Institut für Arbeits-, Sozial- und Umweltmedizin Stress Analysis in Flight Attendants During a 3 Day Round Trip From Germany to Japan Compared to a 4 Day Rotation D.-M. Rose, B. Stoeld 1, K.Rohrberg, S. Letzel Institute of Occupational-, Social- and Environmental Medicine University Medicine of the Johannes Gutenberg- University of Mainz, Germany 1 contains data of the thesis of B. Stoledt Univ.-Prof. Dr. med. D.-M. Rose, ASU Jo Gu-University of Mainz, Germany 1
Introduction Aircrew fatigue has become a serious problem Long duty periods, disturbed and restricted sleep combined with circadian disruption are severe strain Duty periods and duration of circulations are negotiated between works council and management This study had been initialized, to investigate different stress and strain by round trips from Germany to Japan with 1 or 2 days overlay in Japan Univ.-Prof. Dr. med. D.-M. Rose, ASU Jo Gu-University of Mainz, Germany 2
Participants (Study Group) (I) 30 experienced flight attendants (12 male, 18 female) in the age of 35.6 +/- 8,3 years flew on an voluntary basis each 2 round trips from Frankfurt (Germany) to Tokyo (Japan) with either 1 or 2 days layover in Tokyo between May 18 th and June 24 th 2010 Crew 1 flew first a 3 day and than a 4 day round trip Crew 2 flew first a 4 day and than a 3 day round trip between the 2 round trips to Japan in both groups laid 18 days from arrival from Japan (trip 1) to departure from Germany (trip 2) 4 days off before start to trip 1 or 2 no time zone flights 1 week before each round trip Univ.-Prof. Dr. med. D.-M. Rose, ASU Jo Gu-University of Mainz, Germany 3
Participants (Study Group) (II) no. male/ female nativ Japonese crew 1 15 5/ 10 5 crew 2 15 7/ 8 3 total 30 12/ 18 8 age mean, SD, median 34,9 y +/- 8,3 y, 35 y 36,3 y +/- 8,6 y, 39 y 35,6 y +/- 8,3 y, 38 y work experience (years) 13,3 y +/- 9,1 y 17,1 y +/- 7,5 y 15,2 y +/- 8,4 y Univ.-Prof. Dr. med. D.-M. Rose, ASU Jo Gu-University of Mainz, Germany 4
Methods (I) Flight time to Japan has been 10:55 hours, block time 13:05 hours Flight time from Japan has been 11:40 hours, block time 13:40 hours Univ.-Prof. Dr. med. D.-M. Rose, ASU Jo Gu-University of Mainz, Germany 5
Methods (II) Physiological data HRV continuously the day before and during the whole trip, RR and body temperature were measured the day before and during work time on board at 6 intervals and HRV and temperature the day after the round trip) Psychological data d2-test, Stanford Sleepiness Scale (SSS), fatigue scale (Samn & Pirelli (1982)), NASA Task Load Index (NASA TXL), questionnaire to alertness and stress relaxation, sleep log Univ.-Prof. Dr. med. D.-M. Rose, ASU Jo Gu-University of Mainz, Germany 6
Psychological data (II) Methods (III) Standard Shiftwork Index (Folkard) once the day before first trip (Barton et al.,1995, German or English version) (chron. fatigue, health complaints, sleep quality and disturbances, chronotype (morning / evening type), cognitive or somatic anxiety, job satisfaction and strain, coping strategies) Mental state directly before and directly after flight (questionnaire) Univ.-Prof. Dr. med. D.-M. Rose, ASU Jo Gu-University of Mainz, Germany 7
Results (NASA TXL Subscales) mental demand physical demand low, no differences 1 vs.2 day layover varied according to tasks, no differences 1 vs.2 day layover temporal demand performance effort frustration high, specially after start and before landing, no diff. 1 vs.2 day layover low, no differences 1 vs.2 day layover growing during flights and max. on the end of flights, individually sig. diff. betw. 1 and 2 day layover no measurable frustration on outgoing flights, measurable on the end of return flights, sig. higher after 3 day round trip Univ.-Prof. Dr. med. D.-M. Rose, ASU Jo Gu-Universität Mainz 8
NASA Task Load Index Univ.-Prof. Dr. med. D.-M. Rose, ASU Jo Gu-University of Mainz, Germany 9
NASA Task Load Index Univ.-Prof. Dr. med. D.-M. Rose, ASU Jo Gu-University of Mainz, Germany 10
Stanford Sleepiness Scale (SSS) Univ.-Prof. Dr. med. D.-M. Rose, ASU Jo Gu-University of Mainz, Germany 11
d2 test (concentration performance test) Univ.-Prof. Dr. med. D.-M. Rose, ASU Jo Gu-University of Mainz, Germany 12
Samn & Pirelli Fatigue Questionnaire ** ** ** ** ** ** Univ.-Prof. Dr. med. D.-M. Rose, ASU Jo Gu-University of Mainz, Germany 13
Results (Summary) all tests showed a high correlation and came to the same results ( increased fatigue and decreased performance at the end of the return flight after the 3 day round trip with 1 day layover in Japan) no significant differences were found between all outgoing flights fatigue at the end of the return flight was severe to very severe after the 3 day round trip but not after the 4 day round trip for cabin personnel an increased risk for flight safety due to an one day layover can not be stated generally Univ.-Prof. Dr. med. D.-M. Rose, ASU Jo Gu-Universität Mainz 14
Discussion The strain increased significantly for all flight attendants during a eastbound 3 day rotation compared to a 4 day rotation The results are comparable to previous done studies with westbound rotation. Thus, not the flight direction is the primary strain, but the workload, the recovery time and the unfavorable wake up time (disrupted sleep) physiologically and with respect to occupational health an extended layover time is recommended Univ.-Prof. Dr. med. D.-M. Rose, ASU Jo Gu-Universität Mainz 15
However, not only cabin crew could be a flight safety issue Thank you for your attention! Univ.-Prof. Dr. med. D.-M. Rose, ASU Jo Gu-University of Mainz, Germany 16