James C. Miller

Fatigue Countermeasures in Aviation

Pilot fatigue is a significant problem in modern aviation operations, largely because of the unpredictable work hours, long duty periods, circadian disruptions, and insufficient sleep that are commonplace in both civilian and military flight operations. The full impact of fatigue is often underappreciated, but many of its deleterious effects have long been known. Compared to people who are well-rested, people who are sleep deprived think and move more slowly, make more mistakes, and have memory difficulties. These negative effects may and do lead to aviation errors and accidents. In the 1930s, flight time limitations, suggested layover durations, and aircrew sleep recommendations were developed in an attempt to mitigate aircrew fatigue. Unfortunately, there have been few changes to aircrew scheduling provisions and flight time limitations since the time they were first introduced, despite evidence that updates are needed. Although the scientific understanding of fatigue, sleep, shift work, and circadian physiology has advanced significantly over the past several decades, current regulations and industry practices have in large part failed to adequately incorporate the new knowledge. Thus, the problem of pilot fatigue has steadily increased along with fatigue-related concerns over air safety. Accident statistics, reports from pilots themselves, and operational flight studies all show that fatigue is a growing concern within aviation operations. This position paper reviews the relevant scientific literature, summarizes applicable U.S. civilian and military flight regulations, evaluates various in-flight and pre-/postflight fatigue countermeasures, and describes emerging technologies for detecting and countering fatigue. Following the discussion of each major issue, position statements address ways to deal with fatigue in specific contexts with the goal of using current scientific knowledge to update policy and provide tools and techniques for improving air safety.

Timing Light Treatment for Eastward and Westward Travel Preparation

Jet lag degrades performance and operational readiness of recently deployed military personnel and other travelers. The objective of the studies reported here was to determine, using a narrow bandwidth light tower (500 nm), the optimum timing of light treatment to hasten adaptive circadian phase advance and delay. Three counterbalanced treatment order, repeated measures studies were conducted to compare melatonin suppression and phase shift across multiple light treatment timings. In Experiment 1, 14 normal healthy volunteers (8 men/6 women) aged 34.9±8.2 yrs (mean±SD) underwent light treatment at the following times: A) 06:00 to 07:00 h, B) 05:30 to 07:30 h, and C) 09:00 to 10:00 h (active control). In Experiment 2, 13 normal healthy subjects (7 men/6 women) aged 35.6±6.9 yrs, underwent light treatment at each of the following times: A) 06:00 to 07:00 h, B) 07:00 to 08:00 h, C) 08:00 to 09:00 h, and a no-light control session (D) from 07:00 to 08:00 h. In Experiment 3, 10 normal healthy subjects (6 men/4 women) aged 37.0±7.7 yrs underwent light treatment at the following times: A) 02:00 to 03:00 h, B) 02:30 to 03:30 h, and C) 03:00 to 04:00 h, with a no-light control (D) from 02:30 to 03:30 h. Dim light melatonin onset (DLMO) was established by two methods: when salivary melatonin levels exceeded a 1.0 pg/ml threshold, and when salivary melatonin levels exceeded three times the 0.9 pg/ml sensitivity of the radioimmunoasssy. Using the 1.0 pg/ml DLMO, significant phase advances were found in Experiment 1 for conditions A (p < .028) and B (p < 0.004). Experiment 2 showed significant phase advances in conditions A (p < 0.018) and B (p < 0.003) but not C (p < 0.23), relative to condition D. In Experiment 3, only condition B (p < 0.035) provided a significant phase delay relative to condition D. Similar but generally smaller phase shifts were found with the 2.7 pg/ml DLMO method. This threshold was used to analyze phase shifts against circadian time of the start of light treatment for all three experiments. The best fit curve applied to these data (R2 = 0.94) provided a partial phase-response curve with maximum advance at approximately 9–11 h and maximum delay at approximately 5–6 h following DLMO. These data suggest largest phase advances will result when light treatment is started between 06:00 and 08:00 h, and greatest phase delays will result from light treatment started between 02:00 to 03:00 h in entrained subjects with a regular sleep wake cycle (23:00 to 07:00 h).

The Fatigue Avoidance Scheduling Tool: Modeling to Minimize the Effects of Fatigue on Cognitive Performance

Operator fatigue and time-of-day induced variations in cognitive effectiveness can lead to lapses in attention, slowed reactions, and impaired reasoning and decision-making that has been shown to contribute to accidents, incidents and errors in a host of industrial and military settings. During the past three years, the US Air Force has sponsored the development of a model of human fatigue and circadian variation and a scheduling tool based upon the model that will be used to minimize aircrew fatigue. The initial test version of the tool has passed review by the operational wings of the AF and a final operational product is in advanced development and validation. The software was developed by SAIC and NTI and is called the Fatigue Avoidance Scheduling Tool (FAST). This fatigue forecasting system is being developed and tested by NTI under a small business innovative research (SBIR) grant from the US Air Force, now in the third year of a three-year program. Fatigue predictions are derived from the Sleep, Activity, Fatigue, and Task Effectiveness (SAFTE) model invented by Dr. Steven Hursh of SAIC. The patented SAFTE model has received a broad scientific review and the DoD considers it the most complete, accurate, and operationally practical model currently available to aid operator scheduling. The Department of Transportation is in the second phase of a three-phase project to validate and calibrate the model for avoiding excessive fatigue in transportation operations. The FAST scheduling tool uses the model to compare schedules in terms of predicted performance effectiveness. FAST allows easy entry of proposed schedules and generates graphical predictions of performance along with tables of estimated effectiveness scores for objective comparison. Optimal schedules may be selected based on average effectiveness for proposed work periods or mission critical events. The tool may also be used for retrospective analysis of fatigue related factors that may have contributed to an accident, error or safety related incident. In this mode, information on the work and sleep schedules of operators prior to the event may be entered into the tool and a projection of performance effectiveness at the time of the event is determined. In combination with other information, this analysis can project the combined effects of time of day and sleep history as a contributing factor to safety related events.

Real-time bio-sensors for enhanced C2ISR operator performance

The objectives of two Air Force Small Business research topics were to develop a real-time, unobtrusive, biological sensing and monitoring technology for evaluating cognitive readiness in command and control environments (i.e., console operators). We sought an individualized status monitoring system for command and control operators and teams. The system was to consist of a collection of bio-sensing technologies and processing and feedback algorithms that could eventually guide the effective incorporation of fatigue-adaptive workload interventions into weapon systems to mitigate episodes of cognitive overload and lapses in operator attention that often result in missed signals and catastrophic failures. Contractors set about determining what electro-physiological and other indicators of compromised operator states are most amenable for unobtrusive monitoring of psychophysiological and warfighter performance data. They proposed multi-sensor platforms of bio-sensing technologies for development. The sensors will be continuously-wearable or off-body and will not require complicated or uncomfortable preparation. A general overview of the proposed approaches and of progress toward the objective is presented.