Why are flight attendants’ rates of cancer spiking? Disrupted sleep and radiation may be to blame

Being a flight attendant has its bonuses, like getting to travel the world for free, meet new people, and earn well above the average American salary. But it’s not all free snacks and flights to Paris. The job comes with some costs too—like erratic schedules, aggressive passengers, and significant delays.

But those, while frustrating, may be the tip of the iceberg. This week, new research is boosting concerns about an even more severe hazard: the increased risk of cancer. The study, published in the journal Environmental Science, is the second wave of a 2007 Harvard Flight Attendant Health Survey aimed at analyzing how “occupational exposures impact the health of flight attendants.” 

The initial 2007 study analyzed the general health of flight attendants, finding elevated rates of things like sleep disorders, fatigue, and depression. For this new study, the researchers from the Harvard T.H. Chan School of Public Health focused on cancer, recruiting more than 5,000 current and former flight attendants— 80 percent of whom were female—to share their history. 

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22 things your flight attendant won’t tell you
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22 things your flight attendant won’t tell you

1. Want to start off on the wrong foot with me?

Put your carry-on in a full overhead bin, leave it sticking out six inches, then take your seat at the window and wait for someone else (me!) to come along and solve the physics problem you just created. By the way, this is what your flight attendant first notices about you.

2. Yes, passengers are incredibly rude...

 

..but stealing a beer, cursing out passengers, and jumping out of a plane is not the way to handle it. You disarm an unruly passenger by introducing yourself, asking his name, and saying something like ‘I’ve been incredibly nice to you for three hours. Why are you treating me like this?’ Generally, that gets the other passengers on your side—and sometimes they’ll even applaud.

3. We don't have a boyfriend in every city.

 And our median age these days is 44.

4. An all-too-common scenario?

I hand you a cup of coffee and say, ‘Cream and sugar?’ You say, ‘What?’ I say, ‘Cream and sugar?’ You say, ‘What?’ Come on, people. What do you think we’re going to ask after we’ve handed you coffee? Your favorite color? (But in all honesty, you probably shouldn't order coffee on a plane.)

5. If you’re traveling with a small child and you keep hearing bells, bells, and more bells...

...please look to see if it’s your child playing with the flight attendant call bell. These are the things you should never do on an airplane.

6. The lavatory door is not rocket science.

Just push.

7. If you have a baby, bring diapers.

If you’re diabetic, bring syringes. If you have high blood pressure, don’t forget your medication. That way, I’m not trying to make a diaper out of a sanitary pad and a pillowcase or asking over the intercom if someone has a spare inhaler. Here are some other little flying etiquette rules you know.

8. Just in case you hadn’t noticed, there are other people on the airplane besides you.

So don’t clip your toenails, snore with wild abandon, or do any type of personal business under a blanket!

9. If you’re traveling overseas, do yourself a favor and bring a pen.

You would not believe how many people travel without one, and you need one to fill out the immigration forms. I carry some, but I can’t carry 200. Here are some more tips to know before your next flight.

10. Passengers are always coming up to me and tattling on each other.

‘Can you tell him to put his seat up?’ ‘She won’t share the armrest.’ What am I, a preschool teacher?

11. I hate working flights to destinations like Vail and West Palm Beach.

The passengers all think they’re in first class even if they’re not. They don’t do what we ask. And the overhead bins are full of their mink coats.

12. Do you really have to go to the bathroom right now, while we’re wrestling a 250-pound food cart down the aisle?

 You can’t wait 90 seconds for us to pass?

13. Is it that difficult to say hello and goodbye?

We say it 300 times on every flight, and only about 40 people respond—saying "hello" is really the one word you need to get your flight attendant to like you.

14. Do not poke or grab me

I mean it. No one likes to be poked, but it’s even worse on the plane because you’re sitting down and we’re not, so it’s usually in a very personal area. You would never grab a waitress if you wanted ketchup or a fork, would you?

15. We’re not just being lazy.

Our rules really say we aren’t allowed to lift your luggage into the overhead bin for you, though we can “assist.” Try these tips for packing light when bringing a carry-on.

16. I don’t care if you want to be in the mile-high club, keep your clothes on.

Who decided the mile-high club was something that everyone wants to do anyway? It’s cramped and dirty in those bathrooms.

17. If you hear us paging for a doctor...

 ...or see us running around with oxygen, defibrillators, and first aid kits, that’s not the right time to ask for a blanket or a Diet Coke. Here are some other pet peeves of flight attendants.

18. The only place you are allowed to pee...

 ...on the airplane is in the lavatory. Period.

19. Don’t ask us if it’s OK to use the lavatories on the ground.

 The answer is always yes. Do you think what goes into the toilet just dumps out onto the tarmac?

20. You really expect me to take your soggy Kleenex?

 Or your kid’s fully loaded diaper? I’ll be right back with gloves.

21. Sure, I don’t mind waiting while you scour the seatback pocket

 ...and the floor for candy wrappers and other garbage, then place them in my bag one by one. I only have 150 other passengers to serve.

22. I’m sorry it’s taking forever to get you a wheelchair.

That’s one thing you can’t blame the airline for. The wheelchair service is subcontracted to the cities we fly into, and it’s obviously not a top priority for many of them. Want more insider air travel info? These are the secrets your airplane pilot won't tell you.

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Once cataloged, the stats were compared with the National Health and Nutrition Examination Survey (NHANES), a nationwide study from the Centers for Disease Control and Prevention. The conclusion is stark. Flight attendants show a higher prevalence of every cancer studied, including breast, uterine, gastrointestinal, thyroid, cervical, melanoma and non-melanoma skin cancer.

Although the authors were not able to nail down an exact reason, concerns have been building for years about the exposure to cancer-causing agents (called carcinogens) on airlines. In this case, the two significant identified risks—which may be driving these numbers—are disrupted circadian rhythms and what’s called “cosmic ionizing radiation.”

Cosmic ionizing radiation is radiation that comes from outer space and is caused by things like solar flares. While only a small amount of it reaches earth, it’s present in much higher doses at flight altitudes. According to the CDC, flight attendants and pilots are exposed to it on every single flight, exposing them to the largest annual ionizing radiation dose of all U.S. workers. 

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Flight attendant's favorite travel hacks
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Flight attendant's favorite travel hacks

Get more attentive service from your flight attendants

"While most passengers tend to choose seats that are at the front of the aircraft so that they can disembark first and have a better chance of securing their preferred meal option, flight attendants know that if you're sitting towards the back, you'll receive the most attentive service," a flight attendant with 2.5 years' experience wrote for Oyster.

"The reason is simple: We like to avoid responding to call bells from the front of the plane because answering one means potentially flaunting whatever item the passenger has requested to everyone else along the way," she wrote. "This can cause a problem since planes often don't have enough extra vodka, pillows, earplugs, and toothbrushes, or the time on shorter flights to deviate from the service schedule.

"For passengers sitting near the back of the plane, however, it's much easier to slip in that second mini bottle of wine," she wrote.

Iron your clothes faster

"Use your flat iron to touch up your clothes when you're in a rush and there's no time for the ironing board," a flight attendant with 30 years' experience told Business Insider.

Always sleep in clean sheets

"Don't sleep on hotel sheets that don't have creases from being folded; someone slept on them already," a flight attendant with 19 years' experience told Business Insider.

Keep the hotel room dark

"Use the clips on the pants hangers in the hotel room to clip your curtains together so there is no light coming through,"a flight attendant with 15 years' experience told Business Insider.

Avoid doing damage to your hearing 

"Avoid flying if you have a severe cold,"a fight attendant with 4 years' experience wrote on Quora. "It can damage your eardrums, and you may lose your hearing. It happened to me once — I couldn't hear properly for a week, and it hurt like hell."

Avoid being seated near a baby

"While there's no escaping (or blaming) the shrill of an upset child, you can lower your odds of sitting directly next to one by choosing a seat that's located far from the partitions on board," a flight attendant with 2.5 years' experience wrote for Oyster.

"These partitions, which go by the technical name 'bulkheads,' are the only places on an aircraft where a parent can safely secure a baby's bassinet — and are, therefore, where most children under one year old will be situated," she wrote.

Fight jet lag

"What helps me sleep is having a bedtime ritual," a flight attendant wrote on Quora.

"Stop using electronics one hour before bedtime, have a cup of tea, and read a bit," he wrote. "Usually that does the trick, but if I can't sleep after an hour I just get up, do something else, and then try again."

Don't get stuck with a heavy bag you have to check

"Less is more," a flight attendant with three years' experience told Business Insider.

"The best way to travel is to pack exactly what you need and nothing more, besides maybe a couple of extra underwear," he said. "But other than that I would pack only what I need for that specific trip."

Pack lighter

"Before your trip, call your hotel and check to see if they have a washer/dryer available," a flight attendant with one year of experience told Business Insider. "If so, bring a couple detergent packs and dryer sheets in a Ziploc bag, and it eliminates two to four days' worth of clothes, depending on your stay.

Save space in your suitcase 

"My favorite travel hack is definitely the clothes-roll technique," a flight attendant with one year of experience told Business Insider. "I am often gone from home for several days, even up to three weeks, and I save space by rolling my clothes instead of folding them."

Get through customs in a jiff

"Pay for Global Entry — it's totally worth it," an anonymous flight attendant told Business Insider.

Never miss out on free breakfast 

"If you know you're not going to be able to attend whatever complimentary meal they're offering because you're leaving before it starts or you know you're not going to be up until after it's over, check with the hotel to see if there's some kind of snack or sack lunch they can provide before or ahead of time," a flight attendant with one year of experience told Business Insider.

"Usually it's just a piece of fruit, a bottle of water, and a thing of string cheese, but that's saved my growling stomach on several occasions," they said.

Get a cheaper upgrade

Some airlines offer reduced-price upgrades the day of the flight, Celessa Dietzel, a flight attendant with three years' experience, told Business Insider. There are even first-class seats available for upgrading sometimes, she said.

"So be in the boarding area good and early during boarding, because this is when you'll hear the announcements for last-minute upgrade purchases you might be able to get," Dietzel said. "It's not for every airline, but it does happen."

Don't miss out on the first-class upgrade if you qualify for it 

"I think it's great we don't have to travel in suits and high heels anymore. You can be comfortable," Dietzel told Business Insider. "But you can also be classy and comfortable."

"Check your air carrier's rules — there are still dress codes sometimes in first class and, who knows, maybe, miracle of the day, you'll get that cheap upgrade to first class. Be comfortable, but if you can avoid wearing your pajamas, that's great," she said.

Get free stuff ... sometimes

United Airlines flight attendant Robert Bingochea previously told Business Insider that, if something goes wrong on your flight, flight attendants are empowered with resolution options, from offering a free drink or meal to upgrading fliers and giving them more points. "We can't fix everything, but at least we can try to give it a chance and try to make things acceptable," he said.

But there's a catch.

"Complaining gets some people free stuff," a flight attendant with 30 years' experience told Business Insider. "But with the airline computer systems today, we can track all the free stuff given. We know who takes advantage."

SEE ALSO: A day in the life of a United Airlines flight attendant, who woke up before 3 a.m. and ran circles around me for 9 hours

DON'T MISS: 11 truths about flying only flight attendants know

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For years, the World Health Association (WHO) has declared a direct link between long-term exposure of this cosmic ionizing radiation and cancer. As a result, the European Union has placed limits on the amount of radiation exposure for flight crew members, specifically for pregnant women, to lessen the risk of cancer and other health effects. Although the CDC offers warnings about the dangers, it doesn’t suggest that the ionizing radiation levels are actively monitored for U.S. flight crews.

On top of that potential carcinogens, the Harvard researchers also point out pervasive disruption of sleep circadian rhythms among flight attendants, due to things like night shifts and changing time zones. While changing sleep cycles may seem benign, a chronically disrupted sleep cycle has been linked to multiple types of cancer including skin and breast.

In the wake of the study, former flight attendants have taken to Twitter to express their concern about how long the information has been concealed.

Echoing their thoughts is Harvard epidemiologist Irina Mordukhovich, one of the researchers involved. “Our study informs future research priorities regarding the health of this understudied group of workers, who have a wide range of job-related exposures to known and probable carcinogens,” she said in a statement. “Our findings raise the question of what can be done to minimize the adverse exposures and cancers common among cabin crew.”

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