[The clinical significance of cosmic radiation in aviation]

The possible adverse health effects of cosmic radiation remains an important topic in the consultation of aviators and frequent flyers. A good number of articles, dealing with this questions have been published recently but produced controversial results.

We performed a Medline database search and identified 20 relevant articles that were published between 1990 and 2003. There were one retro-/prospective, 13 retrospective, 3 prospective cohort studies and 3 metaanalysis reviewed. Sixteen studies were set in the civil aviation environment, two studies in the military aviation environment and two studies were set in both environments.

Seven out of nine studies found an identical or decreased over-all-risk for aviators to develop cancer of any kind compared to the general population. In re- gards to skin cancer, seven out of eight studies found an increased risk for aviators to develop malignant melanoma, basalioma or other kinds of skin cancer. Three studies found an increased risk for the development of prostate cancer and two studies were able to demonstrate a higher risk for the appearance of leukaemia.

Although our review found some studies, that identified higher risks for pilots to develop cancer of the skin, prostate cancer or leukaemia, there is not enough scientific evidence to support the hypothesis, that cosmic radiation is the cause for these findings. It shows to be important to include other factors in the interpretation of the results, since some of the findings may be well explained by life-style factors of the aviation community.