The Civil Aerospace Medical Institute (CAMI) was directed by Congress to conduct research regarding flight attendant fatigue in 2005. Corroboration with NASA Ames Research Center's Fatigue Countermeasures Group produced a report concluding that many of the factors that contribute to fatigue experienced by flight attendants are present in the flight attendant environment. Recommendations were made to establish the problem, to better understand how flight attendant fatigue relates to safety, and to identify the nature of underlying factors contributing to fatigue of the flight attendant. The recommendations include: 1) a survey of field operations; 2) field research on the effects of fatigue; 3) a validation of models for assessing flight attendant fatigue; 4) a focused study of incident reports; 5) a review of international policies and practices; and 6) documenting the potential benefits of training.
CAMI was directed by Congress in 2008 to proceed with follow-on studies. Extensive coordination with representatives of vested organizations (e.g., Air Transport Association, Regional Airline Association, Coalition of Flight Attendants, individual unions, and non-unionized airlines) was made to facilitate support of the projects and ensure participation. Each stakeholder offered ideas, provided guidance, and facilitated accomplishment of the research among the flight attendant community.
CAMI has completed research in four of the recommendation areas, resulting in Office of Aerospace Medicine (OAM) Technical Reports, including the survey of field operations, study of incident reports, review of international policies and practices, and potential benefits of fatigue countermeasures training. Field research on the effects of fatigue is a major undertaking and is currently ongoing. Validation of models for assessing flight attendant fatigue requires data from the field study and will follow completion of that study.
The initial and follow-on reports are listed below with their respective document links and abstracts.
07/21 Flight Attendant Fatigue
by Nesthus T, Schroeder D, Connors M, Rentmeister-Bryant H, DeRoshia C
The Departments of Transportation and Treasury and Independent Agencies Appropriations Bill (House Rpt. 108-671) included a directive to the Federal Aviation Administration to conduct a study of flight attendant fatigue. The NASA Ames Research Center Fatigue Countermeasures Group (FCG) was contracted by CAMI to conduct the study. To meet the goals of the study, this report contains a literature review on fatigue as potentially experienced by flight attendants, an evaluation of currently used (actual vs. scheduled) flight attendant duty schedules, and a comparison of these schedules to the current CFRs. The report additionally reviews fatigue-related incident/accident information from the Aviation Safety Reporting System (ASRS) and the NTSB database. One report section describes the application of three different performance and fatigue models to assess how flight attendant duty schedules contribute to increased levels of fatigue and predicted changes in performance. The report concludes with 6 recommendations concerning issues that require further evaluation, including: 1) Survey of Field Operations. To assess the frequency with which fatigue is experienced, the situations in which it appears, and the consequences that follow; 2) Field Research on the Effects of Fatigue. To explore physiological and neuropsychological effects of fatigue, sleepiness, circadian factors, and rest schedules on flight attendants; 3) Validation of Models for Assessing FA Fatigue. An important step to understanding whether and how models could be used in conjunction with field operations; 4) Focused Study of Incident Reports. To better understand details of the incidents; 5) International Carrier Policies and Practices Review. To learn how other countries address these issues and with what results; and 6) Training. FAs could benefit from information on fatigue, its causes and consequences, its interaction with circadian disruption, and how and when to employ countermeasures (e.g., scheduled naps, physical activity, social interaction, caffeine). http://www.faa.gov/library/reports/medical/oamtechreports/2000s/media/200721.pdf
The newly published OAM reports include:
09/24 Flight Attendant Fatigue, Part I: National Duty, Rest, and Fatigue Survey
by Avers KB, King SJ, Nesthus TE, Thomas S, Banks J
Today's aviation industry is a 24/7 operation that produces a variety of challenges for cabin crew members, including extended duty periods, highly variable schedules, frequent time zone changes, and increased passenger loads. While these operational requirements may be necessary, they are far from ideal with respect to the human body's biological rhythms for managing sleep and alertness. In fact, acute sleep loss, sustained periods of wakefulness, and circadian factors resulting from this form of misalignment all contribute to fatigue and fatigue-related mishaps (Caldwell, 2005; Rosekind et al., 1996). This survey study was conducted to identify the specific operational factors that may contribute to fatigue in cabin crew operations. A retrospective survey was disseminated to flight attendants representing 30 operators (regional = 17, low-cost = 7, and network = 6). The survey addressed seven main topics: work background, workload and duty time, sleep, health, fatigue, work environment, and general demographics. Participants were 9,180 cabin crewmembers who voluntarily and anonymously completed the survey and met the criteria to be included in the report (i.e., active flight attendant that had flown the previous bid period with their current airline). This report outlines the results of this survey and provides specific recommendations regarding fatigue issues in cabin crew operations. http://www.faa.gov/library/reports/medical/oamtechreports/2000s/media/200924.pdf
09/25 Flight Attendant Fatigue, Part IV: Analysis of Incident Reports
by Holcomb K, Avers K, Dobbins L, Banks J, Blackwell L, Nesthus T
Voluntary safety reporting is one method by which aviation personnel can report safety issues to their airline and the Federal Aviation Administration. The Aviation Safety Reporting System (ASRS) is a program managed by the National Aeronautics & Space Administration (NASA) Ames Research Center. This study reviewed flight attendant reports from the ASRS database to identify the frequency of fatigue reports and the conditions under which fatigue occurred. During June 2008, 2,628 cabin crew reports were downloaded from the NASA ASRS website for reports made between January 1990 and December 2007. CAMI researchers reviewed each full-form report narrative for possible contributors to fatigue, or indicators of fatigue. Although the overall number of flight attendant ASRS reports for which full-form coding was completed has decreased over the last three years, both total flight attendant reporting and the number of full-form narratives related to fatigue have increased substantially. This voluntary data allows regulators and operators to discover potential problems in the aviation industry before they result in a mishap. The results of this review indicate that flight attendant fatigue may be occurring more frequently and warrants more attention. http://www.faa.gov/library/reports/medical/oamtechreports/2000s/media/200925.pdf
09/22 Flight Attendant Fatigue, Part V: A Comparative Study of International Flight Attendant Fatigue Regulations and Collective Bargaining Agreements
by Banks JO, Avers KE, Nesthus TE, Hauck EL
In 2008, Congress directed the Civil Aerospace Medical Institute (CAMI) to conduct follow-on studies of six recommendation areas noted in an integrated report by the National Aeronautics and Space Administration (NASA) and CAMI regarding flight attendant fatigue. The report concluded that some degree of fatigue-related performance effects were likely under current prescriptive rules. Internationally, fatigue risk is managed almost solely through prescriptive rules based on the maximum hours of work and minimum hours of rest. Traditional prescriptive rules, however, have limited applications to round-the-clock operations, often excluding fatigue-contributing factors such as time zone transitions, layover and recovery, time of day, and circadian rhythms (Cabon et al, 2009). Prescriptive rules directly affect crew scheduling and are critical to operator viability; however, due to economic recession, operators are routinely scheduling up to the regulation limits, which could result in an increased likelihood of fatigue and fatigue-related mishaps (Nesthus, Schroeder, Connors, et al., 2007). In the present study, we obtained regulations (n=38) and collective bargaining agreements (CBA) (n=13) regarding flight attendant duty time and rest from International Civil Aviation Organization (ICAO) member states using several resources: Civil Aviation Authority websites, an international cabin safety symposium, Web-based ICAO information exchange, and FAA international field offices and aviation safety inspectors. We analyzed each regulation and CBA to identify duty time and rest rules related to working hour limits, sleep and rest requirements, circadian rhythms, and other factors. When comparing the U.S. maximum hours of work and minimum hours of rest with other countries, we concluded that U.S. prescriptive rules are among the least restrictive, representing a greater than typical risk for fatigue- related incidents. We recommend that the U.S. establish a sanctioned fatigue workgroup of subject-matter experts, aviation stakeholders, medical and research scientists, and aviation Safety Management System experts to evaluate current regulations and develop an adaptive fatigue mitigation safety system combining scientific principles and knowledge with operational support. http://www.faa.gov/library/reports/medical/oamtechreports/2000s/media/200922.pdf
