Airplane crew members like pilots and flight attendants face more than twice the risk of developing melanoma compared to the general population, and they also have a 42 percent higher melanoma death rate, according to a new review of available research.
While the higher rates of melanoma among pilots and flight crew have been studied before, UV exposure is still not an acknowledged occupational risk factor for flight crews. Study researcher Susana Ortiz-Urda, M.D., Ph.D., co-director of the Melanoma Program at UC San Francisco, hopes that her new study will prompt the airline industry to recognize UV radiation as a work hazard for flight crews.
The meta-analysis of 19 past studies, published in JAMA Dermatology, analyzed data from more than 266,000 participants and broke down melanoma diagnosis rates and melanoma mortality rates by pilot and cabin crew. Ortiz-Urda found that pilots, who spend most of their time in the cockpit, had a higher risk of developing melanoma and dying from it than members of the cabin crew, who spend most of their time in other parts of the plane.
Ortiz-Urda hypothesized that perhaps the expansive windows of the cockpit, which vary when it comes to blocking ultraviolet A and B rays, may be to blame. In her research, she cited a 2007 Federal Aviation Administration study that surveyed a variety of aircraft and found that, on average, the windshields blocked more than 99 percent of UVB rays.
But the windshields were only able to block 46 percent of UVA radiation, according to the FAA study. UVA radiation penetrates skin more deeply than UVB and is known to cause DNA and skin cell damage, according to the Skin Cancer Foundation. And the higher you go, the more intense UV radiation becomes.
“At 9,000 [meters], where most commercial aircraft fly, the UV level is approximately twice that of the ground,” Ortiz-Urda wrote in the study. “Moreover, these levels are even higher when flying over thick cloud layers and snow fields, which could reflect up to 85 percent of UV radiation.”
Ortiz-Urda recommended that pilots and cabin crew become more proactive about the health of their skin by protecting it from the sun and making annual appointments to get their skin checked by a dermatologist. But she also called upon the FAA to make permanent changes for the health and safety of all airline workers in the U.S.
A spokesman for the FAA told HuffPost that the administration hasn’t seen the study and won’t be able to comment until they had a chance to review it.
David Fisher, M.D., Ph.D., director of the Melanoma Program at Massachusetts General Hospital and the chief of the Department of Dermatology at Harvard Medical School, finds the data “intriguing” but questions the lack of information about study participants’ skin color. Because it’s well known that lighter skin types are more susceptible to cancers like melanoma, Fisher argues that the focus on studies conducted primarily on Northern Europeans could mean the findings don’t apply to all flight crews worldwide.
“I find the data intriguing, but I have concerns about the lack of information on skin phototype (i.e. the pigmentation status of skin) in the pilots and crew relative to the comparison population,” Fisher wrote in an email to HuffPost. “While the authors point out that the comparison population was primarily northern Europeans who are predicted to be generally fair skinned, the possibility of variation in this important risk factor remains unknown and therefore does introduce a limitation on confidence of the conclusion that pilots or crew members are truly at elevated melanoma risk.”
Ortiz-Urda acknowledged this limitation in the meta-analysis, noting that she was not able to control for skin type. However, she argued that because the studies compared Northern European flight crews to general populations in Northern Europe, there shouldn’t be a study bias — unless, of course, “fair skinned individuals were more likely to be hired in flight occupations compared with control occupations.”
Melanoma is the most dangerous form of skin cancer and kills about 9,710 people in the U.S. annually, according to the Skin Cancer Foundation. The American Cancer Society estimates that more than 120,000 new cases of the disease will be diagnosed every year, but the disease can be prevented by avoiding sunburns, tanning beds and sunbathing. People should also use sunscreen with an SPF of at least 30 or higher every day, wear UV-blocking sunglasses and see a doctor for an annual skin exam.
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