The question now is whether these approaches adequately address either flight safety concerns or the occupational health and safety needs of flight attendants. The focus of the Congress of the United States on applying fatigue risk management strategies to flight attendants is laudable. Crew fatigue might threaten passenger safety and personal health if it occurs.
Evidence that flight attendant performance impairment or in capacitation poses a flight safety risk is scant and the costs of a new regulatory framework do not seem to be matched with corresponding benefit. However, concerns do exist about mental health, injury prevention, circadian dysrhythmia, ionizing radiation, reproductive disorders, and cancer.
Characterizing flight attendants ’ lifetime exposures and consequential health outcomes is complicated by diverse international practices on contracting and working conditions, and the disseminated and occupationally mobile nature of their employment, particularly outside the United States. The lack of standardized approaches to collecting data on exposures and health outcomes for flight attendants makes it very difficult to make inferences about health outcomes. What is needed is an evidence-based, comprehensive, and international approach to health and fitness concerns for this important occupational group, and a clear understanding about priorities and accountabilities for managing them, so that funding and priorities can be set in a transparent agenda.