Pulmonary function abnormalities in never-smoking flight attendants exposed to secondhand tobacco smoke in the aircraft cabin

Abstract

Objective: To determine whether the flight attendants who were exposed to secondhand tobacco smoke in the aircraft cabin have abnormal pulmonary function.

Methods: We administered questionnaires and performed pulmonary function testing in 61 never-smoking female flight attendants who worked in active air crews before the smoking ban on commercial aircraft (preban).

Results: Although the preban flight attendants had normal FVC, FEV1, and FEV1/FVC ratio, they had significantly decreased flow at mid- and low-lung volumes, curvilinear flow-volume curves, and evidence of air trapping. Furthermore, the flight attendants had significantly decreased diffusing capacity (77.5% +/- 11.2% predicted normal) with 51% having a diffusing capacity below their 95% normal prediction limit.

Conclusions: This cohort of healthy never-smoking flight attendants who were exposed to secondhand tobacco smoke in the aircraft cabin showed pulmonary function abnormalities suggestive of airway obstruction and impaired diffusion.

Figure 1

Box plot distribution of spirometry of the flight attendants as percent predicted values for their sex, age, and height (N=61). The box represents the interquartile range; the horizontal line inside the box represents the median; and the vertical lines (whiskers) represent the minimum and maximum non-outlier values. Outlier values are shown by a cross (x).

Figure 2

Diffusing capacity (adjusted for hemoglobin) of flight attendants compared to 95% prediction limits of their predicted values (N=61). Subjects are presented in increasing order of their predicted diffusing capacity. Black solid line: predicted diffusing capacity; dash lines: upper and lower 95% prediction limits; black dots: diffusing capacity of flight attendants.