Fatigue. Maya Dickemore. Salt Lake Community College. PILT Sp14

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1 Fatigue Maya Dickemore Salt Lake Community College PILT Sp14

2 Fit for Flight A pilot has much to consider when determining their mental and physical fitness for flight. There is a checklist for most of what a pilot does during the course of their duties. On the checklist that they use to ensure they are safe to pilot an aircraft is an item called fatigue. A pilot must know whether they are fatigued and then make a conscious decision to fly, or not. Fatigue as a safety matter has been garnering much attention in government and medical arenas. Legislation to extend current fatigue rules to all pilots instead of just scheduled passenger carrying operations will be highlighted following a description of what fatigue is and what causes it. This paper will discuss fatigue as a major contributor to the crash of a Cessna 172 in September While, it is not the only aviation accident related to fatigue, it illustrates the dangers of fatigue very well. Fatigue and What Causes it In order to understand the affects of fatigue we must understand what it is and what causes it. The two-part definition as stated in the Medilexicon s medical dictionary is: 1. The state, following a period of mental or bodily activity, characterized by a lessened capacity or motivation for work and reduced efficiency of accomplishment, usually accompanied by a feeling of weariness, sleepiness, irritability, or loss of ambition 2. Sensation of boredom and lassitude due to absence of stimulation, monotony, or lack of interest in one s surroundings. (Nordqvist, 2012) As the definition suggests, there is a difference between mental and physical fatigue. While the two are often experienced together, they are symptoms of a larger problem. Physical fatigue is described as, the person s muscles cannot do things as easily as they used

3 to. (Nordqvist, 2012) While physical fatigue is characterized by muscle weakness, mental fatigue weakens concentration and motivation. Fatigue should not be confused with sleepiness. Fatigue occurs over a long period of time while sleepiness can be caused by boredom or lack of sleep. Fatigue is considered to be the most problematic as it can lead to a lack of motivation and energy. It may also contribute to apathy. A pilot s decision-making capabilites could be adversely affected by mental fatigue. (Nordqvist, 2012) Sleepiness can be resolved with a nap or a good night s sleep, but fatigue is more persistant. Since fatigue is such a large concern, it is helpful to know what to look for when a pilot is trying to determine if they are safe to fly. Lingering exhaustion upon waking after a full night s rest is a key symptom. Patients describe fatigue, especially chronic fatigue as overwhelming, and describe the tiredness as completely different from what they have experienced before not the result of overdoing things, but simply a loss of motivation. (Nordqvist, 2012) Christian Nordqvist mentions over a dozen signs and symptoms in his article on fatigue in Medical News Today. Some items of particular interest to the aviation community are: aching or sore muscles, apathy, chronic tiredness, difficulty in concentrating, dizziness, hallucinations, hand-to-eye coordination impairment, headache, impaired judgement, indecisiveness, moodiness, brain fog, drowsines, slow responses to stimuli, slow reflexes, and blurry vision. Any one of these conditions is detrimental to a pilot s safe performance. Knowing what to look for when evaluating possible fatigue is good, but knowing what causes fatigue can be just as helpful. Grief, boredom, anxiety, and divorce can all cause some amount of mental fatigue. Stress and worry, if not alleviated, can lead to despair. Fatigue will

4 set in if the despair is allowed to continue. Mental fatigue is a large contributor to fatigue, but certain medications can cause fatigue, as well. Pilot s should be aware that antihistamines and anti-anxiety drugs may cause fatigue. On a similar topic, vitamin and mineral deficiencies can lead to increased fatigue suseptibility. Sleep is vital to fighting off fatigue, but many pilots work late into the night as well as experiencing jet lag. Nordqvist specifically pointed out that some jobs are more at risk for fatigue than others like police, nurses and shift workers whose routines are regularly changed. These unususal working conditions must be considered when assessing fatigue factors. (Nordqvist, 2012) The affects of working long hours can be compared to the affects of consuming alcohol. Mark R. Rosekind clarified that 17 to 19 waking hours can have similar affects as a blood alcohol content of.05%, and these can be worse when a person is awake when they would normally be sleeping. (Mark R. Rosekind, 2014) All of the above causes illustrate just how many variables there are in determining how fatigue is affecting a person. It must be noted that, Fatigue can become self-perpetuating. An individual who feels tired, may not exercise; lack of exercise may eventually make it harder and more tiring to perform a physical chore. (Nordqvist, 2012) In this way, fatigue can directly contribute to someone becoming overweight. Someone who is overweight is at a higher risk for health problems like sleep apnea which in turn, causes fatigue. This vicious cycle can be very hard to break for someone on a strained schedule like a pilot. How to Deal with Fatigue What can be done when a pilot finds themselves unfit for flight due to fatigue? Some fatigue-inducing conditions like anemia, fluctuating blood sugar levels, and underactive thyroid

5 can be helped with the use of medications. Here, the pilot must be cautious of side affects that contribute to sleepiness and fatigue. People who participate in a yoga program report, significant improvements in fatigue symptoms as well as sleep quality. (Nordqvist, 2012) A study at Mayo clinic found favorable results from American gensing in reducing fatigue. Even with all the medications and workout routines, the one thing that is still required is sleep! Set routine sleep hours and do not eat within two hours of bedtime. What is eaten is just as important. A study at Hull York Medical School, Engalnd determined that, patients with Chronic Fatigue Syndrome who ate dark chocolate had considerably reduced symptoms of fatigue. (Nordqvist, 2012) Set up a calming environment to relax in before going to bed. These suggestions may be very difficult for pilots that commute and sleep in hotels or apartments with crowded quarters. Pilots that work their maximum work day may not be able to eat two hours before sleeping and still get 8 hours of sleep before returning to work. In fact, pilot s working hours have become a topic of legislation in recent years. Safe Skies Act of 2012 There exists today, a difference in rules for scheduled passenger airline pilots and cargo only airline pilots. New regulations have come out in the form of FAR 117. Theses rules apply only to passenger carrying airlines. The rules have changed duty hours with some consideration given to a pilot s circadian clock. Rest periods and facilities have been detailed using a sciencebased approach. The Airline Pilots Association International Union (ALPA) states that, current rules for cargo pilots allow for 16 hours of duty, regardless of the time a pilot reports to work. Cargo pilots, who fly through the human performance low period of 2-6a.m., greatly need the

6 protections of FAR 117. FAR 117 uses the metric of time since awake instead of hours flown due to the science-based approach of the new rules. Cargo airlines are able to keep their pilots on longer shifts, which may increase pilot fatigue. ALPA argues that the accident rate for cargo operations is four to eight times higher than passenger airlines and that cargo airlines should use the same rules as passenger airlines. Legislation was presented to Congress in the form of H.R. 4350/ S to extend FAR 117 fatigue rules to all pilots, but it has not been passed. As illustrated in the following details from an accident involving an international airline pilot, fatigue builds up over time and can lead to disaterous consequences. Restorative Sleep is Imperative In the case of a Cessna 172S crash in Land O Lakes, Florida in 2012 fatigue was the major factor. The National Transportation Safety Board (NTSB) also made note of the pilot s decision-making process in the following probable cause statement, The pilot s decision to continue the cross-country flight while fatigued, which resulted in him falling alseep during the initial descent for landing. (National Transportation Safety Board, 2013) This was a very experienced pilot who had over 13,480 flight hours. There were at least four major fatigue triggers affecting the pilot at the time of the accident: he was flying during night visual meteorological conditions, he had flown as a captain across the Atlantic Ocean three times in the past nine days, and he had been awake for 18 hours at the time of the accident. He had changed times zones six times during each of his Atlantic crossings; this causes a circadian disruption leading to a diminished ability to get restorative sleep. (National Transportation Safety Board, 2013) When the pilot visited a friend in Tampa, Florida six days prior to the

7 accident she noticed he had gained a lot of weight and fell asleep in his chair multiple times during his weekend visit. (Garrison, 2013) When the pilot arrived in Boulder, Colorado to purchase the Cessna 172 the former owner noticed that the pilot became winded while walking on the ramp. (National Transportation Safety Board, 2013) These observations seem to illustrate the cycle of fatigue decribed earlier by Christian Nordqvist. It took the pilot five hours to fly from Boulder to Woodward, Oklahoma a distance of 340 nm. Peter Garrison (2013) suggests that the pilot may have stopped along the way. He checked in to a motel that evening and departed the airport 12 hours later. It took him more than six hours to travel 350 nm to Minden, Louisiana where he purchased 27 gallons of fuel. Again, Garrison suggests that he stopped along the way. The pilot flew to Pensacola, Florida where he purchased more fuel and texted the former owner that the plane, flies very nicely. (National Transportation Safety Board, 2013) On the final leg to Tampa the pilot seemed to be behind his flight plan when he reported that he was approaching the Seminole VOR when he had already passed it by 20 miles. Garrison surmises he could have fallen asleep while using the autopilot to track inbound and then not noticed that he was, then, tracking outbound. The accident occurred during the descent to Tampa Executive Airport at 0150 local time. Although there was extensive fire damage to the wreckage, no mechanical failures could be identified. Postmortem examination found, no carbon monoxide or cyanide in the blood, no ethanol in vitreous fluid, and no drugs in the urine. (National Transportation Safety Board, 2013) In studiying this accident report it seems that the pilot had plenty of opportunity to rest, under normal circumstances. These were not normal circumstances due to the dispruption of the pilot s circadian clock. (Garrison, 2013) This accident highlights the importance not only of ample sleep, but getting restful sleep.

8 Training Cannot Overcome Fatigue The pilot of the accident highlighted in this paper was an airline captain and had many thousands of flight hours in multiple aircraft. The lesson this provides is powerful fatigue can affect anyone. Pilots must seriously consider their fatigue factors when determining whether they are safe to fly, or not. It must be remembered that fatigue not only leads to sleepiness, but it affects decision-making, reaction time, and even quality of vision! It is an insidious and dangerous condition that no pilot should be in while flying.

9 Works Cited Air Line Pilots Association International. (2012). Retrieved March 2014 Garrison, P. (2013, December). Asleep at the Wheel. Flying, pp. 28,31. Mark R. Rosekind, P. (2014). The NTSB Mission to Enhance Transportation Safety:. Salt Lake City. National Transportation Safety Board. (2013, June 19). Retrieved March 2014, from Nordqvist, C. (2012, July 18). Retrieved March 2014, from What is Fatigue? What Causes Fatigue?

Facts. Sleepiness or Fatigue Causes the Following:

Facts. Sleepiness or Fatigue Causes the Following: www.drowsydriving.org Facts Sleepiness and driving is a dangerous combination. Most people are aware of the dangers of drinking and driving but don t realize that drowsy driving can be just as fatal. Like