Health Risks and Potential Predictors of Fatigue and Sleepiness in Airline Cabin Crew.

Candice C Y Wen,Sandy Clarke-Errey,Amy S Jordan,John Trinder,Christian L Nicholas,Mark E Howard

doi:10.3390/ijerph18010013

Abstract

Background: Aviation pilots and cabin crew regularly undertake shift work, and may experience circadian disruption, restricted sleep, sleepiness and impaired health. Research on aviation fatigue and sleepiness has focused on pilots, with less being known about cabin crew. This study aimed to identify likely predictors of fatigue, sleepiness, shift work disorder (SWD) and depression in cabin crew. Methods: An online anonymous survey was distributed to active cabin crew around the world. It measured sleepiness, fatigue, and screened for insomnia, depression and SWD. Information on individuals’ habits and work schedules were collected. Results: 930 valid responses were analysed. 63.5% of the sample had abnormal levels of fatigue and 46.9% experienced excessive daytime sleepiness. 68.0% were at risk for SWD, 57.7% screened positive for insomnia, and 40.0% for depression. Caffeine and use of alcohol and drugs for sleep were independently associated with insomnia and SWD (p < 0.05), whereas, type of route (international, domestic, both) and number of duty days per week predicted fatigue (p < 0.05). Conclusions: Cabin crew had a high prevalence of fatigue, sleepiness and elevated risk for SWD, insomnia and depression. Many cabin crew engaged in behaviours detrimental to good sleep hygiene, highlighting targets for future interventional studies.

Highlights

Prior to the COVID-19 pandemic, the aviation industry never rested
Australian based cabin crew had the greatest number of responses (42.5%), demographic comparison data was extracted from Australian references
Prior to the COVID-19 pandemic, fatigue and sleepiness impacted a large proportion of airline cabin crew

Summary

Introduction

Prior to the COVID-19 pandemic, the aviation industry never rested. While it is unclear how long it will be until global travel returns to the pre-pandemic levels, it is expected that the aviation industry will resume similar operations in the years to come and the majority of aviation employees (e.g., pilots and cabin crew) will resume shift work.With the 24-h nature of shift work, a large portion of working hours frequently coincide with one’s biological sleep window. Prior to the COVID-19 pandemic, the aviation industry never rested. While it is unclear how long it will be until global travel returns to the pre-pandemic levels, it is expected that the aviation industry will resume similar operations in the years to come and the majority of aviation employees (e.g., pilots and cabin crew) will resume shift work. With the 24-h nature of shift work, a large portion of working hours frequently coincide with one’s biological sleep window. The disruption of one’s circadian rhythm often results in individuals feeling sleepy while on the job (e.g., night shift), unable to fall and/or maintain sleep after work (e.g., daytime). Past research has found shift work contributes to health problems including insomnia [2], cardiovascular diseases [3], gastrointestinal complaints [4], higher body mass index [5,6], diabetes [7,8], cancer [9] and poorer mental health [10]

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