It was once seen as a glamorous occupation that offered young women the opportunity to see the world. But the reality of life as an air stewardess is irregular hours, disrupted sleep, sexual harassment and tensions with their partner over child rearing.
A survey of 2,000 women who worked for a national airline found more than one in five said they had suffered sexual harassment from passengers with one in 20 having to fend off unwanted advances in the past year.
The threat was greater still from members of the crew with almost half of the women saying they had had to put up with offensive remarks or lewd behaviour by colleagues or superiors.
More than one in 10 said they had had to fend off a colleague in the past 12 months and, in a third of the cases, the incident was of the most severe type.
Sexual harassment was classified as receiving unwanted attention, being propositioned, groped, subjected to offensive remarks about personal appearance, shown sexually explicit material, being threatened, blackmailed, or subjected to attempted non-consensual sexual acts.
Women who reported being sexually harassed by passengers were almost three times more likely to rate their health as fair or poor, according to the study published in Occupational and Environmental Medicine.
The survey was conducted among current and former air stewardesses who joined Alitalia, the Italian national airline, between 1965 and 1995.
Terri Ballard and colleagues from the Istituto Superiore di Sanita in Rome, who led the study, said the effect on the women of passengers' behaviour was unexpected. "It might possibly be due to the more constant nature of this type of harassment, and its effect may be compounded by other types of disagreeable passenger relationships," they write.
Anger and anxiety over flight delays could exacerbate the problem by provoking uncooperative behaviour and verbal abuse from passengers.
The authors say: "The effect of sexual harrassment by passengers on the health of flight attendants may be relevant to other working women dealing with the public."
Being a mother added to the stress, the researchers found. More than threequarters of air stewardesses who had children said it was more difficult to be a good mother than for other women in work.
Tension over childcare arrangements with partners increased levels of distress and reduced job satisfaction. Better organisation of the work schedule was seen as crucial to enabling a more normal personal and family life, the researchers say.
Air stewardesses have been dismissed as "trolley dollies" whose job is undemanding and dependent on how they look rather than how they perform. But previous research has shown high levels of mental distress as a result of the pressures of the job. An earlier study by the same team found suicide rates were three times higher among air stewardesses than the general population. All the deaths involved women aged 23 to 44.
"The effects of family and work conflicts, low job satisfaction and sexual harassment should be explored more in depth... among working women in various occupations not just the airline industry," the authors of the study conclude.Reuse content