Mortality from cancer and other causes among male airline cockpit crew in Europe.
Level 3 - non-randomized controlled study
Multi-country retrospective occupational cohort study comparing observed mortality to population-based expected rates.
PubMed 12918075 · doi:10.1002/ijc.11328
What was done
A multicenter cohort study examined mortality among 28,000 male airline pilots and flight engineers from nine European countries (Denmark, Finland, Germany, Great Britain, Greece, Iceland, Italy, Norway, and Sweden) followed between 1960 and 1997, comprising 547,564 person-years at risk. Observed deaths were compared to expected deaths calculated from national mortality rates to determine standardized mortality ratios (SMRs). Stratified and Poisson regression analyses evaluated the influence of employment period and duration.
What was found
Across 2,244 recorded deaths, male cockpit crew showed significantly lower all-cause mortality (SMR = 0.64, 95% CI: 0.61-0.67), total cancer mortality (SMR = 0.68, 95% CI: 0.63-0.74), and lung cancer mortality (SMR = 0.53, 95% CI: 0.44-0.62) compared to national rates. Mortality from malignant melanoma was significantly elevated (SMR = 1.78, 95% CI: 1.15-2.67). Low cardiovascular mortality and increased aviation accident mortality were noted without numerical values in the abstract. No consistent association was found between cancer mortality and employment period or duration.
Why it matters
This large multicenter cohort confirms that European airline pilots have lower overall mortality than the general population but face an increased risk of fatal malignant melanoma, supporting targeted dermatologic monitoring in this occupational group.
Limits
The study included only male cockpit crew, limiting generalizability to female pilots or cabin crew. SMR comparisons against the general population are subject to healthy worker bias. Individual radiation doses, flight hours, and lifestyle confounders such as recreational UV exposure and smoking were not detailed in the abstract.
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