The risk of melanoma in airline pilots and cabin crew: a meta-analysis
- PMID: 25188246
- PMCID: PMC4482339
- DOI: 10.1001/jamadermatol.2014.1077
The risk of melanoma in airline pilots and cabin crew: a meta-analysis
Abstract
Importance: Airline pilots and cabin crew are occupationally exposed to higher levels of cosmic and UV radiation than the general population, but their risk of developing melanoma is not yet established.
Objective: To assess the risk of melanoma in pilots and airline crew.
Data sources: PubMed (1966 to October 30, 2013), Web of Science (1898 to January 27, 2014), and Scopus (1823 to January 27, 2014).
Study selection: All studies were included that reported a standardized incidence ratio (SIR), standardized mortality ratio (SMR), or data on expected and observed cases of melanoma or death caused by melanoma that could be used to calculate an SIR or SMR in any flight-based occupation.
Data extraction and synthesis: Primary random-effect meta-analyses were used to summarize SIR and SMR for melanoma in any flight-based occupation. Heterogeneity was assessed using the χ2 test and I2 statistic. To assess the potential bias of small studies, we used funnel plots, the Begg rank correlation test, and the Egger weighted linear regression test.
Main outcomes and measures: Summary SIR and SMR of melanoma in pilots and cabin crew.
Results: Of the 3527 citations retrieved, 19 studies were included, with more than 266 431 participants. The overall summary SIR of participants in any flight-based occupation was 2.21 (95% CI, 1.76-2.77; P < .001; 14 records). The summary SIR for pilots was 2.22 (95% CI, 1.67-2.93; P = .001; 12 records). The summary SIR for cabin crew was 2.09 (95% CI, 1.67-2.62; P = .45; 2 records). The overall summary SMR of participants in any flight-based occupation was 1.42 (95% CI, 0.89-2.26; P = .002; 6 records). The summary SMR for pilots was 1.83 (95% CI, 1.27-2.63, P = .33; 4 records). The summary SMR for cabin crew was 0.90 (95% CI, 0.80-1.01; P = .97; 2 records).
Conclusions and relevance: Pilots and cabin crew have approximately twice the incidence of melanoma compared with the general population. Further research on mechanisms and optimal occupational protection is needed.
Conflict of interest statement
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Comment in
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Why Do Airline Pilots and Flight Crews Have an Increased Incidence of Melanoma?JAMA Oncol. 2015 Sep;1(6):829-30. doi: 10.1001/jamaoncol.2015.0933. JAMA Oncol. 2015. PMID: 26181192 Free PMC article. No abstract available.
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References
-
- Howlader N. SEER stat fact sheets: melanoma of the skin. National Cancer Institute; [Accessed April 15, 2014]. website. http://seer.cancer.gov/statfacts/html/melan.html.
-
- Buja A, Lange JH, Perissinotto E, et al. Cancer incidence among male military and civil pilots and flight attendants: an analysis on published data. Toxicol Ind Health. 2005;21(10):273–282. - PubMed
-
- Buja A, Mastrangelo G, Perissinotto E, et al. Cancer incidence among female flight attendants: a meta-analysis of published data. J Womens Health (Larchmt) 2006;15(1):98–105. - PubMed
-
- The PRISMA statement. [Accessed February 28, 2014]; website. http://www.prisma-statement.org/
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