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Pooling airline crew cohorts from 10 countries and comparing their mortality with the corresponding one of those countries’ general populations, Hammer et al1 observe a strongly reduced overall mortality and cancer-related mortality in cockpit crew (only males) and, with slightly weaker effects, female cabin crew. This is evident, in particular, for cancers with known strong lifestyle-related risks among their causes, indicating less smoking as well as lower alcohol consumption and healthier body weight in these cohorts. The strong effect in the first 10 years of employment suggests a healthy worker selection, perhaps resulting from a mix of fitness requirements by the employer and self-selection into a job different in many ways to one with regular working hours. Regular medical check-ups of airline crew may contribute to the observation that the effect is not entirely disappearing after decades of employment. The ‘healthy survivor effect’ with healthy survivors retained in …
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