Clinical trial NCT00342407: The Incidence of Breast and Other Cancers Among Female Flight Attendants
Official title: The Incidence of Breast and Other Cancers Among Female Flight Attendants
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Thyroid Cancer
Breast Cancer
Non-Melanoma Skin Cancer
Melanoma
Keywords: Cancer Risk
Cosmic Radiation
Airlines
Flight Attendants
Circadian Rhythm
Lead sponsor: National Institutes of Health Clinical Center (CC)
Sponsor class: NIH
Collaborators: name: Centers for Disease Control and Prevention
name: National Institute for Occupational Safety and Health (NIOSH/CDC)
First posted: 2006-06-21
Enrollment: 6093
Sex: FEMALE
Minimum age (years): 18
Maximum age (years): 100
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: CASE_ONLY
Time perspective: OTHER
Sampling method: PROBABILITY_SAMPLE
Study population: Female flight attendants

Brief summary: Flight attendants may be at an increased risk of breast and other cancers due to work-place exposures including cosmic radiation and circadian rhythm disruption form traveling across multiple time zones. This cancer incidence study will determine whether female flight attendants are at increased risk of breast and other cancers and whether the risk is dose-related. The study will include a cohort of approximately 10,000 women who were employed as flight attendants for one or more years.

Breast cancer cases will be identified from telephone interviews of living subjects and next-of-kin of deceased subjects, as well as from death certificates. The interview will also provide information about non-occupational risk factors for breast cancer such as parity. Both internal and external comparisons will be made. The primary analysis will evaluate the risk associated with occupational exposure within the cohort, controlling for non-occupational risk factors by stratification or modeling. The secondary analysis will compare the incidence of breast cancer in the cohort to that in the general population, with adjustment for factors such as lower parity which might increase breast cancer risk in the cohort independent of occupational exposure to cosmic radiation and circadian rhythm disruption. The risk of other ionizing radiation-related cancers, such as leukemia, lung cancer, and thyroid cancer, among flight attendants will also be evaluated. The results of the study will apply to female flight crew and frequent fliers.

Detailed description: Flight attendants may be at an increased risk of breast and other cancers due to work-place exposures including cosmic radiation and circadian rhythm disruption from traveling across multiple time zones. This cancer incidence study will determine whether female flight attendants are at increased risk of breast and other cancers and whether the risk is dose-related. The study will include a cohort of approximately 9,631 women who were employed as flight attendants for one or more years.

Breast cancer cases will be identified from telephone interviews of living subjects and next-of-kin of deceased subjects, as well as from death certificates. The interview will also provide information about non-occupational risk factors for breast cancer such as parity. Both internal and external comparisons will be made. The primary analysis will evaluate the risk associated with occupational exposure within the cohort, controlling for non-occupational risk factors by stratification or modeling. The secondary analysis will compare the incidence of breast cancer in the cohort to that in the general population, with adjustment for factors such as lower parity which might increase breast cancer risk in the cohort independent of occupational exposure to cosmic radiation and circadian rhythm disruption. The risk of other ionizing radiation-related cancers, such as leukemia, lung cancer, and thyroid cancer, among flight attendants will also be evaluated. The results of the study will apply to female flight crew and frequent fliers.

Eligibility criteria: * INCLUSION CRITERIA:

Employed as a flight attendant for one or more years by Pan AM before Pan Am ceased operation in 1991. For flight attendants who transferred to Pan Am from National Airlines when Pan Am bought National Airlines in 1981, the time employed as a flight attendant at National Airlines will be counted towards the one year minimum.

A U.S. citizen when they began working at Pan Am (or National Airlines, if the flight attendant transferred to Pan AM from National Airlines).

Worked at least one day after January 1, 1953.

Primary outcomes:
measure: Breast and other cancers
timeFrame: Time of questionnaire, time of death
Secondary outcomes:
Other outcomes:
Locations:
city: Cincinnati
country: United States
facility: National Institute for Occupational Safety and Health (NIOSH)
state: Ohio
Study officials:
affiliation: National Cancer Institute (NCI)
name: Mark P Little, Ph.D.
role: PRINCIPAL_INVESTIGATOR
References:
citation: Grajewski B, Waters MA, Whelan EA, Bloom TF. Radiation dose estimation for epidemiologic studies of flight attendants. Am J Ind Med. 2002 Jan;41(1):27-37. doi: 10.1002/ajim.10018.
citation: Pinkerton LE, Waters MA, Hein MJ, Zivkovich Z, Schubauer-Berigan MK, Grajewski B. Cause-specific mortality among a cohort of U.S. flight attendants. Am J Ind Med. 2012 Jan;55(1):25-36. doi: 10.1002/ajim.21011. Epub 2011 Oct 10.
citation: Waters MA, Grajewski B, Pinkerton LE, Hein MJ, Zivkovich Z. Development of historical exposure estimates of cosmic radiation and circadian rhythm disruption for cohort studies of Pan Am flight attendants. Am J Ind Med. 2009 Oct;52(10):751-61. doi: 10.1002/ajim.20738.