Quantifying Risk to Flight Attendants from Secondhand Smoke Exposure in Airline Cabins Using Pharmacokinetic Modeling: A Case Report
Main Article Content
Abstract
Background: Several studies of the health problems incurred by flight attendants flying during the smoking years concluded that they suffered elevated rates of chronic bronchitis, heart disease, skin cancer, breast cancer, melanoma, reproductive cancers, middle ear infections, hearing loss, asthma, pneumonia, chronic obstructive pulmonary disease, various pulmonary function abnormalities, plus depression and anxiety.
Aims: Systematic review of secondhand smoke risks to flight attendants, exemplified using a specific case involving a deceased flight attendant who suffered from a multiplicity of tobacco-smoke-related diseases, including asthma, breast cancer, carotid artery stenosis, cataracts, cervical cancer, chronic obstructive pulmonary disease, coronary artery disease, laryngeal cancer, pneumonia and chronic myeloid leukemia. The decedent died in 2014 at age 68, losing an estimated 18.5 years of life expectancy.
Methods: Pharmacokinetic modeling was used for the first time to estimate the risk from secondhand smoke for flight attendants on typical passenger aircraft flown by the decedent during an 18 year period ending in 1988.
Results: Based on in-flight cotinine dosimetry measured in an Air Canada study, typical flight attendants would have inhaled a dose-equivalent of fine particle air pollution exceeding the “Air Pollution Emergency” levels of the U.S. Environmental Protection Agency’s Air Quality Index. The secondhand smoke cotinine dose for typical flight attendants in aircraft cabins is estimated to have been 6-fold that of the average US worker and 14-fold that of the average person. Thus, ventilation systems massively failed to control secondhand smoke air pollution in aircraft cabins, and led to extreme exposures. The decedent’s estimated lifetime cancer risk from secondhand smoke was 18 times U.S. OSHA’s Significant Risk of Material Impairment of Health level of 1 per 1000 per working lifetime.
Conclusions: In-flight exposure to toxic and carcinogenic tobacco smoke in smoky passenger cabins was the major risk factor leading to the decedent’s multiple smoking-related diseases, and her premature death. This has implications for the extant and future health of the cohort of surviving flight attendants exposed to secondhand smoke on aircraft during the 20th Century Era.
Article Details
How to Cite
REPACE, James.
Quantifying Risk to Flight Attendants from Secondhand Smoke Exposure in Airline Cabins Using Pharmacokinetic Modeling: A Case Report.
Medical Research Archives, [S.l.], v. 11, n. 7.2, july 2023.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/4157>. Date accessed: 26 dec. 2024.
doi: https://doi.org/10.18103/mra.v11i7.2.4157.
Section
Case Reports
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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36. Batty GD, Kivimaki M, Gray L, Smith GD, Marmot MG, Shipley MJ. Cigarette smoking and site-specific cancer mortality: testing uncertain associations using extended follow-up of the original Whitehall study. Ann Oncol. 2008 May;19(5):996-1002. doi: 10.1093/annonc/mdm578. Epub 2008 Jan 22. PMID: 18212091.
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62. Estate of Kathleen Sprowl-Cheney, Plaintiff, vs. Philip Morris USA, Inc. et al., Defendants
·Case No. 00-21850 CA 23, Florida, USA..
63. IN THE CIRCUIT COURT FOR THE COUNTY OF LOUISA, THOMAS ALEXANDER GARRETT, JR., Plaintiff, v. CL19000417-00 FLANNA SHERIDAN (f/k/a GARRETT), Defendant. Virginia, USA.
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