Objectives Work schedules of cabin crew involve early starts, long working hours, night flights and the crossing of time zones. This can impose disturbed sleep, fatigue, lack of alertness, and possibly cause occupational accidents onboard. Although it has been shown that the risk for occupational accidents increases over successive shifts, it is unclear what kind of longitudinal flight schedule exposure affects their incidence. Therefore the objective of this study is to examine the associations between cumulative exposure to different flight schedules and the occurrence of occupational accidents among cabin crew.

Methods Data from the five-year historic MORE cohort was used. The study population consisted of 6311 cabin crew members from this cohort. For each employee, daily flight schedules from 2005 until 2008, and registered occupational accidents in 2009 were collected. The association between the cumulative exposure to different types of flight schedules and the occurrence of occupational accidents was determined using multivariate logistic regression analyses. Multivariate analyses were adjusted for age, gender, marital status, children (yes/no), job title, multiple employers (yes/no) and the number of flights flown during 2005–2008.

Results In 2009, 289 accidents were reported. Multivariate analyses showed that the number of short-haul flights during 2005–2008 was positively associated with the occurrence of occupational accidents in 2009 (β = 0.004; p = 0.012). Cumulative exposure to long-haul flights during 2005–2008 proved to be negatively associated with occupational accidents in 2009 (β = -0.006; p = 0.011).

Conclusions The results of this study show that cumulative exposure to short-haul flights is associated with an increased risk for occupational accidents among cabin crew. This increased risk may be caused by the specific characteristics of short-haul flights, such as frequent customer service and a high time pressure. Future research should focus on the effects of alternation between different flight schedules and the influence of specific roster characteristics of short-haul schedules.