effects of alternating east-west rotations on aircrew fatigue · icasm 2018 - bangkok 2/12...
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Effects Of Alternating East-West Rotations On Aircrew Fatigue
Michel Klerlein (M.D.), Alain Gisquet (M.D.)
Air France Occupational Health Services
Authors have not received non-
governmental ot non-academic support
or funding for the material which we
intend to present
Both authors are employees of Air France.
Their opinion does not necesseraly reflect
the views of Air France
ICASM 2018 - Bangkok 2/12
Statement
➢ During systematic
occ.med. follow up
➢ Criteria:
− At least 4 rotations during last 6
weeks
− Exclusion return to work after
sickness or on request exams
➢ Inclusion of 296 cabin
crew, 61 captain, 96 F/O
➢ Main outcome: Samn-
Perelli fatigue scale
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Questionnaire
Cabin Crew
n = 295
Captain
n = 61
First Officer
n = 96
Age 44.1 55.1 44.7
Commuting (mn/d) 118.0 89.6 109.3
Epworth Score 10.8 9.7 11.2
% Epworth > 10 51.2 % 42.6 % 54.2 %
Sleep quality 2.62 2.37 2.50
Sleep problems 50.0 % 41.0 % 41.7 %
On sleeping pill 17.6 % 11.5 % 20.8 %
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Fatigue, Sleepiness, Sleep Quality : frequent complaints
Overall differences are not statistically significant
(Except for internal comparison in pilots)
p = 0.027
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The Air France network : layovers mentionned in the questionnaire
Alternance are defined by a difference of minimum 3 h combined to
an opposite jetlag between 2 consecutive layovers
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East-West alternances are common
43210
250
200
1 50
1 00
50
0
Number of east-west switches last 6 weeks
Num
ber
of A
ircr
ew
Distribution of aircrew by the count of east-west switches last 6 weeks
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Small relationship between SP score and count of E/W switches
σ 𝒋𝒆𝒕𝒍𝒂𝒈 × (𝟏 + 𝑬𝑾𝒔𝒘𝒊𝒕𝒄𝒉𝒆𝒔) = GKi
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Combining jet lag and E/W alternance : the GKi index
=
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GKi properties
1er quartile 21 .000
Médiane 35.500
3e quartile 59.250
Maximum 180.000
42.21 1 48.201
30.000 40.000
30.203 34.449
A au carré 17.75
Valeur de P < 0.005
Moyenne 45.206
EcTyp 32.185
Variance 1035.902
Asymétrie 1 .24276
Aplatissement 1 .16455
N 446
Minimum 0.000
Test de normalité d'Anderson-Darling
Intervalle de confiance = 95 % pour la moyenne
Intervalle de confiance = 95 % pour la médiane
Intervalle de confiance = 95 % pour l'écart type
1 801 501 209060300
Médiane
Moyenne
5045403530
Intervalles de confiance = 95 %
Rapport récapitulatif pour ASTREINTE
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No univariate relationshipbetween GKi and Fatigue …
02
46
8
Sam
n-P
ere
lli F
atigue S
cale
0 50 100 150 200GK index
R-squared=0.13 %
P-value: 0.5194
Samn-Perelli score by the GK index
➢ No
relationship
with the strain
index
➢ But some
link with sleep
quality,
somnolence
and being
female
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…Neither in multivariate analysis
Age
Seniority
Commuting
Epworth
Sleep qual.
Wake duration
GK index
Gender=2
0 .2 .4 .6 .8
R-square = 37.5 %
(dependant variable : Samn-Perelli score when filling the questionnaire)
Coefficient plot of a multilinear regression
➢No link in multivariate analysis between
fatigue, intensity of jet lag and E/W alternance
during the last 6 weeks
➢ According to crew, airlines should minimize
E/W alternance at 1 per month
➢Despite these results, the occupational
medecine department supports this
recommandation on the basis of
− Bad baseline sleepiness and fatigue scores
− Fear of enhanced consumption of sleeping medications
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In summary
ICASM 2018 - Bangkok
Questions ?