Pilot Fatigue (#22)

Pilot Fatigue has been a hot topic in 2023 and will be in 2024. And not without cause. The Dutch TV program Zembla aired a documentary on the subject, ‘Omerta above the clouds’, pointing out the seriousness of pilot fatigue. Studies show that pilots and cabin crew feel overworked and experience fatigue symptoms while working.

I’ve asked two experts to share their thoughts on Pilot Fatigue. Kathryn Jones is a safety consultant at Human Performance Safety Solutions Ltd., and Norman MacLeod has 48 years of experience in training design, management, and policy.

Kathryn Jones has worked in aviation since 1989 the fields of fatigue management, human factors and safety management systems. Her experience includes: working for an airline (ramp dispatch, ops controller, rostering); a Civil Aviation Authority inspector; and Head of Scheduling for British Airline Pilots' Association (BALPA) . In 2008, she rejoined the CAA and specialising in developing flight operations policy for flight time limitations. She was the CAA’s Human Factors programme lead between 2014 and March 2022. Kathryn now works as an independent safety consultant through Human Performance Safety Solutions Ltd. She specialises in providing consultancy services for safety critical organsiations in the areas of fatigue management, organisational learning and culture. She continues to provide training and consultancy support for CAA International - Part of the UK CAA .

Kathryn has extensive international experience. This includes as a member of the International Civil Aviation Organization Fatigue Risk Management Task Force from 2009. She was involved in the development of Fatigue Managment SARPs for Annex 6 (all parts) and Annex 11, which included the development and revision of the ICAO Fatigue Management Guidance Manuals. She was a member of EASA’s flight time limitations rulemaking group for Subpart FTL and was Chair of the Air Taxi and Emergency Medical Services rulemaking tasks. She was a member of ICAO’s Human Performance Task Force, which developed the Manual on Human Performance for Regulators (Doc.10151). Kathryn holds an Masters in Air Safety Management and is a certified civil and commercial mediator accredited to the UK Civil Mediation Council.

Norman MacLeod served for 22 years as a training specialist in the Royal Air Force (RAF) , claiming to have delivered the RAF's first CRM course in 1989. He then worked as an independent consultant delivering CRM training around the world until joining 国泰航空 , in Hong Kong, as their Human Factors Manager in 2011. He retired from the airline in 2019. He is the author of three books on training development, in general, and CRM in particular.

The Key to Fatigue Management

By Kathryn Jones, Safety Consultant at Human Performance Safety Solutions Ltd.

Fatigue is a safety issue, not just in aviation but in any safety critical industry. When we get right down to it, it’s an issue that all of us need to manage. There has never been so much information or interest in fatigue and sleep as there is today. There are books, blogs, TED talks, TV programmes, all investigating and informing us on how to sleep.

The subject of pilot fatigue, its impact on operational performance and on the pilot themselves, is a regular topic in aviation forums. We live in a 24/7 environment and the expectation for the aviation industry is that we can all go anywhere around the world, at any time of the day. However, pilots are people too, and are affected by the impacts of sleep loss, extended working periods, circadian rhythms, and workload. Somehow, putting on a uniform (in whatever industry) is almost seen as a fatigue mitigation.

Most types of shift work are managed through static shift patterns, something that is fairly predictable, and follows standard shift handover timings, such as 0700 and 1900, four on four off type of patterns. There may be overtime and issues of workload but the stability of shift timings and the management of changes to the pattern are usually predictable. For pilots, though, they are variable shift workers, there is an unpredictability to their working patterns, both at the roster issue stage and dynamically during daily operations. There is irregularity to their work, to the start, end and duration of rostered duties and the potential for disruption and change. Fatigue has the potential to impact on all aspects of their lives, at work and outside of it.

Potential fatigue levels, and its impact on performance, should be considered, not just in the calculation of duty or rest periods, but in the overall design of work, the equipment used, and the expectations placed on people. ICAO SARPS (Annex Eight) aircraft design, states that aircraft should be designed to be operated without exceptional skill, alertness, or strength of the pilot. So, we could say that aircraft need to be designed for the “average” pilot, which includes their average level of alertness. Now, who is “average” and are we our “normal” average selves every day. We are all different and, even within our range of performance, we are all different every day. So, how do we really measure what is a group “norm” for pilots, so that the industry can provide a service to the customers and support their pilots to be able to be able to sustainably manage their fatigue level.

There has been a lot of scientific research that has sought to answer this conundrum. A lot of it has been done with pilots in actual operational conditions. The research has provided a greater understanding of the “average” level of alertness that pilots need to be able to perform their duties. It has sought to understand what the pilot’s capacity is to operate their duties well. It has tried to identify the level by which the pilot can capture and manage threats to the operation, as well as operate the aircraft in normal conditions. The research has taken us a long way to better understanding pilot fatigue levels and how to manage it. By its nature, the science looks to “average” the data, looks to set guidance where the outliers to the average are limited and allocates a number that can be used. It sets informed boundaries but not absolutes. Fatigue, especially cumulative fatigue, is a difficult thing to measure and even harder to individualise.

However, having worked with ICAO, EASA, CAA, pilot unions, individual airlines (and being married to a pilot) I feel there is a key area that is often missed or overlooked. This is an area that really needs to be considered, understood, and applied to be able to support the management of fatigue. This area applies to regulators, organisations, and individuals, and the operational environment. After all it is the organisational and operational environment where the pilot carries out their duties. This key area is not the framework of regulations, (which has an important part to play), it is not the pilot on the day who should “speak up” if they feel fatigued (but they should be supported and encouraged to do so). The key factor is CONTEXT.

It is in fully understanding and considering the “context”, in which pilots operate and applying that to their duties and rosters to proactive support fatigue management within the operation. This is both a known thing (aircraft type, market sector of operation, geographical location, airports, etc.) and an unknown thing, as the environment changes around us every day (the weather, the other crew members, aircraft state, airspace issues, etc.).

Each airline is unique. It operates within its own context, while operating in the wider aviation environment. It has its own goals and systems, cultures, pressures, expectations, and internal level of understanding. Pilots will also be in different stages of their life journey, so they have to understand their own context too. Context really is the key to successful and sustainable fatigue management that enables pilots to manage the dynamic every day.

So, I don’t come with a silver bullet (be wary of anyone who does), but to say before we argue a “number”, we should first look at the context of the operation, and the expectations on the people doing the job. While we all need a plan, it should be focused on considering how to best manage the “average” expectation on performance and alertness level within the context of the operation. However, it also needs to understand that we are all human and that makes none of us “average”.

The Problem with Fatigue

By Norman MacLeod, Organisational Human Factors at Davidson:McKay

Pilots and cabin crew encounter fatigue daily so it is not as if the issue is ‘novel’ or ‘surprising’ but fatigue creates risks for the operation and for the individuals involved. The word itself – ‘fatigue’ – is many-faceted, and this creates misunderstanding. To bring some clarity, I will deal with the easy bit first before moving on to the more troublesome aspect of fatigue.

Currently, aviation fatigue management deals with short term, or acute fatigue. We manage the issue by trying to control the availability of sleep, the duration of a duty and the time of day the duty is scheduled. This is what underpins the biomathematical models that drive fatigue risk management systems. A failure to get adequate sleep will result in a ‘sleep debt’ that can be addressed by simply getting more sleep.

Fatigue has been linked to safety in various modes of transport but the relationship in aviation is elusive. Studies using the LOSA methodology have shown that hours of sleep and hours awake before a duty are linked to increased error rates and degraded error management, but this only implies increased risk, not a clear reduction in safety. Furthermore, a 2014 review by the Australian Civil Aviation Safety Authority of available biomathematical models found that they did not account for chronic fatigue and that:

This chronic component will reflect on a large number of factors including deterioration in health associated with abnormal work schedules and a wide range of individual factors.

Chronic fatigue, then, is the other, more difficult bit of the problem. In simple terms, it is where life outside of work and duty patterns collide. For example, lifestyle issues such as having children under 12 at home are predictors of the condition. Chronic fatigue is associated with ‘burnout’, ‘wellness’ and ‘mental health’. It is probably simpler to think of acute fatigue as physiological in basis and chronic fatigue as psychological, remembering that the 2 do, in fact, interact. For example, sleep quality and excessive daytime sleepiness, measures that are not captured in fatigue modelling, correlate with both acute and chronic fatigue states. In fact, excessive daytime sleepiness is associated with poor mental health.

Although valid measures of acute fatigue exist, we lack an aviation-specific measure of chronic fatigue. Studies have been done using a burnout inventory, which might act as a surrogate, but ‘burnout’ itself is not a clear syndrome with agreed symptoms and an understood aetiology. One tool we can use to look at the problem is the Fatigue Severity Scale, initially developed to study recovery from long-term illness and has been used in a few studies of pilots. An issue we first need to consider is what does ‘normal’ look like. Estimates vary between 27% and 40% for the general population presenting as fatigued on the FSS. In healthcare workers the rate is 60% but we see 80% of pilots scoring above the threshold. In addition, in work I did, the top 40% were also above the cut-off on a measure of burnout. This group also performed worst on measures of work/life balance, morale and, worryingly, mental health.

One problem in studies of association between measures is causality. Does fatiguing work degrade home life or vice versa? One measure that was significant across all measures was recovery form work. The inability to recovery adequately between blocks of work associated strongly with all measures.

What, then, does this all mean? First, an airline FRMS or FTL scheme only looks at one aspect of fatigue. By excluding the factors that lead to chronic fatigue, an FRMS can give the wrong impression of the state of the workforce. Second, the current trend towards pilot peer support schemes and the focus on ‘mental health’ is dealing with the symptoms but not addressing the problem at source. Third, a ‘one-size-fits-all’ approach to pilot productivity and roster management fails to address individual differences in terms of age, health and personal circumstance, all of which influence the susceptibility to fatigue.

Any genuine attempt to deal with fatigue requires progressive management policies that allow for pilots (and cabin crew) to map demand onto circumstance. Current flight time rules allow airlines to maximise productivity. Any proposal to reduce demand is always countered by the argument that it would push up cost. This is a false argument. Workers exploit sickness/absence rules to management personal fatigue. Studies of reduced working time have found that productivity can increase because of reduced absenteeism. Furthermore, HR costs are also reduced because workers tend to stay longer rather than leave to look for better conditions.

But there is another reason why airlines should take the bigger picture. Chronic fatigue does not necessarily mean you ‘feel’ tired’ – remember, its psychological as much as physiological. What we do know is that fatigued workers make risker decisions. This has been seen in bond traders in finance and in aviation as well. Fatigue in pilots exposes airlines to increased risk. Ironically, an industry proud of its exemplary safety record is probably hiding a very dark secret: that enviable record is being paid for with the health and welfare of the workforce.