Secondhand Smoke Linked to Early Vascular Aging in Flight Attendants

Flight attendants with previous exposure to passive or secondhand smoke (SHS) have displayed preclinical signs of accelerated vascular aging, as reported by a study in the February Journal of Occupational and Environmental Medicine.

According to a study by C. Noel Bairey-Merz, MD, of Cedars-Sinai Medical Center based in Los Angeles, and some colleagues, abnormalities found in vascular (blood vessel) properties and functions might account for an accelerated risk of cardiovascular diseases among flight attendants with remote in-cabin SHS exposure. This study has been supported by the Flight Attendant Medical Research Institute (FAMRI).

The study comprised of 26 flight attendants with occupational exposure to SHS since before the advent of smoking bans in airplanes. This ban was established in 1988 for domestic flights and in 1995 for international flights. Most were females with no previously known cardiovascular risk symptoms. For this study, both past and present smokers were excluded.

It was concluded that these flight attendants had almost 14,000 hours of in-cabin SHS exposure over a span of approximately 14 years. They underwent vascular testing as part of the experiment in order to assess the number of blood vessel functional characteristics they possessed that hinted at cardiovascular disease risk.

The results revealed abnormalities on several aspects of cardiovascular function: pulse, blood pressure, augmentation index, and flow-mediated dilation. Results from other vascular tests, including blood pressure, were fairly standard.

The magnitude of abnormal results suggested increased arterial stiffness i.e. decreased compliance and impaired working of the inner lining that is, endothelial layer, of blood vessels. These are warning signs of early onset of vascular aging, which may have serious implications for cardiovascular health in the long run. The researchers also referenced a previous study that reported a shocking 3.5-fold increase in cardiovascular disease risk factor among female flight attendants.

Although these are preliminary results, Dr. Bairey Merz and his coauthors concluded that, “suggest that flight attendants with in-cabin SHS prior to the airline smoking ban have preclinical accelerated vascular aging,” given that cardiovascular disease remains one of the leading cause of mortality in both males and females, the researchers have placed emphasis on the need for more studies that evaluate the link between constant SHS exposure and cardiovascular health.