Work, Gender, and Sexual Harassment in Commercial Air Travel

Work, Gender, and Sexual Harassment on the Frontlines of Commercial Travel: A Cross-Sectional Study of Flight Crew Well-Being

In the latest paper, researchers Dorota Weziak-Białowolska, Piotr Białowolski, Irina Mordukhovich, and Eileen McNeely examined the scale and scope of experience of sexual harassment at work among male and female flight attendants.

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Changes in Passenger Heart Rate and Rhythm During a Simulated Commercial Flight

Changes in Heart Rate and Rhythm During a Crossover Study of Simulated Commercial Flight in Older and Vulnerable Participants

A paper titled, Changes in Heart Rate and Rhythm During a Crossover Study of Simulated Commercial Flight in Older and Vulnerable Participants, has just been published Frontiers of Physiology.  The authors found that among passengers that are typical of elderly flyers (an increasingly common demographic of both flyers and flight crew – flight attendants and pilots) and who would have been cleared to fly without supplemental oxygen or any other particular support based on current medical guidelines experienced changes in heart rate and rhythm.

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health effects among never smokers exposed to occupational secondhand smoke

Legacy health effects among never smokers exposed to occupational secondhand smoke

Secondhand tobacco smoke (SHTS) is a tremendous public health hazard, leading to morbidity and premature mortality worldwide, with racial and ethnic minorities and those of lower socioeconomic status disproportionately affected. Flight attendants were historically exposed to high levels of SHTS in the aircraft cabin. The health effects of active smoking are known to persist for up to a lifetime, but the legacy effects of SHTS exposure have not been well characterized.

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Harvard Flight Attendant Health Study

Qigong can help alleviate a cluster of symptoms related to chronic obstructive pulmonary disease

Effectiveness of a Novel Qigong Meditative Movement Practice for Impaired Health in Flight Attendants Exposed to Second-Hand Cigarette Smoke

This single-arm non-randomized pilot study explores an intervention to improve the health of flight attendants (FA) exposed to second-hand cigarette smoke prior to the smoking ban on commercial airlines. This group exhibits an unusual pattern of long-term pulmonary dysfunction. We report on Phase I of a two-phase clinical trial; the second Phase will be a randomized controlled trial testing digital delivery of the intervention. Subjects were recruited in the Northeastern US; testing and intervention were administered in 4 major cities. The intervention involved 12 h of training in Meditative Movement practices. Based on recent research on the effects of nicotine on fear learning, and the influence of the autonomic nervous system on immune function, our hypothesis was that this training would improve autonomic function and thus benefit a range of health measures. Primary outcomes were the 6-min walk test and blood levels of C-reactive protein. Pulmonary, cardiovascular, autonomic, and affective measures were also taken. Fourteen participants completed the training and post-testing. There was a 53% decrease in high sensitivity C-Reactive Protein (p ? 0.05), a 7% reduction in systolic blood pressure (p ? 0.05), a 13% increase in the 6-min walk test (p ? 0.005), and significant positive changes in several other outcomes. These results tend to confirm the hypothesized benefits of MM training for this population, and indicate that autonomic function may be important in the etiology and treatment of their symptoms. No adverse effects were reported. This trial is registered at and is supported by a grant from the Flight Attendant Medical Research Institute (FAMRI).

The Relevance of Emotional Intelligence in Personnel Selection for High Emotional Labor Jobs

Although a large number of studies have pointed to the potential of emotional intelligence (EI) in the context of personnel selection, research in real-life selection contexts is still scarce. The aim of the present study was to examine whether EI would predict Assessment Center (AC) ratings of job-relevant competencies in a sample of applicants for the position of a flight attendant. Applicants’ ability to regulate emotions predicted performance in group exercises. However, there were inconsistent effects of applicants’ ability to understand emotions: Whereas the ability to understand emotions had a positive effect on performance in interview and role play, the effect on performance in group exercises was negative. We suppose that the effect depends on task type and conclude that tests of emotional abilities should be used judiciously in personnel selection procedures.

Clear Skies and Grey Areas: Flight Attendants’ Secondhand Smoke Exposure and Attitudes toward Smoke-Free Policy 25 Years since Smoking was Banned on Airplanes

Our objective was to provide descriptive data on flight attendant secondhand smoke (SHS) exposure in the work environment, and to examine attitudes toward SHS exposure, personal health, and smoke-free policy in the workplace and public places. Flight attendants completed a web-based survey of self-reported SHS exposure and air quality in the work environment. We assessed the frequency and duration of SHS exposure in distinct areas of the workplace, attitudes toward SHS exposure and its health effects, and attitudes toward smoke-free policy in the workplace as well as general public places. A total of 723 flight attendants participated in the survey, and 591 responded to all survey questions. The mean level of exposure per flight attendant over the past month was 249 min. The majority of participants reported being exposed to SHS always/often in outdoor areas of an airport (57.7%). Participants who worked before the in-flight smoking ban (n=240) were more likely to support further smoking policies in airports compared to participants who were employed after the ban (n=346) (76.7% versus 60.4%, p-value<0.01). Flight attendants are still being exposed to SHS in the workplace, sometimes at concerning levels during the non-flight portions of their travel. Flight attendants favor smoke-free policies and want to see further restrictions in airports and public places.

Flying the smoky skies: secondhand smoke exposure of flight attendants

J. Repace.
Tobacco Control 2004;13;i8-i19

Download the publication: FA smoking lit

Flight attendants reported suffering greatly from SHS pollution on aircraft. Both government and airline sponsored studies concluded that SHS created an air pollution problem in aircraft cabins, while tobacco industry sponsored studies yielding similar data concluded that ventilation controlled SHS, and that SHS pollution levels were low. Between the time that non-smoking sections were established on US carriers in 1973, and the two hour US smoking ban in 1988, commercial aircraft ventilation rates had declined three times as fast as smoking prevalence. The aircraft cabin provided the least volume and lowest ventilation rate per smoker of any social venue, including stand up bars and smoking lounges, and afforded an abnormal respiratory environment. Personal monitors showed little difference in SHS exposures between flight attendants assigned to smoking sections and those assigned to non-smoking sections of aircraft cabins.

Conclusions: In-flight air quality measurements in ,250 aircraft, generalised by models, indicate that when smoking was permitted aloft, 95% of the harmful respirable suspended particle (RSP) air pollution in the smoking sections and 85% of that in the non-smoking sections of aircraft cabins was caused by SHS. Typical levels of SHS-RSP on aircraft violated current (PM2.5) federal air quality standards ,threefold for flight attendants, and exceeded SHS irritation thresholds by 10 to 100 times. From cotinine dosimetry, SHS exposure of typical flight attendants in aircraft cabins is estimated to have been .6-fold that of the average US worker and ,14-fold that of the average person. Thus, ventilation systems massively failed to control SHS air pollution in aircraft cabins. These results have implications for studies of the past and future health of flight attendants.

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

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Download pdf: Air Transportation and Flight Attendant Health

Join the current updated Flight Attendant Health Study


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

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.

We surveyed flight attendants from two domestic U.S. airlines in 2007 and compared the prevalence of their health conditions to contemporaneous cohorts in the National Health and Nutrition Survey (NHANES), 2005-2006 and 2007-2008. We weighted the prevalence of flight attendant conditions to match the age distribution in the NHANES and compared the two populations stratified by gender using the Standardized Prevalence Ratio (SPR). For leading health conditions in flight attendants, we analyzed the association between job tenure and health outcomes in logistic regression models.

Compared to the NHANES population (n =5,713), flight attendants (n = 4,011) had about a 3-fold increase in the age-adjusted prevalence of chronic bronchitis despite considerably lower levels of smoking. In addition, the prevalence of cardiac disease in female flight attendants was 3.5 times greater than the general population while their prevalence of hypertension and being overweight was significantly lower. Flight attendants reported 2 to 5.7 times more sleep disorders, depression, and fatigue, than the general population. Female flight attendants reported 34% more reproductive cancers. Health conditions that increased with longer job tenure as a flight attendant were chronic bronchitis, heart disease in females, skin cancer, hearing loss, depression and anxiety, even after adjusting for age, gender, body mass index (BMI), education, and smoking.

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.