Cohort study of occupational cosmic radiation dose and cancer mortality in German aircrew, 1960–2014

Cosmic Ionizing Radiation: A DNA Damaging Agent That May Underly Excess Cancer in Flight Crews

In the United States, the Federal Aviation Administration has officially classified flight crews (FC) consisting of commercial pilots, cabin crew, or flight attendants as "radiation workers" since 1994 due to the potential for cosmic ionizing radiation (CIR) exposure at cruising altitudes originating from solar activity and galactic sources. Several epidemiological studies have documented elevated incidence and mortality for several cancers in FC, but it has not yet been possible to establish whether this is attributable to CIR. CIR and its constituents are known to cause a myriad of DNA lesions, which can lead to carcinogenesis unless DNA repair mechanisms remove them. But critical knowledge gaps exist with regard to the dosimetry of CIR, the role of other genotoxic exposures among FC, and whether possible biological mechanisms underlying higher cancer rates observed in FC exist. This review summarizes our understanding of the role of DNA damage and repair responses relevant to exposure to CIR in FC. We aimed to stimulate new research directions and provide information that will be useful for guiding regulatory, public health, and medical decision-making to protect and mitigate the risks for those who travel by air.

Aircrew Health: A Systematic Review of Physical Agents as Occupational Risk Factors

The primary objective of this systematic review was to analyze the main physical agents representing risk factors for commercial aircrew, together with their consequences. The secondary objective was to identify the countries in which studies on the topic were conducted, as well as the quality of the publications available. Thirty-five articles, published between 1996 and 2020, were selected for the review, having met all inclusion criteria. The majority of studies were conducted in the United States, Germany, and Finland and had moderate or low methodological quality of evidence. The main risk factors for aircrew identified in publications were exposure to abnormal air pressure, cosmic radiation, noise, and vibrations. Hypobaric pressure was explored in response to demands for studies on this agent, a factor which may lead to otic and ear barotraumas, as well as acceleration of atherosclerosis of the carotid artery. However, there is a dearth of research exploring this phenomenon.

Ionizing radiation exposure during adulthood and risk of developing central nervous system tumors: systematic review and meta-analysis

Many studies on ionizing radiation (IR) exposure during childhood have shown deleterious effects on the central nervous system (CNS), however results regarding adult exposure are inconsistent, and no systematic reviews have been performed. The objectives are to synthesize the findings and draw evidence-based conclusions from epidemiological studies on the risk of benign and malignant brain and CNS tumors in humans exposed to low-to-moderate doses (< 0.5 Gy) of IR during adulthood/young adulthood. A systematic literature search of four electronic databases, supplemented by a hand search, was performed to retrieve relevant epidemiological studies published from 2000 to 2022. Pooled excess relative risk (ERR_pooled) was estimated using a random effect model. Eighteen publications were included in the systematic review and twelve out of them were included in a meta-analysis. The following IR sources were considered: atomic bombs, occupational, and environmental exposures. No significant dose-risk association was found for brain/CNS tumors (ERR_pooled at 100 mGy = − 0.01; 95% CI: − 0.05, 0.04). Our systematic review and meta-analysis did not show any association between exposure to low-to-moderate doses of IR and risk of CNS tumors. Further studies with histological information and precise dose assessment are needed.

Multimode Representation of the Magnetic Field for the Analysis of the Nonlinear Behavior of Solar Activity as a Driver of Space Weather

Estimating and predicting space weather is important to the space industry and space missions. The driver of space weather, especially near the Earth, is solar activity, the study of which is an important task. In particular, there is a direction of problems based on models of solar magnetic field generation that require research. In our work, we build a nonlinear dynamic system of equations that describes the behavior of the solar magnetic field harmonics based on the alpha-omega dynamo model. We found that, at the beginning of the magnetic field generation process, when the dynamo number significantly exceeds the threshold, the most rapidly growing waves are in the lead. Then, over time, these waves stop growing quite quickly. In this case, the initially slowly increasing harmonics of the magnetic field become the leaders, which then make the main contribution to the process of magnetic field generation.

Interplay Between Air Travel, Genome Integrity, and COVID-19 Risk vis-a-vis Flight Crew

During air travel, flight crew (flight attendants, pilots) can be exposed to numerous flight-related environmental DNA damaging agents that may be at the root of an excess risk of cancer and other diseases. This already complex mix of exposures is now joined by SARS-CoV-2, the virus that causes COVID-19. The complex exposures experienced during air travel present a challenge to public health research, but also provide an opportunity to consider new strategies for understanding and countering their health effects. In this article, we focus on threats to genomic integrity that occur during air travel and discuss how these threats and our ability to respond to them may influence the risk of SARS-CoV-2 infection and the development of range of severity of the symptoms. We also discuss how the virus itself may lead to compromised genome integrity. We argue that dauntingly complex public health problems, such as the challenge of protecting flight crews from COVID-19, must be met with interdisciplinary research teams that include epidemiologists, engineers, and mechanistic biologists.

Radiation in the Atmosphere—A Hazard to Aviation Safety?

Exposure of aircrew to cosmic radiation has been recognized as an occupational health risk for several decades. Based on the recommendations by the International Commission on Radiological Protection (ICRP), many countries and their aviation authorities, respectively have either stipulated legal radiation protection regulations, e.g., in the European Union or issued corresponding advisory circulars, e.g., in the United States of America. Additional sources of ionizing and non-ionizing radiation, e.g., due to weather phenomena have been identified and discussed in the scientific literature in recent years. This article gives an overview of the different generally recognized sources due to weather as well as space weather phenomena that contribute to radiation exposure in the atmosphere and the associated radiation effects that might pose a risk to aviation safety at large, including effects on human health and avionics. Furthermore, potential mitigation measures for several radiation sources and the prerequisites for their use are discussed.

Cognitive Changes in a Commercial Pilot Secondary to an Olfactory Meningioma

BACKGROUND: Olfactory meningiomas are typically benign, slow-growing intracranial tumors with subtle presentations that result in delayed diagnosis. To date, only a few published reports describe meningiomas in airmen. None specifically mention olfactory meningiomas or detail the associated presence of cognitive impairment.CASE REPORT: This was a 55-yr-old commercial pilot with over 20 yr of flight experience who presented for a fitness-for-duty evaluation due to alarming performance at work and neurocognitive concerns. On examination, the patient had an odd affect and anosmia. Imaging showed a large, frontal, midline intracranial mass consistent with an olfactory meningioma.DISCUSSION: Fitness-for-duty cases are often challenging and even more so when neurocognition is called into question. Symptoms may be subtle and gradual in onset, making recognition and diagnosis difficult. Dementia, alcohol or substance misuse/abuse, and psychiatric diagnoses are often the first conditions considered when evaluating new cognitive impairment in a pilot. This case highlights the importance of keeping a broad differential, including intracranial masses, conducting a thorough neurological examination, and the judicious use of brain imaging.Hong M, Kreykes AJ. Cognitive changes in a commercial pilot secondary to an olfactory meningioma. Aerosp Med Hum Perform. 2020; 91(12):966969.

Ionising radiation as a risk factor for lymphoma: a review

The ability of ionising radiation to induce lymphoma is unclear. Here, we present a narrative review of epidemiological evidence of the risk of lymphoma, including chronic lymphocytic leukaemia (CLL) and multiple myeloma (MM), among various exposed populations including atomic bombing survivors, industrial and medical radiation workers, and individuals exposed for medical purposes. Overall, there is a suggestion of a positive dose-dependent association between radiation exposure and lymphoma. The magnitude of this association is highly imprecise, however, with wide confidence intervals frequently including zero risk. External comparisons tend to show similar incidence and mortality rates to the general population. Currently, there is insufficient information on the impact of age at exposure, high versus low linear energy transfer radiation, external versus internal or acute versus chronic exposures. Associations are stronger for males than females, and stronger for non-Hodgkin lymphoma and MM than for Hodgkin lymphoma, while the risk of radiation-induced CLL may be non-existent. This broad grouping of diverse diseases could potentially obscure stronger associations for certain subtypes, each with a different cell of origin. Additionally, the classification of malignancies as leukaemia or lymphoma may result in similar diseases being analysed separately, while distinct diseases are analysed in the same category. Uncertainty in cell of origin means the appropriate organ for dose response analysis is unclear. Further uncertainties arise from potential confounding or bias due to infectious causes and immunosuppression. The potential interaction between radiation and other risk factors is unknown. Combined, these uncertainties make lymphoma perhaps the most challenging malignancy to study in radiation epidemiology.

Measurements of UV—A Exposure of Commercial Pilots Using Genesis-UV Dosimeters

A number of studies suggest that pilots are at twice the risk of melanoma and keratinocyte skin cancers than the general population, and that they have a raised mortality from melanoma. No conclusive links with in-flight exposure to ionising radiationor circadian rhythm disruption due to the pilots’ shift work were found. Possible over-exposure to ultraviolet radiation (UVR) may be implicated as pilots may be exposed to higher UV-A levels at cruise altitude compared with those at ground levels. The direct method of making in-flight spectral measurements has been carried out on a limited number of flights, but this technique is challenging; the use of small wearable sensors may be more appropriate but there are a few issues that should be addressed for their use in cockpit measurements. While the spectral response of sensors for erythema effective values usually closely matches the corresponding weighting function, the response of UV-A sensors may not be spectrally flat, which, if not corrected to account for the transmission of the aircraft windshield, could potentially result in large errors. In this paper, the spectral correction method was applied to the UV-A sensor of the Genesis-UV unit to measure UVR exposure of commercial pilots on 312 flights to a range of destinations from four UK airports from September 2016 to August 2017.