Harvard Flight Attendant Health Study

Flight attendants are some of the most understudied workers, yet studies have shown reduced respiratory and cardiovascular health, increased breast cancer, melanoma, non-melanoma skin cancer, and non-Hodgkin’s lymphoma risk, and higher rates of musculoskeletal conditions, ALS, anxiety, depression, and fatigue disorders among aircrew.

The research we conduct as part of the Flight Attendant Health Study in particular shows this population of healthy workers to have higher rates of health conditions including chronic bronchitis, skin and reproductive cancers, fatigue disorders, depression, and anxiety.

Flight crew are exposed to many physical and psychosocial stressors, such as cosmic ionizing radiation, jet fuel, engine oils and brominated compounds in the aircraft cabin, hypoxic air, higher ozone levels, stressful interactions with passengers, hypoxia/reduced oxygenation, and potentially severe circadian rhythm disruption. As such, our work aims to advance knowledge that will improve working conditions for flight crew in the U.S. and internationally.

In particular, we are studying the mechanisms underlying these associations. For example, we are conducting interdisciplinary research in molecular and cellular biology, epidemiology, and environmental health to understand how flight attendants’ combined environmental exposures impact DNA repair capacity.

We have also developed an app called Flight Health that measures information about cardiac, respiratory, and blood oxygen parameters, a range of self-reported health and well-being symptoms, and processing measured by the PVSAT test. Our goal is that this helps us understand the pathways through which flight affects health, and is complementary to our research regarding cardiac, respiratory and blood oxygen measures with respect to oxygenation to an equivalent of 7,000 feet in a chamber study of flight exposure conditions.

We also study the effects of flight attendants’ psychological/social environments on mental health and musculoskeletal health within the Flight Attendant Health Study cohort.

We are evaluating the health effects of flight attendant uniforms, after thousands of flight attendants reported health complaints such as severe skin rash, respiratory symptoms, fatigue, and thyroid disease, which our work has also observed among Flight Attendant Health Study participants. Our group has conducted laboratory screenings on these garments and detected the presence of metals, sensitizers, and allergenic dyes. We are currently working to evaluate the synergistic effects of these exposures as well as the aircraft environment.

Finally, we, along with colleagues at Dartmouth Medical School, are co-editing a themed issue at the journal Frontiers regarding the Aerospace Health and Safety in order to further advance the interdisciplinary state of knowledge with respect to public health, health psychology, engineering, cardiovascular and respiratory medicine, molecular biology, and physiology.

For more information please view the Flight Attendant Health Study website: www.fahealth.org


PUBLICATIONS

Mark J. Meyer, Irina Mordukhovich, Brent A. Coull, John McCracken, Gregory A. Wellenius, Murray A. Mittleman and Eileen McNeely.  Impact of simulated flight conditions on supraventricular and ventricular ectopy. Scientific Reports (2023).

Christopher Scheibler, Sneh M. Toprani, Irina Mordukhovich, Matthew Shaefer, Steven Staffa, Zachary D. Nagel and Eileen McNeely.  Cancer risks from cosmic radiation exposure in flight: A review. Frontiers in Public Health (2022).

Mark J. Meyer, Selina Carter, Eileen McNeely, and Elizabeth J. Malloy. Model Selection and Inference in Variational Longitudinal Distributed Lag Models. arXiv preprint arXiv:2206.04012 (2022).

Dorota Węziak-Białowolska, Piotr Białowolski, Irina Mordukhovich & Eileen McNeely. Work, Gender, and Sexual Harassment on the Frontlines of Commercial Travel: A Cross-Sectional Study of Flight Crew Well-Being. Aerospace Psychology (2020).

Mark J. Meyer, Irina Mordukhovich, Gregory A. Wellenius, Murray A. Mittleman, John P. McCracken, Brent A. Coull and Eileen McNeely. Changes in Heart Rate and Rhythm During a Crossover Study of Simulated Commercial Flight in Older and Vulnerable Participants. Frontiers in Physiology (2019). 

Eileen McNeely, Irina Mordukhovich, Samuel Tideman, Sara Gale and Brent Coull. Estimating the health consequences of flight attendant work: comparing flight attendant health to the general population in a cross-sectional study. BMC Public Health (2018). 

Eileen McNeely, Irina Mordukhovich , Steven Staffa, Samuel Tideman, Brent Coull.  Legacy health effects among never smokers exposed to occupational secondhand smokePLOS One (2019)

Sara Gale, Irina Mordukhovich, Sami Newlan and Eileen McNeely.  The Impact of Workplace Harassment on Health in a Working CohortFrontiers in Psychology (2019).

Eileen McNeely, Irina Mordukhovich, Steven Staffa, Samuel Tideman, Sara Gale and Brent Coull. Cancer prevalence among flight attendants compared to the general population. BMC Environmental Health (2018). 

Eileen McNeely, Irina Mordukhovich, Steven Jaffa, Brent Coull. Symptoms related to new flight attendant uniformsBMC Public Health (2017).

Eileen McNeely, Sara Gale, Ira Tager, Laurel Kincl, Julie Bradley, Brent Coull, and Steve Hecker. The self-reported health of U.S. flight attendants compared to the general population. Environmental Health (2014).