title: Prevalence of risk factors for breast cancer in German airline cabin crew: a cross-sectional study.
abstract: BACKGROUND
  Many epidemiological studies point to an increased risk of breast cancer among female airline cabin crew. Possible causes include occupational factors (e.g. cosmic radiation exposure, chronodisruption), as well as lifestyle and reproductive factors.
  
  
  OBJECTIVE
  To investigate the frequency of various risk factors in German flight attendants which are recognised to be associated with breast cancer.
  
  
  METHODS
  2708 current and former female cabin crew were randomly selected by a flight attendants' union and mailed a questionnaire; 1311 responded (48% response). Descriptive statistics were used to compare the distribution of breast cancer risk factors with general German population data.
  
  
  RESULTS
  On average, cabin crew were 3.0 cm (95% CI 2.7-3.3) taller than the comparison group, while their body mass index was 2.5 kg/m(2) (95% CI 2.4-2.6) lower. We found less use of hormone replacement therapy, but longer average use of oral contraceptives. Nulliparity among respondents aged 45+ was 57% (95% CI 54%-60%) compared to 16%. Average age at first birth was 32.1 years (95% CI 31.7-32.4) vs. 25.5 years. The birth rate was 0.62 (95% CI 0.58-0.67), less than half the population average of 1.34. Alcohol consumption was considerably higher, whereas cabin crew tended to smoke less and performed more physical exercise.
  
  
  CONCLUSIONS
  We found important differences in terms of anthropometric, gynaecological, reproductive and lifestyle factors. Some of these differences (e.g. higher nulliparity, alcohol consumption, taller size) could contribute to a higher breast cancer risk, whereas others could lead to a reduction (e.g. increased physical exercise, lower BMI, less HRT use).
authors: Institute for Medical Statistics, Epidemiology and Informatics, University Medical Center, Johannes Gutenberg University Mainz, Obere Zahlbacher Straße 69, 55131 Mainz, Germany.
authors: Mareen
authors: M
authors: Winter
authors: Institute for Medical Statistics, Epidemiology and Informatics, University Medical Center, Johannes Gutenberg University Mainz, Obere Zahlbacher Straße 69, 55131 Mainz, Germany.
authors: Maria
authors: M
authors: Blettner
authors: Leibniz Institute for Prevention Research and Epidemiology-BIPS, Dep. of Prevention and Evaluation, Achterstr. 30, 28359 Bremen, Germany ; Health Sciences Bremen, University of Bremen, Germany, Bibliothekstr 1, 28359 Bremen, Germany.
authors: Hajo
authors: H
authors: Zeeb
keywords: Breast cancer; Cabin crew; Flight attendants; Germany