Incident skin melanoma in Danish male military pilots: a nested case–control study

Objectives A growing body of research has reported that pilots have an increased risk of skin melanoma, which may be caused by occupational exposure to cosmic and solar ultraviolet A radiation in aircraft cockpits. However, the existing literature cannot rule out confounding, for example, that pilots may spend more leisure time in the sun compared with the general population, which therefore leaves the current evidence inconclusive. The present study aimed to provide more knowledge regarding this association. Methods This nested case–control study included 199 male cases of skin melanoma diagnosed between 1990 and 2003, and 1126 male cancer-free controls identified from a large Danish military population. Among these individuals, 10 cases had ever worked as a pilot. Detailed information on military service and other held jobs together with socioeconomic and lifestyle characteristics, for example, leisure-time sun exposure habits, had been obtained from a structured questionnaire. Results Adjusted results showed a positive association between work onboard aircraft and skin melanoma (OR=2.30, 95% CI: 1.06–4.97) and the risk was indicated only to be increased in pilots (OR=7.08, 95% CI: 2.51–19.93). A positive association between longer duration of employment as a pilot and skin melanoma was also observed (OR per year =1.07, 95% CI: 1.01–1.14). Conclusions The findings from this study conducted among Danish military personnel suggest that pilots have an increased risk of skin melanoma after accounting for leisure-time sun exposure and socioeconomic status. Future large-scale studies focusing on the risk of skin melanoma in pilots, including detailed objective information on dimensions of exposure and potential confounders, are warranted.