Table 1

Irregular short-term intermittent hypoxia

First author, year of publicationCountryParticipantsKind of participantsYearsYielding /person-yearsOutcomeSMRCI
Irvine,22 1993England/Wales6209Male pilots (all heart disease)1950–1992143 506↓ CD0.390.33 to 46.2
Male pilots (IHD)0.390.32 to 45.9
1153Male flight engineers (all CD)29 094↓ CD0.410.28 to 56.8
Male flight engineers (IHD)0.400.27 to 0.57
Band,16 1996Canada2740Male pilots (circulatory system)1950–199262 449↓ CD0.60.49 to 0.72
Male pilots (IHD)↓ CD0.570.45 to 0.71
Male pilots (AMI)↓ CD0.610.45 to 0.80
Male pilots (cerebrovascular disease)↓ CD0.550.27 to 0.99
Male pilots (aortic aneurysm)↓ CD0.950.26 to 2.45
Ballard,15 2002Italy3022Male cockpit crew members (CD)1965–199654 072↓ CD0.760.57 to 0.99
Male cockpit crew members (AMI)↓ CD0.910.62 to 1.29
Male cockpit crew members (CVD)↓ CD0.280.11 to 0.57
3418Male cabin attendants (CD)49 391↓ CD0.640.36 to 1.05
Male cabin attendants (AMI)↓ CD0.540.22 to 1.11
Male cabin attendants (CVD)↓ CD0.610.17 to 1.55
6440Female cabin attendants (CD)53 305↑ CD1.28*0.16 to 4.63
Female cabin attendants (CVD)↓ CD0.810.10 to 2.94
Zeeb,18 2002German6061Male cockpit crew (all cardiovascular)1960–1997105 037↓ CD0.460.34 to 0.62
Male cockpit crew (hypertension)↓ CD0.240.01 to 1.39
Male cockpit crew (AMI)↓ CD0.430.28 to 0.65
Male cockpit crew (other IHD)↓ CD0.650.36 to 1.10
Male cockpit crew (other CD)↓ CD0.410.22 to 0.72
Blettner,23 2002German16 014Female cabin attendants (CVD)1960–1997188 218↓ CD0.50.10 to 1.60
Female cabin attendants (all CD)↓ CD0.230.04 to 0.74
Female cabin attendants (other IHD)↓ CD0.750.02 to 4.62
Female cabin attendants (Hp)↑ CD1.17*0.03 to 7.15
Female cabin attendants (other CD)↓ CD0.160.00 to 0.98
4537Male cabin attendants (CVD)606 650↓ CD0.260.01 to 1.56
Male cabin attendants (all CD)↓ CD0.410.18 to 0.86
Male cabin attendants (other IHD)↓ CD0.670.08 to 2.63
Male cabin attendants (Hp)↓ CD0.180.02 to 0.71
Male cabin attendants (other IHD)↓ CD0.750.23 to 1.89
Qiang,30 2003USA3263Male commuter/air taxi pilots1987–199735 427↓ CD0.180.15 to 0.22
Zeeb,19 2003German6061Male cockpit crew <30 years (all CV)1960–1997105 000↓ CD0.20.1 to 0.5
Male cockpit crew <30 years (AMI)↓ CD0.20.1 to 0.5
Male cockpit crew <30 years (other IHD)↓ CD0.30.0 to 1.3
Male cockpit crew <30 years (other CD)↓ CD0.320.1 to 0.9
Male cockpit crew >30 years (all CV)↓ CD0.60.4 to 0.8
Male cockpit crew >30 years (AMI)↓ CD0.60.4 to 0.9
Male cockpit crew >30 years (other IHD)↓ CD0.750.4 to 1.3
Male cockpit crew >30 years (other CD)↓ CD0.460.2 to 0.9
Male cockpit crew <55 years (all CV)↓ CD0.40.2 to 0.6
Male cockpit crew <55 years (AMI)↓ CD0.30.1 to 0.7
Male cockpit crew <55 years (other IHD)↓ CD0.60.1 to 1.8
Male cockpit crew <55 years (other CD)↓ CD0.40.1 to 0.9
Male cockpit crew >55 years (all CV)↓ CD0.50.4 to 0.7
Male cockpit crew >55 years (AMI)↓ CD0.50.3 to 0.8
Male cockpit crew >55 years (other IHD)↓ CD0.70.3 to 1.2
Male cockpit crew >55 years (other CD)↓ CD0.50.2 to 0.9
Paridou,29 2003Greece843Male cockpit crew1960–199717 587↓ CD0.20.0 to 0.9
Blettner,24 2003Denmark, Finland, Germany, Great Britain, Greece, Iceland, Italy, Norway and Sweden27 797Male cockpit crew (CVD)1921–1997547 564↓ CD0.510.41 to 0.62
Male cockpit crew (all CV)↓ CD0.510.46 to 0.56
Male cockpit crew (AMI)↓ CD0.500.44 to 0.57
Zeeb,20 2003Denmark, Finland, Germany, Greece, Iceland, Italy, Norway and Sweden33 063Female cabin crew (All CD)1960–1997485 831↓ CD0.510.27 to 0.91
Female cabin crew (CVD)↓ CD0.270.14 to 0.49
11 079Male cabin crew (all CD)170 634↓ CD0.610.33 to 1.12
Male cabin crew (CVD)↓ CD0.620.48 to 0.83
Linnersjö,26 2011Sweden1478MCP (30–39 years)1957–199433 127
MCP (40–49 years)↓ CD0.260.03 to 0.96
MCP (50–59 years)↓ CD0.480.22 to 0.91
MCP (60–69 years)↓ CD0.440.23 to 0.76
MCP (70–79 years)↓ CD0.450.23 to 0.81
MCP (≥80 years)↑ CD1.4*0.45 to 3.27
2166Male military pilots (30–39 years)52 141↑ CD1.080.13 to 3.90
Male military pilots (40–49 years)↓ CD0.330.09 to 0.85
Male military pilots (50–59 years)↓ CD0.410.23 to 0.67
Male military pilots (60–69 years)↓ CD0.580.40 to 0.76
Male military pilots (70–79 years)↓ CD0.50.35 to 0.65
Male military pilots (≥80 years)↓ CD0.750.47 to 1.03
991MMN and mechanics (30–39 years)24 252↑ CD1.27*0.03 to 7.08
MMN and mechanics (40–49 years)=CD1.050.38 to 2.28
MMN and mechanics (50–59 years)↓ CD0.760.42 to 1.28
MMN and mechanics (60–69 years)↓ CD0.650.39 to 0.92
MMN and mechanics (70–79 years)↓ CD0.990.66 to 1.32
MMN and mechanics (≥80 years)↓ CD0.520.19 to 1.13
632Male cabin crew14 658↓ CD0.500.28 to 0.73
2324Female cabin crew48 001↓ CD0.310.09 to 0.80
Houston,21 2011UK14 379Male commercial pilots2008↓ CD
Female commercial pilots↓ CD
De Stavola,31 2012UK15 881Male flight crew1989–1999258 650↓ CD0.190.16 to 0.23
446Female flight crew↓ CD
Yong,17 2014USA5964CCC (cerebrovascular)1960–2008202 316↓ CD0.610.50 to 0.74
CCC (rheumatic heart)↓ CD0.30.06 to 0.88
CCC (all ischaemic heart)↓ CD0.490.43 to 0.55
CCC (AMI)↓ CD0.370.31 to 0.43
CCC (all other CD)↓ CD0.470.39 to 0.56
Hammer,25 2014Denmark, Finland, Germany, Greece, Iceland, Italy, Norway, Sweden, UK and USA36–816Male cockpit crew (all CD)21.72 032 279↓ CD0.420.37 to 0.46
Male cockpit crew (RHD)↓ CD0.110.02 to 0.35
Male cockpit crew (IHD)↓ CD0.360.29 to 0.44
Male cockpit crew (AMI)↓ CD0.450.38 to 0.52
Male cockpit crew (Hp)↓ CD0.420.21 to 0.74
Male cockpit crew (other CD)↓ CD0.470.37 to 0.59
12 288Male cabin crew (all CD)↓ CD0.720.60 to 0.85
Male cabin crew (RHD)
Male cabin crew (IHD)↓ CD0.860.64 to 1.13
Male cabin crew (AMI)↓ CD0.580.44 to 0.76
Male cabin crew (Hp)=CD1.030.45 to 2.00
Male cabin crew (other CD)↓ CD0.760.53 to 1.06
44 667Female cabin crew (RHD)
Female cabin crew (IHD)↓ CD0.30.16 to 0.50
Female cabin crew (AMI)↓ CD0.270.16 to 0.43
Female cabin crew (Hp)↓ CD0.380.12 to 0.91
Female cabin crew (other CD)↓ CD0.540.37 to 0.77
McNeely,27 2014USA3208Female flight attendants (CD)2005–2006 2007–2008↑ CD(SPR) 3.512.72 to 4.30
Female flight attendants (Hp)↓ CD(SPR) 0.540.49 to 0.58
802Male flight attendants (CD)↑ CD(SPR) 1.390.79 to 1.98
Male flight attendants (Hp)=CD(SPR) 1.000.86 to 1.19
McNeely,28 2018USA998Male flight attendants (CD)2014–2015↓ CD(SPR) 0.730.47 to 1.15
Male flight attendants (Hp)↓ CD(SPR) 0.630.56 to 0.70
4368Female flight attendants (CD)↓ CD(SPR) 0.530.29 to 0.96
Female flight attendants (Hp)↓ CD(SPR) 0.440.30 to 0.50
  • ↑, increase; ↓, decrease; =, no change.

  • *Standardised mortality ratio (SMR) higher than 1.

  • AMI, acute myocardial infarction; CCC, commercial cockpit crew; CD, cardiovascular disease; CVD, cerebral vascular disease; Hp, hypertension; IHD, ischaemic heart disease; MCP, male commercial pilots; MMN, male military navigators; RHD, rheumatic heart disease; SPR, standardised prevalence ratio.