Study Links Secondhand Smoke to Early Vascular Aging in Flight Attendants

Flight attendants with past exposure to secondhand smoke (SHS) have preclinical signs of accelerated vascular (blood vessel) aging, according to a study recently published in the Journal of Occupational and Environmental Medicine.

Flight attendants with past exposure to secondhand smoke (SHS) have preclinical signs of accelerated vascular (blood vessel) aging, according to a study recently published in the Journal of Occupational and Environmental Medicine.

According to the study by C. Noel Bairey-Merz, MD, of Cedars-Sinai Medical Center, Los Angeles, and colleagues, abnormalities in blood vessel characteristics and function might account for increased cardiovascular risk among flight attendants who have experienced remote in-cabin SHS exposure. The study was supported by the Flight Attendant Medical Research Institute (FAMRI).

The study included 26 flight attendants who had experienced occupational exposure to SHS prior to the implementation of airline smoking bans—1988 for domestic and 1995 for international flights. Most of the flight attendants were women with no known cardiovascular risk factors, and past or current smokers were excluded.

The flight attendants in the study had almost 14,000 hours of in-cabin SHS exposure over an average of 14 years. They went through vascular testing to assess a number of blood vessel functional characteristics linked to risk of cardiovascular disease.

The results showed abnormalities on several measures of vascular function, including pulse pressure, augmentation index, and flow-mediated dilation. Other vascular tests, including blood pressure, had normal results.

The abnormal results suggest increased arterial stiffness (decreased compliance) and impaired function of the inner lining (endothelial layer) of the blood vessels, both signs of early vascular aging. These may have implications for future cardiovascular health. The researchers cited a previous study that reported a 3.5-fold increase in risk of cardiac disease among female flight attendants.

The results are preliminary, but the new findings do "suggest that flight attendants with in-cabin SHS prior to the airline smoking ban have preclinical accelerated vascular aging," concluded Dr. Bairey Merz and coauthors.

As cardiovascular disease remains the leading cause of death in both women and men, the researchers emphasize the need for larger studies to evaluate the relationship between chronic exposure to SHS and vascular health.

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