Pilots, Flight Attendants Face Higher Risk of Radiation-Related Cancer Deaths

Flight attendants and pilots have the highest proportions of radiation-related cancer deaths among more than 500 U.S. occupations, according to a new study published Aug. 17 in JAMA Internal Medicine.

The findings add to concerns about long-term exposure to cosmic radiation at high altitudes and support stronger occupational protections for U.S. aircrews, researchers said.

“The results]support considering occupational radiation protections for U.S. aircrew members commensurate with their level of exposure,” said senior author Anupam Jena, the Joseph P. Newhouse Professor of Health Care Policy at Harvard Medical School.

Researchers analyzed nearly 13 million U.S. death certificates from 2020 through 2024 across 503 occupations, including approximately 14,000 pilots and 7,000 flight attendants. The analysis adjusted for age at death, sex, race, ethnicity, education and marital status.

About 6.9% of deaths among flight attendants and 6.7% among pilots were attributed to radiation-related cancers, the highest proportions of all occupations studied. Nuclear technologists, who routinely work around non-cosmic radiation, ranked 12th.

Pilots and flight attendants had significantly higher rates of death from breast cancer, central nervous system cancers, prostate cancer and melanoma. Pilots also had a higher rate of death from leukemia.

Aircrew members receive an estimated 3 to 6 millisieverts of cosmic radiation annually, depending on flight routes. By comparison, an average traveler taking 10 cross-country round trips per year receives about 0.4 millisieverts, according to the CDC.

Cosmic radiation exposure increases at altitude, making aircrew members the U.S. workforce with the largest estimated annual effective dose of ionizing radiation.

Although the Federal Aviation Administration recognizes pilots and flight attendants as occupationally exposed to ionizing radiation, U.S. aircrew are not subject to federal radiation dose limits or monitoring requirements, unlike some other radiation-exposed workers and aircrews in other countries.

The study, led by Vishal Patel, a Harvard Medical School clinical fellow in surgery at Brigham and Women’s Hospital, provides stronger mortality evidence than previous research by drawing on the National Vital Statistics System and recently available occupational information on death certificates.