Pilots may be well travelled and handsomely paid, but their hefty salaries (British Airways captains earn an average of £167,000) are arguably outweighed by the pressures of the job. Indeed, it was rated as the world’s third most stressful job in 2018.
Travel pressures and an element of danger are sure-fire ways to increase stress, according to the survey respondents, both of which are part and parcel with piloting a plane. Another factor is disrupted circadian rhythms (the process that regulates the sleep-wake cycle) – an occupational hazard for pilots. "The truth is we're exhausted," an anonymous pilot told Reader's Digest in 2013.
But do these aspects take a long-term toll on a pilot's health – and ultimately life expectancy? We examined the research and asked the British Airline Pilots Association (Balpa), and a sleep expert, for their views.
What does the research say, and how reliable is it?
There are a few papers that were published in – or used data up to – the Nineties, with varying results. One from 1992, for Flight Safety Digest – a former publication of the US-based Flight Safety Foundation - concluded that pilots do die at a younger age than the general population, based on two main data sources.
The first was taken from seven airline pilot associations that looked at the number of pilot deaths between ages 50 and 74 (with an average retirement age of 54). The second came from the US Airline Pilots Association and looked at pilot deaths after the age of 60. Analysing these two sources, the study’s authors deduced that the average age of death for pilots was 61, compared to the average age of death of the general population, which was 63.
In 1995, another study looked at historic data. It said chatter among the aviation industry perpetuates the idea pilots die young. “Each time an airline pilot dies the first few years after retirement, the hypothesis of airline pilots’ premature death is reborn and reinforced in the minds of the observers," said the study's authors.
The study lists “physical and emotional” stressors that are thought to affect airline pilots’ health. The intimadating-sounding list includes (although isn't limited to): fatigue; cosmic radiation and electromagnetic field effects; circadian dysrhythmia; sound and vibration exposure; ambient pressure and mild hypoxia (where the body is deprived of adequate oxygen supply); potential air quality contaminants; questionable nutrition; responsibility for passenger safety and survival; the threat of losing their career; anxiety of disqualification through professional errors and concerns of losing medical certification from accidents; disease and ageing.
However, Rob Hunter, Balpa’s head of safety, said: “The inherent limitations of the studies that have looked at pilot health is that they are historic, they look at data over many years in the past.
“That would not be much of a limitation if conditions were unchanged for pilots, but it is likely to be a substantial limitation because conditions have changed for pilots.”
Later studies specific to pilots in Japan and the UK (British Airways) actually found them to have a higher life expectancy than the average person – in part because their health is checked more frequently, and thoroughly.
How often is pilots’ health checked?
According to Balpa, pilots require a check up for their ‘Class 1’ medical typically once a year. Checks are more frequent according to age and previous medical conditions. The checks include hearing, eyesight, blood pressure and cholesterol. There are also checks for diabetes and HIV, both of which would have cost pilots their careers until recently when rules were relaxed.
Hunter said: “There has been research to show that pilots generally have much better health than their matched controls [i.e. an average person that the study compares them to].
“If you see in a population with a better outcome than matched controls it doesn’t mean that the potential hazards exposed to [haven’t had an effect], it could be the case that if hazards were removed their health would be better still.”
So pilots might live even longer (especially given how many check-ups they have) if they weren't exposed to the hazards of their profession.
What health problems are common among pilots?
Hunter pointed to malignant melanoma (a type of cancer that develops from pigment containing cells). He said: “The reasons for the excess of malignant melanoma are unclear. However, Balpa is concerned about the blue light and near-visible ultraviolet light exposure in the cockpit, as well as circadian rhythm disruption.”
On the point of malignant melanoma, studies have “consistently demonstrated” there to be an excess of cases among pilots, according to Hunter.
A study published in 2015 concluded that pilots and cabin crew have approximately twice the incidence of melanoma than the general population.
How might disrupted sleep affect pilot's health?
We asked Dr Neil Stanley, an independent sleep expert and former director of sleep research at the University of Surrey, for his perspective on disrupted sleep among pilots and its impact on their health. He pointed to effects of jet lag, which, he said, can disrupt sleep and daytime performance for a lot longer than people think.
He said: “It can take 1 to 1.5 days per hour-change for your sleep to adapt, and therefore travelling from New York to London could take up to 10 days or so for your sleep to recover. The issue with pilots is that they rarely get the time between flights to fully adapt.”
Stanley pointed towards a few relevant scientific papers, including one published in 2010, in which the authors wrote: "Over 40 years of evidence indicate a strong association between nightly sleep duration and mortality risk".
But Stanley caveated some of the findings. As for how a general loss of sleep impacts health, he says: "There is certainly a link between short sleep on all-cause mortality but the increased risk of particular illnesses, while statistically significant, may not be clinically relevant."
He did add, though, that shift work is known to be extremely detrimental to health and well-being.
While Hunter said of pilots: "The most marked feature of their work is that they are shifting shift workers, so in a way they have the most severe of all the shift work effects. That means not only do they have the problems of workers who are starting early and working through the night, those start times vary to a degree that is not within human perfomance to adapt to."
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