cosmic radiation. A meta-analysis was conducted to study whether the occupational exposure of female flight attendants (FA) increased their relative risk of cancer incidence.
  
  
  METHODS
  A bibliographical computer search from 1966 to 2005 of cancer incidence cohort studies of female FA was performed. Combined relative risks (RRc) in cancer incidence were calculated by means of meta-analysis.
  
  
  RESULTS
  RRc and 95% confidence interval (CI) for malignant melanoma and breast cancer in female FA were 2.13 (95% CI: 1.58-2.88) and 1.41 (1.22-1.62) (p < 0.0001). Excess risk was not significant for all-site cancer with RRc of 1.10 (0.99-1.21).
  
  
  CONCLUSIONS
  The meta-analysis confirmed the significantly increased risks for malignant melanoma and breast cancer in female FA. Increased exposure to cosmic radiation during flight has been suggested as a potential occupational risk factor. Ultraviolet radiation exposure on board seems an unlikely occupational risk, but nonoccupational leisure time sun exposure is a possible risk factor. The etiology of the observed increase in incidence of some cancers remains controversial because assessment of possible confounders, especially nonoccupational exposure factors, has thus far been limited.
authors.affiliation: Department of Hygiene, National Defense Medical College, Tokorozawa, Japan. ostokuma@med.oita-u.ac.jp
authors.forename: Osamu
authors.initials: O
authors.lastname: Tokumaru
authors.forename: Kosuke
authors.initials: K
authors.lastname: Haruki
authors.forename: Kira
authors.initials: K
authors.lastname: Bacal
authors.forename: Tomomi
authors.initials: T
authors.lastname: Katagiri
authors.forename: Taisuke
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Sakurai
mesh_terms: D000396:Air Pollutants, Radioactive / Q000032:analysis; D001359:Aviation; D001943:Breast Neoplasms / Q000453:epidemiology; D003359:Cosmic Radiation; D005260:Female; D006801:Humans; D015994:Incidence; D008545:Melanoma / Q000453:epidemiology; D008875:Middle Aged; D009381:Neoplasms, Radiation-Induced / Q000453:epidemiology*; D009784:Occupational Diseases / Q000453:epidemiology*; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D012042:Registries; D012307:Risk Factors; D012878:Skin Neoplasms / Q000453:epidemiology; D016387:Women's Health; D014931:Women, Working / Q000706:statistics & numerical data*; D000078329:Workforce
chemical_list: D000396:Air Pollutants, Radioactive