Health effects and conditions effected by long term air travel

Symptoms related to new flight attendant uniforms

Eileen McNeely, Steven J. Staffa, Irina Mordukhovich and Brent Coull

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Flight attendants at Alaska Airlines reported health symptoms after the introduction of new uniforms in 2011. The airline replaced the uniforms in 2014 without acknowledging harm. To understand possible uniform-related health effects, we analyzed self-reported health symptoms in crew who participated in the Harvard Flight Attendant Health Study between 2007 and 2015, the period before, during, and after the introduction of new uniforms.


We calculated a standardized prevalence of respiratory, dermatological and allergic symptoms at baseline, as well as during and after uniform changes in 684 flight attendants with a varying number of surveys completed across each time point. We used Generalized Estimating Equations (GEE) to model the association between symptoms at baseline versus the exposure period after adjusting for age, gender and smoking status and weighting respondents for the likelihood of attrition over the course of the study period.


We found the following symptom prevalence (per 100) increased after the introduction of new uniforms: multiple chemical sensitivity (10 vs 5), itchy/irritated skin (25 vs 13), rash/hives (23 vs 13), itchy eyes (24 vs 14), blurred vision (14 vs 6), sinus congestion (28 vs 24), ear pain (15 vs 12), sore throat (9 vs 5), cough (17 vs 7), hoarseness/loss of voice (12 vs 3), and shortness of breath (8 vs 3). The odds of several symptoms significantly increased compared to baseline after adjusting for potential confounders.


This study found a relationship between health complaints and the introduction of new uniforms in this longitudinal occupational cohort.


Environmental health, Textiles, Uniforms, Flight attendants, Occupational epidemiology, Allergic, Respiratory, Dermatological, Multiple chemical sensitivity

What this paper adds

  • We know little about the health effects of chemicals in our clothing as compared to substances we ingest, even though skin absorption can be quite efficient and researchers have found metals, dyes, formaldehyde and formaldehyde releasers, dioxin, perfluorinated compounds, flame retardants, phthalates and other plasticizers such as diisodecyclmaleate, pesticides and fungicides in clothing.

  • This study offers a unique window into the potential health effects of textile chemicals after the introduction of new work uniforms in an occupational cohort– a rare opportunity to appreciate a common exposure in a defined population with a specific release date.

  • We found significantly increased prevalence of symptoms after the introduction of new uniforms including eye pain/dry eyes/itchy eyes, blurred vision, combined EENT, cough, hoarseness/loss of voice combined lower respiratory, itchy/irritated skin, and rash/hives.

  • These findings together with reports of similar health reactions in yet another U.S. flight attendant population after the introduction of new uniforms this year warrants further investigation of the specific chemical toxicants, clothing concentrations, body burdens and health effects.

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.

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 (
Sara Gale (
Ira Tager (
Laurel Kincl (
Julie Bradley (
Brent Coull (
Steve Hecker (

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.

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