Airplane pilot mental health

Environ Health. 2016 Dec 15;15(1):121.

Airplane pilot mental health and suicidal thoughts: a cross-sectional descriptive study via anonymous web-based survey.

Wu ACDonnelly-McLay DWeisskopf MGMcNeely EBetancourt TSAllen JG.

Abstract

BACKGROUND:

The Germanwings Flight 9525 crash has brought the sensitive subject of airline pilot mental health to the forefront in aviation. Globally, 350 million people suffer from depression-a common mental disorder. This study provides further information on this important topic regarding mental health especially among female airline pilots. This is the first study to describe airline pilot mental health-with a focus on depression and suicidal thoughts-outside of the information derived from aircraft accident investigations, regulated healthexaminations, or identifiable self-reports, which are records protected by civil aviation authorities and airline companies.

METHODS:

This is a descriptive cross-sectional study via an anonymous web-based survey administered between April and December 2015. Pilots were recruited from unions, airline companies, and airports via convenience sampling. Data analysis included calculating absolute number and prevalence of health characteristics and depression scores.

RESULTS:

One thousand eight hundred thirty seven (52.7%) of the 3485 surveyed pilots completed the survey, with 1866 (53.5%) completing at least half of the survey. 233 (12.6%) of 1848 airline pilots responding to the Patient Health Questionnaire 9 (PHQ-9), and 193 (13.5%) of 1430 pilots who reported working as an airline pilot in the last seven days at time of survey, met depression threshold-PHQ-9 total score ≥ 10. Seventy-five participants (4.1%) reported having suicidal thoughts within the past two weeks. We found a significant trend in proportions of depression at higher levels of use of sleep-aid medication (trend test z = 6.74, p < 0.001) and among those experiencing sexual harassment (z = 3.18, p = 0.001) or verbal harassment (z = 6.13, p < 0.001).

CONCLUSION:

Hundreds of pilots currently flying are managing depressive symptoms perhaps without the possibility of treatment due to the fear of negative career impacts. This study found 233 (12.6%) airline pilots meeting depression threshold and 75 (4.1%) pilots reporting having suicidal thoughts. Although results have limited generalizability, there are a significant number of active pilots suffering from depressive symptoms. We recommend airline organizations increase support for preventative mental health treatment. Future research will evaluate additional risk factors of depression such as sleep and circadian rhythm disturbances.

Flight Attendants in a Qigong Meditative Movement Study Experienced Improved Endurance and Reduced Blood Pressure

Qigong can help alleviate a cluster of symptoms related to chronic obstructive pulmonary disease (COPD) and chronic or traumatic stress in first responders.

Miscarriage Among Flight Attendants

Grajewski, Barbara; Whelan, Elizabeth A.; Lawson, Christina C.; Hein, Misty J.; Waters, Martha A.; Anderson, Jeri L.; MacDonald, Leslie A.; Mertens, Christopher J.; Tseng, Chih-Yu; Cassinelli, Rick T. II; Luo, Lian

Epidemiology. 9000;Publish Ahead of Print:10.1097/EDE.0000000000000225.

Abstract

Background: Cosmic radiation and circadian disruption are potential reproductive hazards for flight attendants.

Methods: Flight attendants from 3 US airlines in 3 cities were interviewed for pregnancy histories and lifestyle, medical, and occupational covariates. We assessed cosmic radiation and circadian disruption from company records of 2 million individual flights. Using Cox regression models, we compared respondents (1) by levels of flight exposures and (2) to teachers from the same cities, to evaluate whether these exposures were associated with miscarriage.

Results: Of 2654 women interviewed (2273 flight attendants and 381 teachers), 958 pregnancies among 764 women met study criteria. A hypothetical pregnant flight attendant with median first-trimester exposures flew 130 hours in 53 flight segments, crossed 34 time zones, and flew 15 hours during her home-base sleep hours (10 pm-8 am), incurring 0.13 mGy absorbed dose (0.36 mSv effective dose) of cosmic radiation. About 2% of flight attendant pregnancies were likely exposed to a solar particle event, but doses varied widely. Analyses suggested that cosmic radiation exposure of 0.1 mGy or more may be associated with increased risk of miscarriage in weeks 9-13 (odds ratio = 1.7 [95% confidence interval = 0.95-3.2]). Risk of a first-trimester miscarriage with 15 hours or more of flying during home-base sleep hours was increased (1.5 [1.1-2.2]), as was risk with high physical job demands (2.5 [1.5-4.2]). Miscarriage risk was not increased among flight attendants compared with teachers.

Conclusions: Miscarriage was associated with flight attendant work during sleep hours and high physical job demands and may be associated with cosmic radiation exposure.

(C) 2015 by Lippincott Williams & Wilkins, Inc

Link to article published online ahead of print

Residential exposure to aircraft noise and hospital admissions for cardiovascular diseases: multi-airport retrospective study

Andrew W Correia quantitative analyst 1, Junenette L Peters assistant professor 2, Jonathan I Levy
professor2, Steven Melly geographic information systems specialist3, Francesca Dominici professor,
associate dean of information technology

Download the article: Aircraft Noise and CVD admissions

Objective: To investigate whether exposure to aircraft noise increases the risk of hospitalization for cardiovascular diseases in older people (≥65 years) residing near airports.

Design: Multi-airport retrospective study of approximately 6 million older people residing near airports in the United States. We superimposed contours of aircraft noise levels (in decibels, dB) for 89 airports for 2009 provided by the US Federal Aviation Administration on census block resolution population data to construct two exposure metrics applicable to zip code resolution health insurance data: population weighted noise within each zip code, and 90th centile of noise among populated census blocks within each zip code. Setting 2218 zip codes surrounding 89 airports in the contiguous states. Participants 6 027 363 people eligible to participate in the national medical insurance (Medicare) program (aged ≥65 years) residing near airports in 2009.

Main outcome measures: Percentage increase in the hospitalization admission rate for cardiovascular disease associated with a 10 dB increase in aircraft noise, for each airport and on average across airports adjusted by individual level characteristics (age, sex, race), zip code level socioeconomic status and demographics, zip code level air pollution (fine particulate matter and ozone), and roadway density. Results Averaged across all airports and using the 90th centile noise exposure metric, a zip code with 10 dB higher noise exposure had a 3.5% higher (95% confidence interval 0.2% to 7.0%) cardiovascular hospital admission rate, after controlling for covariates.

Conclusions: Despite limitations related to potential misclassification of exposure, we found a statistically significant association between exposure to aircraft noise and risk of hospitalization for cardiovascular diseases among older people living near airports.

Flight Attendant Fatigue, Part IV: Analysis of Incident Reports

Federal Aviation Administration
December 2009

Download the publication: Crew Fatigue IV CAMI 2009

Voluntary safety reporting is one method by which aviation personnel can report safety issues to their airline and the Federal Aviation Administration. The Aviation Safety Reporting System (ASRS) is a program managed by the National Aeronautics & Space Administration (NASA) Ames Research Center. This study reviewed flight attendant reports from the ASRS database to identify the frequency of fatigue reports and the conditions under which fatigue occurred.

During June 2008, 2,628 cabin crew reports were downloaded from the NASA ASRS Web site for reports made between January 1990 and December 2007. CAMI researchers reviewed each fullform report narrative for possible contributors to fatigue, or indicators of fatigue. Although the overall number of flight attendant ASRS reports for which full-form coding was completed has decreased over the last 3 years, both total flight attendant reporting and the number of full-form narratives related to fatigue have increased substantially. This voluntary data allows regulators and operators to discover potential problems in the aviation industry before they result in a mishap. The results of this review indicate that flight attendant fatigue may be occurring more frequently and warrant more attention.

Kali Holcomb
Katrina Avers
Lena Dobbins
Joy Banks
Lauren Blackwell
Thomas Nesthus
Civil Aerospace Medical Institute
Federal Aviation Administration
Oklahoma City, OK 73125
December 2009
Final Report
DOT/FAA/AM-09/25
Office of Aerospace Medicine
Washington, DC 20591
OK-10-

Final Report
DOT/FAA/AM-09/25
Office of Aerospace Medicine
Washington, DC 20591
OK-10-

fa health

Cancer incidence in airline cabin crew

Cancer incidence in airline cabin crew
E A Whelan

Evidence that flight crew are at increased risk for certain types of cancer is growing although epidemiological evidence remains inconclusive.

Download the article: Cancer and Flight Crews – Whelan

Conclusion: The evidence that flight crew are at increased risk for certain types of cancer is growing and current concerns about
potential hazards in this occupation are not without basis. However, thus far, the epidemiological evidence remains inconclusive due to limitations in exposure assessment, sample size, and characterization of confounders. The studies from the European Union and the USA will move us further towards understanding the nature of the risks involved for workers in this unique occupation.

Occup Environ Med 2003;60:805–806

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The self-reported health of U.S. flight attendants compared to the general population

Download: McNeely_et_al2014_provisional

Environmental Health 2014, 13:13 doi:10.1186/1476-069X-13-13
Eileen McNeely (emcneely@hsph.harvard.edu)
Sara Gale (gale@hsph.harvard.edu)
Ira Tager (ibt@berkeley.edu)
Laurel Kincl (laurel.kincl@oregonstate.edu)
Julie Bradley (juliembradley@gmail.com)
Brent Coull (bcoull@hsph.harvard.edu)
Steve Hecker (shecker@uw.edu)

Background
Few studies have examined the broad health effects of occupational exposures in flight
attendants apart from disease-specific morbidity and mortality studies. We describe the health
status of flight attendants and compare it to the U.S. population. In addition, we explore
whether the prevalence of major health conditions in flight attendants is associated with
length of exposure to the aircraft environment using job tenure as a proxy.

Conclusions
This study found higher rates of specific diseases in flight attendants than the general
population. Longer tenure appears to explain some of the higher disease prevalence.
Conclusions are limited by the cross-sectional design and recall bias. Further study is needed
to determine the source of risk and to elucidate specific exposure-disease relationships over
time.

2007 Flight Attendant Health Study Results

Researchers at Harvard School of Public Health conducted a landmark study in 2007 on this subject, and follow-up today is needed to understand trends in flight attendant health over time.

  • Over 4,000 flight attendants participated in the first study. Help us exceed this number.
  • The prevalence of respiratory disease amongst Flight Attendants was approximately three times that found in the general U.S. population.
  • In addition, sleep disorders, fatigue, depression and heart disease were greatly increased in female Flight Attendants compared to the U.S. population.
  • Release of the FAA Report (Coming Soon!)  Read our presentation at the International Society of Environmental Epidemiology conference, Barcelona, Spain 2011

Take me to the journal article online

Download pdf: Air Transportation and Flight Attendant Health

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A history of second hand smoke exposure: are we asking the right questions?

 A history of second hand smoke exposure:
are we asking the right questions?

CranePaperMardi A. Crane-Godreau* and Peter Payne

The 2006 Surgeon General’s Report, “Health Consequences of Involuntary Exposure to Tobacco Smoke” (Surgeon General, 2006) documents the health implications of exposure to SHS, including firm evidence that SHS contributes to coronary and lung disease, lung can- cer, premature death in adults, slow lung development, SIDS, asthma, and ear infections in children, as well as suggestive evidence that implicate SHS in COPD, asthma, breast cancer, and nasal sinus cancer in adults, and leukemia, lymphoma, and brain tumors in children. The report indicates that there is no risk-free level of SHS. Despite evidence that SHS is a risk factor for disease, most healthcare orga- nizations and many physicians fail to ask patients about their history of SHS exposure. The implications of that failure are considerable because knowledge of a patient’s history of SHS exposure enables providers to make better-informed decisions about what to include in each patient’s examination and lab tests, and how to conduct longterm monitoring, as well as alerting the patient to the need for measures to help them avoid further smoke exposure.

Download: A history of second hand smoke exposure: are we asking the right questions?