Review date
19 July 2023
Article publication date
May 2023
Summary
This systematic review examined the physical agents flight crew are exposed to during their work. The review included 35 epidemiological studies (32 cohort, 2 case-control and 1 cross-sectional). The review reported that most of the included studies were of moderate quality, and often had short observation durations which reduce the level of evidence they provide. It found that cosmic radiation, air pressure, noise, and vibrations were the main risk factors for aircrew. The study also investigated hypobaric pressure as a potential risk factor but found knowledge gap in this area. The review reported conflicting results with some research linking cosmic radiation exposure in aircrew to increased cancer incidence and other research reporting no significant difference between cancer cases in aircrew and the general population. The systematic review concluded that long term studies are needed to improve the understanding of potential occupational health risks among aircrews.
Link to
Aircrew Health: A Systematic Review of Physical Agents as Occupational Risk Factors
Published in
International Journal of Environmental Research and Public Health
ARPANSA commentary
The findings of this review are consistent with a previous Australian study (Dusingize et al, 2019) conducted in conjunction with ARPANSA that examined how flying hours of pilots influence the incidence of cancer, particularly melanoma. The study identified cosmic radiation and ultraviolet (UV) radiation as possible risk factors. The Australian study found that the most exposed pilots are at no increased risk of melanoma when comparing pilots who fly the most and those that fly the least. Another review by Scheibler et al (2022) reported that the epidemiological literature provides little consistent evidence that directly links cosmic radiation with cancer in flight crew. This review does go on to say that there is some evidence of an association between cancer and occupational exposure to the flight environment, however, it is difficult to disentangle cosmic radiation exposure from other environmental influences such as circadian rhythm disruption.
The ARPANSA Guide for Radiation Protection in Existing Exposure Situations Radiation Protection Series G-2 provides a framework for managing existing exposure situations, including exposure of aircrew due to cosmic radiation. Similarly, ARPANSA’s Radiation Protection Standard for Occupational Exposure to Ultraviolet Radiation (2006) sets fundamental requirements for safety in relation to occupational UV radiation exposure. Although an elevated risk of skin melanoma among commercial pilots has been indicated by recent epidemiological studies (Olsen et al, 2019), generally, there is no increase in health risk from exposure to cosmic or UV radiation for casual flyers. However, some of the frequent flyers (critical population groups e.g., pregnant women and children) may exceed exposure safety limits for cosmic radiation (Tate et al, 2021), and hence additional awareness or protection may be considered.
