Epidemiology of turbulence-related injuries in airline cabin crew, 1992-2001.

Background: The purpose of this study was to determine the rate of flight attendant turbulence-related injuries in Part 121 air carrier operations from 1992-2001, and to identify the significant epidemiological determinants of turbulence-related injuries.

Methods: The National Transportation Safety Board's Aviation Accident Database was searched for the period from 1 January 1992 through 31 December 2001 for all records involving Part 121 air carrier turbulence-related accidents. Cases of turbulence-related flight attendant injuries were categorized by year and month of occurrence, aircraft type, air carrier, phase of flight, injury severity, type of injury, location in the aircraft where the injury occurred, status of the seat belt sign, and prevailing meteorological conditions. Continuous variables were analyzed by the Spearman rank-correlation method and ANOVA and categorical variables by the chi-square test.

Results: From 92 accident reports, 179 cases were identified. Of these cases, 82 (45.8%) involved serious injuries and 97 (54.2%) involved minor injuries. There was a non-significant upward trend in the rate of turbulence-related injuries, especially during the period from 1995 through 2000. Significant relationships were found between turbulence-related injuries and the phase of flight, location in the aircraft, seat belt sign illumination, aircraft type, and air carrier. The most frequent type of turbulence-related injury was lower extremity fractures, especially the ankle.

Conclusion: The number of flight attendant turbulence-related injuries is on the rise, although mostly due to a corresponding increase in flight hours. The significant epidemiological determinants appear to be unrestrained cabin crew, aircraft type, and air carrier.