Fatigue, workload, and health risks among Aircraft crews on (ultra-)long-haul flights
A review
Background
With the recovery of international air traffic after the COVID-19 pandemic, (ultra)long-haul flights ((U)LR) with flight times of over 16 hours are increasing again. These flights pose particular occupational health challenges for crew members. Fatigue is considered a key risk factor for loss of performance and therefore also indirectly jeopardizes flight safety.
Aim
The aim of this narrative review is to describe work-related stress as well as the development, effects, and prevention options of fatigue in cockpit and cabin crews in the context of (U)LR flights.
Methods
A selective literature search was conducted including current empirical studies, reviews, and international recommendations on fatigue, workload, and health risks in flight crews on (U)LR flights.
Results
Fatigue during (U)LR flights is multifactorial, in particular due to sleep deprivation, prolonged wakefulness, circadian dysregulation, and high workload. Empirical studies show that both pilots and cabin crew on (U)LR flights often show clinically relevant symptoms of fatigue, which manifest themselves in reduced performance, concentration, and reaction time as well as increased susceptibility to errors. Fatigue is most pronounced during the circadian low and at the end of long duty periods. Chronic fatigue is associated with increased risks of mental disorders, sleep problems, cardiovascular diseases, and cancer. Countermeasures discussed include fatigue risk management systems, optimized duty schedules, strategic sleep breaks, melatonin and caffeine intake, and preventive training.
Conclusion
Fatigue poses a relevant risk to the safety and health of onboard personnel in (U)LR operations. Evidence-based fatigue risk management, including both structural and individual measures, is crucial to ensure sustainable performance and safety. Further research is recommended, particularly on the effectiveness of specific interventions and on taking into account the particularities of cabin crew.
