Fit to Fly ? Ries Simons & Pierre Valk Netherlands Organization for Applied Scientific Research Advisory Board ESAM ries.simons@tno.nl 20-9-2018

TNO Aircrew Fitness Program stimulating safety & performance of aircrew since 1986 Sleep – Alertness FTL Lifestyle FCL Medication - Drugs FCL ries.simons@tno.nl 20-9-2018

TNO Aircrew Alertness Program Sleep Surveys Flight Time Limitations Bunk Sleep and Augmented Crew Early Starts and Irregular Rosters “Cockpit Nap” ECASS (ULR OPS, “Moebus” Report) Effects of Medication / Alcohol Fit to Fly Tool ries.simons@tno.nl 20-9-2018

Impaired Fitness ≈ Fatigue in the context of Flight OPS A state of reduced mental or physical performance capability that can impair a crew member’s alertness and ability to safely operate an aircraft or perform safety related duties ries.simons@tno.nl 20-9-2018

Impaired Fitness ≈ Fatigue Time on Task Time since awake Pre-Duty Sleep Phase of Circadian Cycle Work load / Monotony Medication, hangover Cabin environmental conditions Life style Health / Psychological Factors ries.simons@tno.nl 20-9-2018

evaluate risks and take action Fit to Fly Programme Predict fitness-related safety risks and indicate which factors can be improved to reduce the risk: evaluate risks and take action Provide a method to evaluate rosters / requirements Stimulate awareness of fitness-related aspects of safe functioning ries.simons@tno.nl 20-9-2018

Fit-to-Fly Tool - Aim Evaluation of rosters and route schedules Evaluation of alertness-related safety of operations Stimulate awareness of effects of fatigue, sleep, life style on performance and health On which points can I improve ? On which points can the management improve ? ries.simons@tno.nl 20-9-2018

Lifestyle-Ailments-Medication-Alcohol In-flight Crew Alertness Model Lifestyle-Ailments-Medication-Alcohol ries.simons@tno.nl 20-9-2018

Fit-to-Fly Tool - Design In analogy with CFIT Checklist (FSF): risk factors risk multiplying factors risk reducing factors Model based on data of TNO Aircrew Fitness Program ries.simons@tno.nl 20-9-2018

Field Studies: 380 pilots Actiwatch Vigilance and Tracking Task Questionnaires/rating scales Samn-Perelli 7 pt SSS KSS – 9 pt GSQS ries.simons@tno.nl 20-9-2018

Fatigue & Alertness during FDP Fatigue SP Reaction Time ries.simons@tno.nl 20-9-2018

Pre-duty sleep and in-flight performance Top of Descent ** **: p<0.001 ** Pre-flight Sleep Duration ries.simons@tno.nl 20-9-2018

Short Haul Early reporting: Vigilance at TOD Top of Descent ** * : p<0.05 **: p<0.001 * ries.simons@tno.nl 20-9-2018

Long Haul Flights: Vigilance ries.simons@tno.nl 20-9-2018

Crew augmentation and In-flight Sleep Extension of flying duty period by in-flight relief. Report TNO-DV 2007 C362 (Simons & Spencer) ries.simons@tno.nl 20-9-2018

Alcohol: acute and post-alcohol effects on Vigilance BAC 0.07% (delta) BAC 0.00% ries.simons@tno.nl 20-9-2018

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Fit-to-Fly Tool - Method Categories of risk factors / risk reducing factors: pre-flight sleep pre-flight fitness history of recent duty actual flight operation - numerical values are assigned to each item of each category  score for each category  Risk Index ries.simons@tno.nl 20-9-2018

Fit-to-Fly Tool Pre-flight Sleep Pre-flight Fitness Recent Work load - Quality, duration, efficiency Pre-flight Fitness - Sleepiness, medication, alcohol Recent Work load - Early reporting, late arrival, jet lag, excessive workload Actual Flight Operation - Early reporting, night flight, onboard rest opportunities ries.simons@tno.nl 20-9-2018

FTF Tool Evaluation in Long + Short Haul OPS: Long haul rotations 77 pilots from AMS to: BKK - 6 day ops / shuttle flight TPE JNB - 6 day ops / shuttle flight CPT NRT - 3 day ops (1 local night) MEX - 5 day ops Short Haul rotations 45 pilots 36 different destinations 5 - 6 day duty periods ries.simons@tno.nl 20-9-2018

Pre-flight sleep Risk Factors difficulty falling asleep tossing and turning frequent awakenings poor sleep quality tired after waking up TST 0-4 hours TST 4-6 hours TST 6-7 hours ries.simons@tno.nl 20-9-2018

Pre-flight sleep Risk Reducing Factors TST >7 hours sleep in circadian sleep phase sleep quality: good sleep quality: very good pre-flight nap: 1-2 hours pre-flight nap: >2 hours ries.simons@tno.nl 20-9-2018

Pre-flight Fitness Risk Factors sedative medication last night headache, common cold hay fever 2-4 alcoholic drinks last night >4 alcoholic drinks last night actual status: tired actual status: foggy actual status: sleepy ries.simons@tno.nl 20-9-2018

Pre-flight Fitness Risk Reducing Factors no sedative medication last night <1 alcoholic drink last night actual status: fit actual status: very fit ries.simons@tno.nl 20-9-2018

Operational Factors: History of recent duty Risk Factors short haul: start <6 a.m. within last 36 hrs short haul: start 6-8 hrs within last 36 hrs short haul: arrival after midnight within last 36 hrs >5 time zones crossed within last 36 hrs >5 time zones crossed within last 48 hrs long haul: all night flying in last 2 days excessive workload during last 2 days ries.simons@tno.nl 20-9-2018

Operational Factors: actual flight Risk Multiplying Factors short haul: start <6 a.m. short haul: start between 6 - 8 a.m. short haul: arrival after midnight short haul: arrival between 10 - 12 p.m. long haul: all night flying inadequate opportunities for break(s) ries.simons@tno.nl 20-9-2018

Operational Factors: actual flight Risk Reducing Factors day-light flight adequate rest between 2 sectors augmented crew opportunities for in-flight rest in cockpit seat opportunities for in-flight rest in business seat opportunities for in-flight rest in bunk duration in-flight rest 0.5-1 hour duration in-flight rest 1-2 hours duration in-flight rest >2 hours in-flight rest in circadian sleep phase ries.simons@tno.nl 20-9-2018

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Fit-to-Fly tool: part of FRMS ? monitoring education Fit-to-Fly tool: part of FRMS ? monitoring evaluation ries.simons@tno.nl 20-9-2018

Stimulate healthy life style using Fit-to-Fly tool ries.simons@tno.nl 20-9-2018

Thanks for your attention ries.simons@tno.nl