Steward offers food and drinks to economy class passengers on the plane

Symptoms related to new flight attendant uniforms

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

1/3/2018

publications
Abstract
Background:
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.
Methods:
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.Results:
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.

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

 

 

Cancer prevalence among flight attendants compared to the general population

Eileen McNeely, Irina Mordukhovich, Steven Staffa, Samuel Tideman, Sara Gale and Brent Coull

publications
Abstract
Background:
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.
Methods:
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.

Results:
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.

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

 

Cancer incidence in California flight attendants (United States)

Peggy Reynolds, James Cone, Michael Layefsky, Debbie E. Goldberg, Susan Hurley

publications
Abstract
Objective:
To examine unusual exposure opportunities to flight crews from chemicals, cosmic radiation, and electric and magnetic fields.

Methods:
This project evaluated the incidence of cancers of the breast and other sites among Association of Flight Attendants (AFA) members residing in California. AFA membership files were matched to California’s statewide cancer registry to identify a total of 129 newly diagnosed invasive cancers among AFA members with California residential histories between 1988 and 1995.

Results:
Compared to the general population, female breast cancer incidence was over 30% higher than expected, and malignant melanoma incidence was roughly twice that expected. Both of these are cancers that are associated with higher socioeconomic status and have been suggestively associated with various sources of radiation.

Conclusions:
Consistent with the results from Nordic studies of cabin crews and a recent meta-analysis of prior studies, these data suggest that follow-up investigations should focus on the potential relative contribution of workplace exposures and lifestyle characteristics to the higher rates of disease for these two cancers.

 

Airliner wing

“Impact factors of ultra long range flights on cabin crew and passengers : “”pushing the plane– pushing the people”” : a thesis submitted in partial fulfilment of the requirements for the degree of Master of Aviation, Massey University”

Haines, Michael John

Abstract: Long distance flight is an entrenched transportation mode that has brought with it a range of issues and impacts on the human cabin occupants. Development of ultra long range aircraft allows a single airline flight to last more than 16 hours in flight time which will have added impact on cabin crew and passengers.

This study was conducted to analyse the varied and diverse issues that ultra long range flights present in relation to the cabin and its occupants. Research included two surveys, one survey to international airlines from around the world and one survey to New Zealand based cabin crew who operate on international flights. Both surveys analysed current long range flight impacts and allowed respondents to identify new ultra long range flight issues.

The survey to organisations was responded to by seven airlines with three of the respondents currently operating ultra long range flights. The seven respondents rated operational issues as areas to be addressed including cabin crew issues related to duties, training and in-flight rest. Passenger related areas were mainly in relation to customer comfort.

The cabin crew survey had 119 respondents with a range of international cabin crew experience up to 36 years and averaging 5.7 long range flights per month. The respondents rated their cabin safety role as extremely important but did not believe their employers rated their safety role as highly. Respondents rated fatigue, sleep and dehydration as the main health impacts from long haul flights and 97.3% believed these health impacts will increase with ultra long range flight. In regard to rest and rest facilities 62% of respondents believed the current rest periods provided were inadequate and 70.7% believed the current rest facilities were inadequate. There was found to be a strong statistical relationship between rest adequacy and rest facilities adequacy. In relation to ultra long range flight respondents rated in-flight rest facilities as the foremost item to address for cabin crew and cabin air quality as the foremost item to address for passengers.

In general the survey of cabin crew identified the cabin environment, fatigue and lack of management emphasis on cabin crew as areas to be addressed for ultra long range flight. For passengers the cabin environment, facilities, and seating issues need addressing for ultra long range flight.

Further analysis based on the survey results found that ultra long range flight research has focussed on aircraft performance, engine reliability and the impacts of extended flight time on flight crew. Study on the impact of ultra long range flight on cabin crew and passengers are limited and lack the depth of research given to flight crew.

This study has identified that aircraft manufacturers and airline operators need to research and address a range of issues related to the cabin, in particular impacts related to cabin crew and passengers. Aviation regulators need to address many areas to improve regulations related to cabin crew and passenger health and safety. These areas need to be researched and addressed to ensure the impacts of ultra long range flight are reduced.

Dr. Mardi Crane-Godreau

Digital Delivery of Meditative Movement Training Improved Health of Cigarette-Smoke-Exposed Subjects

https://www.frontiersin.org/articles/10.3389/fpubh.2018.00282/full

Download the Article – PDF

Many FA who flew prior to the ban on smoking in commercial aircraft exhibit an unusual pattern of long-term pulmonary dysfunction. This randomized controlled study tested the hypothesis that digitally delivered meditative movement (MM) training improves chronic obstructive pulmonary disease (COPD)-related symptoms in flight attendants (FA) who were exposed to second-hand cigarette smoke (SHCS) while flying. Phase I of this two-phase clinical trial was a single-arm non-randomized pilot study that developed and tested methods for MM intervention; we now report on Phase II, a randomized controlled trial comparing MM to a control group of similar FA receiving health education (HE) videos. Primary outcomes were the 6-min walk test and blood levels of high sensitivity C-reactive protein (hs-CRP). Pulmonary, cardiovascular, autonomic and affective measures were also taken. There were significant improvements in the 6-min walk test, the Multidimensional Assessment of Interoceptive Awareness (MAIA) score, and the COPD Assessment Test. Non-significant trends were observed for increased dehydroepiandrosterone sulfate (DHEAS) levels, decreased anxiety scores and reduced blood hs-CRP levels, and increased peak expiratory flow (PEF). In a Survey Monkey questionnaire, 81% of participants who completed pre and post-testing expressed mild to strong positive opinions of the study contents, delivery, or impact, while 16% expressed mild negative opinions. Over the course of the year including the study, participant adoption of the MM practices showed a significant and moderately large correlation with overall health improvement; Pearson’s R = 0.62, p < 0.005. These results support the hypothesized benefits of video-based MM training for this population. No adverse effects were reported.

Alarm clock on bed in morning with sun light

Flight Attendant Rest Times Increased!

After over 20 years of research and advocacy, U.S. flight attendants have been successful in raising their minimum rest times between shifts to from 8 to 10 hours. This occurred due to the passing of the FAA re-authorization bill in October of 2018. This is a substantial increase over the earlier 8-hour minimum rest time, which does not include deplaning, boarding passengers, or traveling to and from the airport. It only includes time between landing and the next take-off, so an 8-hour minimum rest time could easily result in getting just a few hours of actual rest or sleep between flights.

In contrast, a 10-hour mandatory rest period is the same as that guaranteed to pilots, and rightfully recognizes flight attendants’ crucial role in protecting the safety and security of passengers. It also a great development given research into cabin crew fatigue, Circadian rhythm disruption, sleep disorders, and associated health effects, such as depression or possibly even cancer and cardiovascular disease. The Harvard Flight Attendant Health Study has reported that U.S. flight attendants have higher rates of fatigue, diagnosed sleep disorders, and depression relative to employed people in the U.S. general population, despite being healthier overall in terms of weight, smoking, blood pressure, and other factors related to overall health and healthy lifestyle choices.

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

and Estimating the health consequences of flight attendant work: comparing flight attendant health to the general population in a cross-sectional study

US Flight Crew Have Higher Cancer Rates Compared to the General Population

American flight attendants have a higher prevalence of several forms of cancer, including breast, uterine, gastrointestinal, thyroid, and cervical cancers, when compared with the general public, according to new research from the Harvard T.H. Chan School of Public Health.

Estimating the health consequences of flight attendant work: comparing flight attendant health to the general population in a cross-sectional study

Link to the publication

Background

Flight attendants are an understudied occupational group, despite undergoing a wide and unique range of adverse job-related exposures. In our study, we aimed to characterize the health profile of cabin crew relative to the U.S. general population.

Methods

In 2014–2015, we surveyed participants of the Harvard Flight Attendant Health Study. We compared the prevalence of their health conditions to a contemporaneous cohort in the National Health and Nutrition Examination Survey (NHANES 2013–2014) using age-weighted standardized prevalence ratios (SPRs). We also analyzed associations between job tenure and selected health outcomes, using logistic regression and adjusting for potential confounders.

Results

Compared to the NHANES population (n = 2729), flight attendants (n = 5366) had a higher prevalence of female reproductive cancers (SPR = 1.66, 95% CI: 1.18–2.33), cancers at all sites (SPR = 2.15, 95% CI: 1.73–2.67 among females), as well as sleep disorders, fatigue, and depression, with SPRs ranging between 1.98 and 5.57 depending on gender and the specific condition examined. In contrast, we observed a decreased prevalence of cardiac and respiratory outcomes among flight crew relative to NHANES. Health conditions that increased with longer job tenure were sleep disorders, anxiety/depression, alcohol abuse, any cancer, peripheral artery disease, sinusitis, foot surgery, infertility, and several perinatal outcomes.

Conclusions

We observed higher rates of specific adverse health outcomes in U.S. flight attendants compared to the general population, as well as associations between longer tenure and health conditions, which should be interpreted in light of recall bias and a cross-sectional design. Future longitudinal studies should evaluate specific exposure-disease associations among flight crew.

Flight Attendant

Symptoms related to new flight attendant uniforms

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

View the entire article

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.

Methods

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.

Results

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.

Conclusion

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

Keywords

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.

Symptoms related to new flight attendant uniforms

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

1/03/2018

Background:
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.

Methods:
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.

Results:
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.

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

<https://bmcpublichealth.biomedcentral.com/track/pdf/10.1186/s12889-017-4982-4>