Above the Clouds: Occupational Exposures and Reproductive Outcomes among Flight Attendants : A Scoping Review

Sammanfattning

Background: Flight attendants are exposed to occupational factors, that may influence reproductive outcomes. Despite existing GSRHR frameworks, evidence on reproductive outcomes among this population remains underexplored. Aim: This thesis aims to map the existing literature on occupational exposures in flight attendant work and their associations with reproductive outcomes to identify knowledge gaps for future research and policy development. Methodology: A scoping review was used to identify and chart scientific studies from the PubMed and CINAHL databases. The search strategy was guided by the PEO framework and reported in accordance with PRISMA-ScR guidelines. Gray literature was excluded. Findings were summarised descriptively. Results: The review includes 12 studies, primarily published between 2015 and 2025. The evidence base is limited and methodologically heterogeneous, with a predominance of associative findings. Circadian disruption and cosmic ionising radiation are the most consistently examined exposures. Evidence on direct reproductive outcomes is focused on miscarriage, while several studies report broader reproductive outcomes. Conclusions: The findings suggest that reproductive health among flight attendants is shaped by interacting occupational exposures. Longitudinal, multi-level, and methodologically innovative approaches in future research could better address the cumulative complexity of aviation work environments and reproductive outcomes within an SRHR-informed perspective.