Air Transportation and Flight Attendant Health

Eileen McNeely¹, Sara Gale², Ira Tager², Judy Bradley¹, Judith Muraski³, Laurel Kincl⁴, Steve Hecker ⁵

1 Harvard School of Public Health, Boston, MA; 2 School of Public Health, University of California, Berkeley, CA; 3 Association of Flight Attendants-CWA, AFL-CIO, Seattle, WA; 4 University of Oregon, Portland, OR; 5 University of Washington, Seattle, WA

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A flight attendant’s job requires working at 35,000 ft altitude, ergonomic challenges while moving passengers, baggage and carts in confined spaces, circadian rhythm disruption, exposure to infectious diseases, ozone, cosmic radiation, low cabin pressures, jet fuel byproducts, pesticides, and flame retardants.

Current U.S. flight attendants have been in their jobs longer than previous generations, given rule changes since the 1970’s. Few studies have evaluated the health effects of these continuous exposures aboard the aircraft.

Results

• Respiratory symptoms were associated with more tenure and recent work hours, adjusting for covariates.
• Flight attendants have a higher prevalence of chronic respiratory problems, reproductive cancer, heart disease (CHD), sleep disorders, depressed mood & fatigue than a comparative national survey sample.
• The most prevalent conditions in flight attendants include respiratory and musculoskeletal conditions, sleep disruption, fatigue, and anxiety/depression.
• Prevalence of conditions are associated with greater exposures: more work hours; recent work hours and tenure, after adjustment for other factors.
• The prevalence of several health conditions were greater in flight attendants compared to the general U.S. population (based on NHANES).
• This result is striking because the flight attendant sample is likely to be biased by “healthy worker effects” (i.e. sick workers leave the sample).

Exposure to flame retardant chemicals on commercial airplanes

Joseph G Allen¹, Heather M Stapleton², Jose Vallarino¹, Eileen McNeely¹, Michael D McClean³, Stuart J Harrad⁴, Cassandra B Rauert⁴ and John D Spengler¹

¹Harvard School of Public Health, Boston, MA, USA; ²Duke University, Nicholas School of the Environment, Durham, NC, USA; ³Boston University School of Public Health, Boston, MA, USA; ⁴University of Birmingham, School of Geography, Earth and Environmental Sciences, Birmingham, UK

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Flame retardant chemicals are used in materials on airplanes to slow the propagation of fire. These chemicals migrate from their source products and can be found in the dust of airplanes, creating the potential for exposure.  To characterize exposure to flame retardant chemicals in airplane dust, we collected dust samples from locations inside 19 commercial airplanes parked overnight at airport gates. In addition, hand-wipe samples were also collected from 9 flight attendants and 1 passenger who had just taken a cross-country (USA) flight. The samples were analyzed for a suite of flame retardant chemicals. To identify the possible sources for the brominated flame retardants, we used a portable XRF analyzer to quantify bromine concentrations in materials inside the airplanes.

Results

• A wide range of flame retardant compounds were detected in 100% of the dust samples collected from airplanes, including BDEs 47, 99, 153, 183 and 209, tris(1,3-dichloro-isopropyl)phosphate (TDCPP), hexabromocyclododecane (HBCD) and bis-(2-ethylhexyl)-tetrabromo-phthalate (TBPH).
• Airplane dust contained elevated concentrations of BDE 209 (GM: 500 ug/g; range: 2,600 ug/g) relative to other indoor environments, such as residential and commercial buildings, and the hands of participants after a cross-country flight contained elevated BDE 209 concentrations relative to the general population.
• TDCPP, a known carcinogen that was removed from use in children’s pajamas in the 1970’s although still used today in other consumer products, was detected on 100% of airplanes in concentrations similar to those found in residential and commercial locations.

Conclusion

This study adds to the limited body of knowledge regarding exposure to flame retardants on commercial aircraft, an environment long hypothesized to be at risk for maximum exposures due to strict flame retardant standards for aircraft materials. Our findings indicate that flame retardants are widely used in many airplane components and all airplane types, as expected. Most flame retardants, including TDCPP, were detected in 100% of dust samples collected from the airplanes. The concentrations of BDE 209 were elevated by orders of magnitude relative to residential and office environments.