Airline Pilots Research Articles

Association Between Health Behaviors and Mental Health Among Airline Pilots

ABSTRACTBackgroundLifestyle behaviors including physical activity, sleep, nutrition, smoking, and alcohol consumption are independently associated with health, yet the relationship between these behaviors and mental health has not been explored among airline pilots. The aim of this study was to measure the association between health behaviors and mental health.MethodsA cross‐sectional study was conducted among 502 airline pilots. The primary outcome measure was the mental component score (MCS), derived from the Short Form Health Survey 12v2. We collected information regarding age, sex, ethnicity, height, body mass, alcohol consumption, tobacco smoking status, moderate‐to‐vigorous physical activity (MVPA), fruit and vegetable intake, and sleep duration.ResultsAfter controlling for demographic and anthropometric parameters, MVPA, fruit and vegetable intake, and sleep duration were positively correlated with MCS (p ≤ 0.001), and alcohol consumption and tobacco smoking were negatively correlated with MCS (p ≤ 0.001). Multiple linear regression analyses revealed alcohol consumption was the strongest predictor of MCS (β = −0.308, p ≤ 0.001), followed by smoking (β = −0.236, p ≤ 0.001), MVPA (β = 0.233, p ≤ 0.001), sleep (β = 0.148, p ≤ 0.001), and fruit and vegetable intake (β = 0.097, p = 0.003).ConclusionThe results suggest that greater physical activity, sleep duration, and fruit and vegetable intake are associated with better mental health. Meanwhile, excessive alcohol consumption and tobacco smoking undermine mental health status.

A Flight Path to Well-Being: The Mediating Role of Continuous Learning between Burnout and Work Performance in Aviation Professionals

The profession of airline pilots is characterized by high levels of stress and a significant risk of burnout. The health emergency period has exacerbated these challenges to health and well-being, with long COVID adding further strain to aviation professionals even in the post-pandemic scenario. In this context, it is essential to promote positive organizational behaviors to reconcile individual well-being with work performance. This study aimed to explore the mechanisms linking burnout to work performance behaviors (i.e., proficiency, adaptivity, and proactivity) among pilots, hypothesizing the mediating role of continuous learning behaviors. Based on the Conservation of Resources theory, we posited that burnout depletes pilots’ resources, thereby hindering continuous learning and reducing performance behaviors. Moreover, this study examined the work-related stress factors that could affect burnout and the consequences of performance behaviors on actual performance measured by a flight simulator. Data were collected from 123 pilots through an online survey and analyzed using path analysis. The results revealed that continuous learning mediated the relationship between burnout and work performance behaviors. Furthermore, work-related stress factors were significantly related to burnout, and work performance behaviors were linked to flight simulator performance. Our findings underscored the critical role of continuous learning in explaining the adverse effects of burnout on performance. These insights could inform targeted interventions to promote continuous learning and stress management among aviation professionals, ensuring sustained performance and well-being in the long term.

Ecological and Cost Advantage from the Implementation of Flight Simulation Training Devices for Pilot Training

The paper discusses a case study of obtaining an airline pilot license in integrated training—the so-called “from zero to Airline Transport Pilot License”. The environmental implications of simulator-based training were examined across multiple dimensions. Key areas of research include the reduction of harmful exhaust gases pollution associated with traditional flight training activities. Based on our analysis, it can be stated that increasing the use of Flight Simulation Training Devices in pilot training should be significant consideration. This approach brings many benefits, especially ecological ones. Changing the training program and increasing the use of flight simulators can result in a reduction of CO2 emissions by up to 70%. Based on country specific electricity factors, CO2 emissions during flight training in each EU country were calculated. Using Levelized Cost of Electricity average value to calculate training costs in EU countries depends on the mix of energy sources (wind, photovoltaics, carbon and gas). The findings highlight the significant ecological advantages of simulator-based training methods in mitigating the environmental footprint of aviation operations. By seeking to minimize environmental disruption and increase training efficiency, the adoption of simulators is a sustainable approach to pilot training that is consistent with global efforts to mitigate climate change and protect natural ecosystems.

Short Rest Between Flights Is Associated With Increased Serum Stress Hormone Levels in Airline Pilots: A Cross-Sectional Study.

Work-related stress is a critical area of research in civil aviation, given the potential for severe consequences when airline pilots (APs) are overwhelmed or unable to perform optimally. While pilots are traditionally considered to be exposed to various stressors, the impact of specific occupational characteristics on stress in the aviation industry remains inadequately understood. Considering that biomarkers are increasingly being utilized as objective measures of stress in human research, this cross-sectional study investigated the association between occupational variables and serum levels of cortisol and dehydroepiandrosterone sulfate (DHEAS) as stress biomarkers in commercial APs. A total of 120 male APs completed a survey assessing the following work-related characteristics: position (captain vs. first officer), years of experience, total flight hours, flight hours in the preceding year, inter-flight rest duration, and flight route length. Serum cortisol and DHEAS concentrations were determined from venous blood samples obtained between 08:00 and 09:00 a.m., following a minimum eight-hour fasting period. The biomarker data were analyzed in relation to the aforementioned occupational characteristics. The mean serum cortisol and DHEAS concentrations in the entire cohort were 8.5±2.1 µg/dL and 214.6±96.4 µg/dL, respectively. There were no significant differences in the levels of the two stress hormones in relation to position, years of experience, total flight hours, flight hours in the preceding year, or flight route length. However, an inter-flight rest period of less than one hour was significantly associated with elevated serum cortisol (P<0.01) and reduced DHEAS levels (P<0.001) compared to longer rest durations. Notably, a stepwise decrease in DHEAS concentrations was observed for rest periods of <1 hour, 1-4 hours, 4-24 hours, and >24 hours. After adjustment for potential confounders in multivariable analyses, a rest period of <1 hour remained independently associated with both serum cortisol (odds ratio [OR]=1.09, 95% confidence interval [CI]=1.04-1.13, P<0.01) and DHEAS (OR=0.94, 95% CI=0.92-0.97, P<0.001). Serum stress hormones in APs are associated with short inter-flight rest periods. Optimization of rest durations may contribute to improved pilot well-being and performance. Further research is warranted to determine ideal rest period lengths and develop interventions to mitigate the potential adverse effects of abbreviated rest periods between flights.

Navigating the skies: a cross-sectional study of depression among Saudi Arabian airline pilots

BackgroundDepression poses a significant challenge globally, including in safety-critical industries such as aviation. In Saudi Arabia, where the aviation sector is rapidly expanding, pilots encounter unique stressors inherent to their profession. However, research on pilot mental health, particularly within the Saudi context, remains limited despite its critical role in flight safety.MethodsThis cross-sectional survey was designed to estimate the self-reported prevalence of depression in a convenience sample of airline pilots in Saudi Arabia. Participants were recruited from various commercial airlines in Saudi Arabia. Recruitment efforts utilized targeted outreach on social media platforms, focusing on pilot forums and groups. The survey was administered online for accessibility and convenience. The structured questionnaire, developed through a literature review and expert consultation, comprises sections on demographic and professional characteristics, occupational information, health habits, and depression assessment via the Patient Health Questionnaire-9 (PHQ-9).ResultsThis study enrolled 310 participants, with the largest cohort (34.8%, n = 108) falling within the 30–39 years age group, closely followed by individuals under 30 years (30.0%, n = 93). Males dominated the sex distribution (99.0%, n = 307). The mean PHQ-9 score was 8.2 ± 5.4. Notably, 40.6% (n = 126) of the participants had a score of 10 or higher, indicating the potential for moderate, moderate-severe, or severe depression. Multivariable binary logistic regression analysis revealed that pilots with 11–15 years of experience had greater odds of experiencing depression than did those with 0–10 years of experience did (odds ratio [OR]: 3.0, 95% confidence interval [CI]: [1.1–8.4], p = 0.04). Pilots with rest times exceeding 24 h had lower odds of depression than did those with rest times less than 1 h (OR: 0.3, 95% CI: [0.1–0.8], p = 0.02). Engaging in regular exercise was associated with reduced odds of depression (OR: 0.3, 95% CI: [0.2–0.5], p < 0.01), as was longer sleep duration (> 8 h) (OR: 0.2, 95% CI: [0.1–1.0], p = 0.04).ConclusionOur study estimates the prevalence and severity of self-reported depressive symptoms among airline pilots in Saudi Arabia, surpassing global estimates. The identified factors, including lack of regular exercise, short sleep duration, and insufficient rest between flights, underscore the complex mental health challenges faced by pilots in this region. Addressing these issues is crucial not only for pilot well-being but also for flight safety.

Comparative Analysis of Taste Perception Among Airline Pilots, Construction Workers, and Office Employees.

Objective Occupational exposures may influence gustatory sensations through mechanisms such as fatigue, acute or chronic stress, circadian rhythm disruptions, and exposure to various chemicals. In this cross-sectional study, we sought to compare taste perception across three professional groups, namely airline pilots, construction workers, and office employees, by assessing taste identification times for sweet, salty, sour, and bitter flavors, alongside salivary pH levels. Methods The study cohort consisted of 90 healthy male participants, with 30 individuals in each occupational group, matched for age and professional experience. Salivary pH was measured using pH meter paper, whereas taste identification times were assessed using aqueous solutions applied to dissolvable strips for each taste. Results There were no significant differences in salivary pH among the study groups. However, airline pilots exhibited a significantly longer identification time for sweet taste (9.8 ± 3.9 seconds) compared to construction workers (7.0 ± 3.1 seconds, P < 0.05) and office employees (7.1 ± 3.3 seconds, P < 0.05). Conversely, construction workers demonstrated a significantly prolonged identification time for sour taste (6.1 ± 2.9 seconds) compared to pilots (4.2 ± 2.6 seconds, P < 0.05) and office employees (4.6 ± 2.5 seconds, P < 0.05). No significant differences were observed in the identification times for salty and bitter tastes across the groups. Conclusion We found significant differences in taste perception among airline pilots, construction workers, and office employees, particularly concerning sweet and sour tastes. These findings suggest that occupational factors may influence gustatory function in a complex manner. Further research is warranted to explore the underlying mechanisms and potential implications for dietary habits and health within specific occupational groups.

Understanding Pilots' Perceptions of Mental Health Issues: A Qualitative Phenomenological Investigation Among Airline Pilots in the United States.

Background and objective Although mental health is always a major concern, particularly for airline pilots, knowledge of and attitudes toward mental health have not always been emphasized for safe operations in the aviation industry. Fear of self-reporting, stigmas, and lack of knowledge about mental health conditions are prevalent in this industry. The purpose of our research was to examine pilots' perceptions of mental health issues, the resources available to them, and the reasons they may or may not report these issues. Methods We conducted a qualitative, phenomenological study in which 21 commercial pilots were interviewed to better understand their perceptions of mental health issues, available self-help resources, and rationale for failing to report mental health issues. Results The results of our analysis using NVivo softwareshowed that pilots neither reported the issues nor trusted the processes meant to address mental health issues. Three themes emerged from the research: (1) pilots avoid discussing mental health issues for fear of repercussions, (2) although resources exist, pilots generally distrust the confidentiality of reporting systems, and (3) pilots honestly believe that reporting any mental health issue will be devastating to their careers. Conclusions Airline companies and the Federal Aviation Administration (FAA) need to change processes and instill a sense of trust in reporting systems among pilots so that they feel safe reporting mental health concerns and receive improved treatment. This can lead to more accurate reporting of conditions andensure safe flight operations.

Commercial Airline Pilots’ Stress Across the Travel Cycle: Multi-Level Stressors, Spillover Effects, and the Role of Resources

Commercial airline pilots (CAPs) are a key employee group within the travel industry who are exposed to multi-level institutional and organizational demands that impact their lived experience of stress potentially leading to accidents and incidents. This study explores CAPs’ lived experience of stress and draws on conservation of resources theory and context and travel stage frameworks to investigate unique stressors that CAPs face at different travel stages. Utilizing qualitative data from interviews with 28 CAPs combined with archival data, we surface a range of multi-level factors that impact their lived experience of stress at each travel stage. To cope with stressors, and in the absence of valuable contextual resources, CAPs utilized multiple personal resources. We additionally found evidence of significant spillover across the travel stages. Findings highlight the need to improve contextual resources available to pilots, strengthen their personal resources, and customize support to the requirements of the travel stage.

Is Declined Cognitive Function Predictive for Fatal Accidents Involving Aging Pilots?

Background. Civil aviation comprises airlines/charters and general aviation (GA). Currently, airlines are experiencing a pilot shortage, partly reflecting scheduled retirements mandatory for airline (but not GA) pilots aged 65 years, fueling a debate as to whether the retirement age should be increased. Herein, using 16–40 years-of-age aviators as a reference, we determined whether GA pilots aged 60+ years (i) incurred an elevated accident rate, employing, for the first time, age-tiered flight time as a measure of risk exposure and (ii) carried an excess risk for cognitive deficiency-related fatal accidents. Methods. Airplane accidents (2002–2016) involving Class 3 medical certificated pilots were per the National Transportation Safety Board (NTSB) databases. Age-tiered pilot risk exposure represented a summation of flight hours per Class 3 medical applications. Cognitive decline measures were per NTSB field codes. Statistical analyses employed Chi-Square, Mann–Whitney, logistic regression, and binomial tests. Results. Using flight hours as the denominator, the fatal accident rate for older pilots (41–80 years) was unchanged compared with aviators aged 16–40 years. In the logistic regression, no cognitive deficiency measure was predictive (p = 0.11, p = 0.15) for pilots aged 61+ years who were involved in fatal accidents. Conclusion. These findings question the necessity of an automatic disqualification of air transport pilots at 65 years of age.

An evaluation of legislation designed to improve airline pilots' safety and performance

An evaluation of legislation designed to improve airline pilots' safety and performance

The Effects of Stress and Fatigue on Levels of Anxiety in Pilots: An Aviation Industry Sample

This study aims to provide a comprehensive understanding of the impact of stress and fatigue on pilots’ well-being, with a focus on anxiety. A quantitative research design utilizing structured questionnaires was employed to gather subjective reports from a sample of sixty airline pilots in the commercial aviation industry. Stressors such as demanding flight schedules and operational pressure significantly contributed to increased anxiety levels among pilots. Secondly, fatigue resulting from irregular work hours and long flights emerged as a prominent factor influencing anxiety. Lastly, organizational factors such as lack of support systems and limited access to mental health resources were identified as additional contributors to heightened anxiety levels among pilots.

Carotid Intima-Media Thickness, Overweight, and Poor Sleep Quality in Commercial Airline Pilots: A Cross-Sectional Study.

Background Cardiovascular disease is a leading cause of premature career termination in commercial airline pilots (APs). In this cross-sectional study, we sought to investigate the relationship between intima-media thickness (IMT), a marker of subclinical atherosclerosis, and cardiovascular risk factors in APs, focusing on overweight status and sleep quality. Methods A total of 140 male APs were categorized into four groups based on body mass index (BMI) and Pittsburgh Sleep Quality Index (PSQI) score: overweight poor sleepers (OW-PS), overweight good sleepers (OW-GS), normal weight poor sleepers (NW-PS), and normal weight good sleepers (NW-GS). IMT was quantified in the common carotid artery (CCA) and carotid bulb using ultrasound, yielding a composite IMT (IMTcom) measure. Common cardiovascular risk factors were assessed in all participants. Results The prevalence of overweight and poor sleep quality was 43.6% and 32.9%, respectively. The OW-PS group had significantly higher age, heart rate, total cholesterol, and low-density lipoprotein (LDL) cholesterol compared to other groups (p<0.05). Overweight pilots, regardless of sleep quality, had increased IMTcom compared to normal-weight pilots (p<0.001). Age and LDL cholesterol were independent predictors of IMTcom in the OW-PS and OW-GS groups (p<0.05). Conclusions Overweight status, irrespective of sleep quality, is associated with increased IMT in APs, suggesting a higher burden of subclinical atherosclerosis. Interventions focused on reducing LDL cholesterol levels and managing age-related cardiovascular risk factors could be advantageous in mitigating the risk of atherosclerotic vascular disease in overweight pilots.

Impact of Unidentified Aerial Phenomena (UAPs) on air safety: Evidence from Airbus® TCAS/ROSE simulators

The present research was designed to provide evidence into why and when Unidentified Aerial Phenomena (UAPs) occur and pose a threat to aviation safety. Specifically, the goal was to understand how causal illusions interact with perceptual biases with and without irrational reasoning. A total of 408 airline pilots participated in an experiment using Airbus® aircraft TCAS/ROSE simulators. Analyses were conducted using structural equation modeling (SEM), controlling for the effects of fatigue and flight hours. Results indicated that causal illusions were 82.4% predictive of UAP sightings only when magical inference was present. Our experimental evidence shows that UAPs may be explained as cognitive biases and would pose a threat to aviation safety if pilots—or even aircraft AIs—were to detect them in an irrational way (e.g., as alien objects). A novel theorization that integrates major perception, clinical, and cognition models is offered. Additionally, the authors discuss the implications for aviation safety and determine when a UAP sighting may pose a real danger on a commercial flight.

Orbital Solitary Fibrous Tumor in a Commercial Airline Pilot.

BACKGROUND: In the literature, central serous retinopathy (CSR) accompanying solitary fibrous tumors (SFT) in a pilot has not been reported. In airline pilots, mass effect-related symptoms such as diplopia, ptosis, etc., seen with orbital tumors may endanger flight safety.CASE REPORT: A 62-yr-old male commercial airline pilot presented with blurred vision in the right eye. He had been receiving treatment for 2 mo because of CSR. His visual acuity was 10/20 in the right eye and 20/20 in the left. During examination, ptosis and exophthalmos were noticed in the right eye. Ocular movements were free in all cardinal directions and there was downward displacement in the right eye. There was no diplopia. Magnetic resonance imaging revealed a 1.5- to 2-cm well-defined contrast-enhancing mass in the lateral extraconal orbit. His medical flight certificate was suspended for 3 mo due to decreased visual acuity and superior visual defect. Superior orbitotomy was performed without any complication. Ptosis and CSR had regressed 1 wk after surgery. All systemic and ophthalmological examinations met aviation medical certificate requirements. He returned to flight on the condition of being checked every 3 mo. At the 1-yr follow-up, there was no sign of recurrences of SFT or CSR.DISCUSSION: SFTs are slow-growing neoplasms that can manifest symptoms related to mass effect. In the current literature, there are no reported cases of the coexistence of orbital SFT and CSR or pilots able to resume flight duties only 1 wk after a successful orbitotomy and tumor resection surgery.Altinbas M, Ozpınar A, Akbaba M, Nacaroglu SA, Sargolzaeimoghaddam M, Sargolzaeimoghaddam M. Orbital solitary fibrous tumor in a commercial airline pilot. Aerosp Med Hum Perform. 2024; 95(6):333-336.

Brushing Away the Blues: Self-Reported Oral Hygiene Practices Are Associated With Mild Depressive Symptoms in Airline Pilots.

Introduction Airline pilots are susceptible to mental health issues, with depression prevalence ranging from 1.9% to 12.6%. Recent research in the general population indicates a potential link between depression and oral health. In this cross-sectional study, we soughtto investigate the association between self-reported oral hygiene practices and depressive symptoms among airline pilots. Methods One hundred actively working male airline pilots of Caucasian descent voluntarily enrolled in the study during routine occupational health visits. Depressive symptoms were assessed using the Beck Depression Inventory II (BDI-II). Self-reported oral hygiene practices, including toothbrushing frequency and mouthwash usage, were examined. Univariable and multivariable logistic regression analyses were performed to investigate associations between depressive symptoms and oral hygiene practices. Results Twelve pilots (12%) demonstrated mild depressive symptomatology (BDI-II scores 14-19). Pilots with mild depression reported significantly lower rates of brushing teeth twice or more per day (33.3% vs. 80.7%) and higher rates of rarely brushing (16.7% vs. 1.1%) compared to those with minimal depressive symptoms (p < 0.001). Nonuse of mouthwash was more prevalent among pilots with mild depression (66.6% vs. 23.9%, p = 0.008). Multivariable logistic regression analysis revealed that pilots who rarely brushed their teeth (adjusted odds ratio (OR) = 14.6; 95% confidence interval (CI) = 1.3-197.9; p < 0.05) or did not use mouthwash (adjusted OR = 5.7; 95% CI = 1.4-25.2; p< 0.05) had significantly higher odds of mild depressive symptoms. Conclusions Self-reported oral hygiene habits may serve as a proxy indicator for mild depressive symptoms among airline pilots. Incorporating oral health assessments into routine aeromedical examinations could provide a practical method of identifying pilots at risk for depression, supporting timely interventions and enhancing flight safety.

Effects of age and flight experience on prefrontal cortex activity in airline pilots: An fNIRS study

It is essential for airlines to have a deep understanding of the cognitive impact of aging among pilots. The current literature on executive function indicates that compensatory mechanisms in the brain may counteract age-related cognitive decline, at least up to certain task load levels. However, few studies have been administered to evaluate changes in aircrew competence as they age. The present study focuses on dorsolateral prefrontal cortex (DLPFC) activity as it is implicated in cognitive performance and working memory, which are associated with skill proficiency. We measured the DLPFC activity for airline pilots, including trainees, during maneuvering using a flight simulator. Our preliminary results indicated that only expert (aged) pilots demonstrated higher activity of the left DLPFC than the right one. However, for youth trainees, not only was the error rate high while using the flight simulator, but the activity of the DLFPC was also lower than that of the expert pilots, and there was no statistically significant difference between the left and right DLPFC. Although these findings partially differ from those reported in previous studies on age-related changes, it is evident that training as an airline pilot for over 20 years may affect such results. We believe that this noninvasive approach to objective quantification of skill will facilitate the development of effective assessment competence in aging.

Personality traits changes in the training process of Chinese airline transport pilots

OBJECTIVE: To study the personality changes of Chinese airline transport pilots in the training process from cadets to captains. METHODS: In This paper, we used the Cattell 16 Personality Factor Questionnaire (16PF) to track and record the personality traits of 200 students majoring in flight technology and 200 “college graduates to pilot” in five different periods from the beginning of aviation theory training to becoming captains. RESULTS: Before the aviation theory training, for the 16 factors of 16PF, there was a significant difference in 11 factors (including Warmth (A), Reasoning (B), etc.) between the students majoring in flight technology and “college graduates to pilot” (p&lt; 0.05). After the completion of theory training, there were only four factors (Sensitivity (I), Openness to Change (Q1), Self Reliance (Q2) and Perfectionism (Q3) (p&lt; 0.05) between the students majoring in flight technology and “college graduates to pilot”, then after the flight training, there is no significant difference between them. When they became captains, compared with when they were flying cadets, 13 factors of students majoring in flight technology and 7 factors of “college graduates to pilot” had changed significantly. From the perspective of the growth of flying cadets, in the process of becoming a captain, there are three stages that have a great influence on the personality of the participants. The first stage is the university study. The second stage is the flight training, and the third stage is the copilot growing into a captain. CONCLUSION: During the process of a pilot growing from a cadet to a captain, his or her personality is constantly developing and changing, and on the whole, develops towards a personality direction conducive to flight safety. In particular, when a copilot grows into a captain, the personality traits of a qualified airline pilot, including Emotional Stablity (C), Rule-Consciousness (G), Social Boldness (H), Privateness (N), Self-Reliance (Q2), etc., have been greatly strengthened at this stage.

Prevalence and network analysis of internet addiction, depression and their associations with sleep quality among commercial airline pilots: A national survey in China

ObjectiveAirline pilots are members of a unique occupational group that is often confronted with sleep routine disruptions, yet relatively few studies have examined their mental health status. This study assessed the prevalence and network structure of internet addiction, depression and sleep quality problems in commercial airline pilots. MethodA total of 7055 airline pilots were included in analyses. Internet addiction and depression were measured with the Internet Addiction Test (IAT) and 9-item Patient Health Questionnaire (PHQ-9), respectively. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). The network model was constructed based on an Ising model and its association with sleep quality was evaluated using a flow procedure. ResultsInternet addiction, depression and sleep quality were common among airline pilots. The prevalence of internet addiction was 8.0 % (95 % CI: 7.3–8.6 %), while the rates of depression and poor sleep quality were 23.3 % (95 % CI: 22.3–24.2 %) and 33.0 % (95 % CI: 31.9–34.1 %), respectively. In the depression and internet addiction network model, “Fatigue” (PHQ4; Expected Influence (EI): 2.04) and “Depressed/moody/nervous only while being offline” (IAT20; EI: 1.76) were most central symptoms while “Fatigue” (PHQ4; Bridge EI: 1.30) was also the most important bridge symptom. The flow network model of sleep quality with internet addiction and depression showed that “Appetite” (PHQ5) had the strongest positive association with poor sleep quality. ConclusionInternet addiction, depression and sleep quality were common among airline pilots and warrant regular screening and timely treatment. Strategies to improve sleep hygiene may be useful in preventing onsets or exacerbations in depression and internet addiction among airline pilots.

‘Me and the Sky’: smashing the glass ceiling in Come from Away, neoliberal feminism, and climate change

ABSTRACT This article considers neoliberal feminism and environmental concerns in Irene Sankoff and David Hein’s musical Come from Away. While the musical is not directly concerned with anthropogenic climate change, many types of skies appear as thematic and metaphorical preoccupations in the piece: feminist blue skies, stormy Newfoundland skies, the clear skies of the American Dream, skies of terror, and skies of war. I argue that Come from Away hides the tragedy of climate change in plain sight, in the sky. Undertaking a close analysis of the showstopping number ‘Me and the Sky,’ sung by the airline pilot Beverly Bass – based on the real-life woman of the same name – I observe the rift between neoliberal feminist success, acts of terror, and the slow-moving tempo of a changing climate. Come from Away’s celebration of neoliberal feminism is cut short in the song, but it foreshadows the possibilities of a more successful recognition of the conjunction between feminist and environmental awareness.

European and US Aeromedical Authority Guidance for Neurocognitive Evaluation of Airline Pilots With Mental Disorders

Abstract: Commercial airline pilots must exhibit specific neurocognitive skills and aptitudes to perform their safety-critical roles. This review addresses neuropsychological assessment in mental disorders derived from guidance developed by European and US aviation authorities as well as indications in the current literature in relation to major depression and suicidality, self-harm, attention-deficit/hyperactivity disorder, posttraumatic stress disorder, and bipolar disorder in aeromedical evaluations. Several studies show that cognitive functioning may be impaired during major depression. The results of neurocognitive assessments provide useful information about a pilot’s performance. Obstacles to referring crew for neuropsychological testing are the paucity of neuropsychological specialists to undertake assessments and aeromedical examiners’ varied training and experience in assessing mental health problems of pilots in general.