Occup Environ Med 2000;57:175-179 ( March )

Incidence of cancer among commercial airline pilots

Vilhjálmur Rafnsson^a, Jón Hrafnkelsson^b, Hrafn Tulinius^{a c}

^a Department of Preventive Medicine, University of Iceland, Soltun 1, 105 Reykjavik, Iceland, ^b Department of Oncology, Landspítalinn, Reykjavik, Iceland, ^c Icelandic Cancer Registry, Skógarhlí 8, 105 Reykjavik, Iceland

Correspondence to: Dr Vilhjálmur Rafnsson, Department of Preventive Medicine, Soltun 1, 105 Reykjavik, Iceland email vilraf{at}hi.is

Accepted 15 October 1999

OBJECTIVESTo describe the cancer pattern in a cohort of commercial pilots by follow up through the Icelandic Cancer Registry.
METHODSThis is a retrospective cohort study of 458 pilots with emphasis on subcohort working for an airline operating on international routes. A computerised file of the cohort was record linked to the Cancer Registry by making use of personal identification numbers. Expected numbers of cancer cases were calculated on the basis of number of person-years and incidences of cancer at specific sites for men provided by the Cancer Registry. Numbers of separate analyses were made according to different exposure variables.
RESULTSThe standardised incidence ratio (SIR) for all cancers was 0.97 (95% confidence interval (95% CI) 0.62 to 1.46) in the total cohort and 1.16 (95% CI 0.70 to 1.81) among those operating on international routes. The SIR for malignant melanoma of the skin was 10.20, 95% CI 3.29 to 23.81 in the total cohort and 15.63, 95% CI 5.04 to 36.46 in the restricted cohort. Analyses according to number of block-hours and radiation dose showed that malignant melanomas were found in the subgroups with highest exposure estimates, the SIRs were 13.04 and 28.57 respectively. The SIR was 25.00 for malignant melanoma among those who had been flying over five time zones.
CONCLUSIONSThe study shows a high occurrence of malignant melanoma among pilots. It is open to discussion what role exposure of cosmic radiation, numbers of block-hours flown, or lifestyle factorssuch as possible excessive sunbathingplay in the aetiology of cancer among pilots. This calls for further and more powerful studies. The excess of malignant melanoma among those flying over five time zones suggests that the importance of disturbance of the circadian rhythm should be taken into consideration in future studies.


Keywords: cancer registry; malignant melanoma of the skin; cosmic radiation; block-hours; time zones

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© 2000 by Occupational and Environmental Medicine
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