FAA Flight Attendant Fatigue Oct 11

8/3/2019 FAA Flight Attendant Fatigue Oct 11

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Katrina Avers,1 DarinNei,1 S. Janine King,2

Suzanne Thomas,2 Carrie Roberts,2

Joy O. Banks,1 Thomas E. Nesthus1

1

Civil Aerospace Medical InstituteFederal Aviation AdministrationOklahoma City, OK 73125

2Xyant Technology, Inc.6500 S. MacArthur Blvd.Oklahoma City, OK 73125

October 2011

Final Report

Flight Attendant Fatigue:A Quantitative Review ofFlight Attendant Comments

DOT/FAA/AM-11/16

Ofce of Aerospace Medicine

Washington, DC 20591

OK-12-0025-JAH

Federal Aviation

Administration


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NOTICE

This document is disseminated under the sponsorship

of the U.S. Department of Transportation in the interest

of information exchange. The United States Government

assumes no liability for the contents thereof.

___________

This publication and all Office of Aerospace Medicine

technical reports are available in full-text from the CivilAerospace Medical Institutes publications Web site:

www.faa.gov/library/reports/medical/oamtechreports


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Technical Report Documentation Page

1. Report No. 2. Government Accession No. 3. Recipient's Catalog No.

DOT/FAA/AM-11/16

4. Title and Subtitle 5. Report Date

October 2011Flight Attendant Fatigue: A Quantitative Review of FlightAttendant Comments 6. Performing Organization Code

7. Author(s) 8. Performing Organization Report No.

Avers KB,1Nei D,

1King JS,

2Thomas S,

2Roberts C,

2Banks JO,

1

Nesthus TE1

9. Performing Organization Name and Address 10. Work Unit No. (TRAIS)

11. Contract or Grant No.

1FAA Civil Aerospace Medical InstituteP.O. Box 25082Oklahoma City, OK 73125

2Xyant Technology, Inc.

6500 S. MacArthur Blvd.Oklahoma City, OK 73125

12. Sponsoring Agency name and Address 13. Type of Report and Period Covered

Office of Aerospace MedicineFederal Aviation Administration800 Independence Ave., S.W.Washington, DC 20591 14. Sponsoring Agency Code

15. Supplemental Notes

Work assigned and accomplished under approved tasks AM-A-08-HRR-521.16. Abstract

Todays aviation industry is a 24/7 operation that produces a variety of challenges for cabin crew membersincluding extended duty periods, highly variable schedules, frequent time zone changes, and increased passengerloads. The present content analysis study was conducted to provide a quantitative review of flight attendantcomments provided on the congressionally mandated survey of flight attendant field operations that wasconducted in 2008. This report can be used as a supplement to interpret the published survey results (Avers etal., 2009b). Two hundred surveys were randomly selected for each type of operation and level of seniority. Atotal of 1,800 surveys with comments were content analyzed (936 paper, 864 online). Eight broad commentcategories were identified, including: scheduling, health, airline and airline policy, job performance and

satisfaction, meals, survey, workload, and break facilities. Each category consisted of multiple positive andnegative issues identified by flight attendants. This report outlines the most frequently reported categories andissues, summarizes the key issues by type of operation (low-cost, regional, network carrier) and seniority level(junior bottom one-third, mid middle one-third, senior top one-third), and provides examples of actualrespondent comments for the most commonly identified topics.

17. Key Words 18. Distribution Statement

Fatigue, Flight Attendant, Survey, Duty Time, Workload,Scheduling, Comments

Document is available to the public through theDefense Technical Information Center, Ft. Belvoir, VA22060; and the National Technical InformationService, Springfield, VA 22161

19. Security Classif. (of this report) 20. Security Classif. (of this page) 21. No. of Pages 22. Price

Unclassified Unclassified 23Form DOT F 1700.7 (8-72) Reproduction of completed page authorized


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ACkNOwlEdgmENTs

Thank you to the many airlines, labor organizations, and ight attendants or your collaboration, support, and

eedback. This report was supported and unded by the FAA Air Trafc Organizations Human Factors Research and

Engineering Group.


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CONTENTs

Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

IntroductIon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Method. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Comment Sample . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Comment Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Analyses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Overall Frequency o Occurrence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Scheduling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Job Perormance and Satisaction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Airline and Airline Policy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Meals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Workload and Break Facilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

dIscussIon. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Limitations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

General Findings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

conclusIons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

references. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

appendIxa: Categories, Subcategories, and Issues a1

appendIxB: Examples o Comments B1


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Flight AttendAnt FAtigue:A QuAntitAtive ReviewoF Flight AttendAnt Comments

BACkgrOuNd

While a great deal o research has been conducted onhuman circadian processes as applied to the schedulingand training o ight crews, relatively little research hasbeen accomplished in cabin crew operations. Cabin crewmembers work in an environment that requires multipleight legs, extended duty days, limited time o, earlydepartures, late arrivals, and less-than-optimal sleep-ing conditions (Avers, Hauck, Blackwell, & Nesthus,2009a; Caldwell, 2005; Nesthus, Schroeder, Connors,Rentmeister-Bryant, & DeRoshia, 2007). Perormance

o cabin duties is critical to the saety and security o thegeneral ying public. Sleep researchers have ound that allhuman perormance is vulnerable to sleep loss and dailyvariations in physiological processes tied to underlyingbody-clock mechanisms (Caldwell, 2005). Sleep loss andthe extent to which it aects atigue and the perormanceo cabin crew members operating under the current dutyregulations is currently unknown.

In 2005, the U.S. Congress directed the Civil AerospaceMedical Institute (CAMI) to address issues regardingight attendant (FA) atigue. CAMI contracted with theNational Aeronautics and Space Administration (NASA)

Ames Research Centers Fatigue Countermeasures Groupto conduct literature and incident report reviews andexamine a range o typical ight attendant schedulesto assess potential vulnerability to atigue. A publishedFederal Aviation Administration (FAA) Ofce o Aero-space Medicine Technical Report (Nestus et al., 2007)integrated two NASA reports. The report concluded thatsome degree o atigue-related perormance decrementswere likely under the current regulations and suggested sixareas o research that would acilitate understanding andgovernment-industry decision making. The six recom-mendations included: 1) a survey o feld operations, 2)feld research on the eects o atigue, 3) a validation omodels or assessing ight attendant atigue, 4) a ocusedstudy o incident reports, 5) a review o internationalpolicies and practices, and 6) a review o the potentialbenefts o training with corresponding recommendationsor a training program.

In 2008, Congress provided another directive orCAMI to conduct ollow-up studies in each o the sixrecommendation areas noted in the 2007 report. To ac-complish this directive, CAMI researchers developed a

project plan or completing each recommendation. Toacilitate support or these projects and ensure participa-tion, CAMI researchers coordinated with representativeso vested organizations (e.g., Air Transport Association,Regional Airline Association, Coalition o Flight Atten-dants) and provided them with the opportunity to reviewand comment on aspects o the project plan prior to itscommencement.

The current report provides a quantitative review oight attendant comments provided on the 2008 surveyo ight attendant feld operations (recommendation #1).This report can be used as a supplement to interpret the

published survey results (Avers et al., 2009b).

INTrOduCTION

Technological advances in the last 20 years have sig-nifcantly contributed to a 24/7 aviation industry. As aresult, cabin crew members are challenged continually bymultiple ight legs, extended duty days, limited time o,early departures, late arrivals, less-than-optimal sleepingconditions, jet lag, and non-standard work hours suchas night duty and rotating schedules (Caldwell, 2005).Despite operational requirements, the bodys biological

need or sleep does not change. In other words, individualsare not physiologically prepared to operate eectively onthe 24/7 schedules that defne todays ight operations. In2008, the FAA was congressionally mandated to examineatigue implications or cabin crew operations. A surveywas developed as one o six projects to identiy the typeand requency o atigue experienced by ight attendantsand to assess how atigue may impact airline saety.

Overall, responses to the survey indicated that ightattendants consider atigue to be a signifcant issue. Ac-cording to reports rom the surveyed ight attendants,most have experienced atigue while at work and agreethat it is both a common experience and a saety risk.More than hal o the survey respondents reported thatthey had nodded o (i.e., micro-sleep) during ight dur-ing the previous bid period. Flight attendants reportedaverage work days o 9.6 hr, with an average minimumo 6.4 hr and an average maximum o 12.9 hr. O thetop-10 contributors to atigue, length o duty day (10 13 hr) was the most requently cited actor contributingto atigue. Duty days longer than 14 hr were identifedas contributing the most to perceived atigue.


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Scheduling actors made up nine o the 10 most com-mon recommendations or operational change that ightattendants had selected rom a list identifed to reduceight attendant atigue. The most commonly selectedrecommendations were: eliminate reduced rest, do notmix continuous duty overnight with early-morning reporttimes, maintain consistent scheduling, limit number o

ight segments/legs, limit number o duty hours allowed,start scheduled rest period on arrival at hotel, lengthen restperiods, do not schedule several-hour breaks or airportsits between ight segments/legs, schedule enough timebetween ight segments/legs or meals, and provide ightattendants with ood and beverages on ights.

The survey provided ight attendants the opportu-nity to submit comments and urther expound on theirpersonal challenges, concerns, and recommendationsassociated with atigue. Due to the large number o com-ments submitted, a random sample o comments wascontent-analyzed and quantifed. This report outlines

the most requently reported issues, summarizes the keyissues by type o operation (low-cost, regional, networkcarrier) and seniority level (junior bottom one-third,mid middle one-third, senior top one-third), andprovides examples o actual respondent comments or themost commonly identifed issues. An examination o thecomments provided a prioritization o ight attendantissues in a ree-orm context and illustrated the intricaciesassociated with atigue and current cabin crew operations.

mEThOd

The ight attendant atigue survey was administeredboth electronically and in hard-copy orm to 20,826FAs. Although 10,550 were completed and returned orsubmitted online, only 9,180 met the criteria or inclu-sion in analyses (i.e., an active FA working or his/hercurrent airline at least one month and had own withinthe previous bid period). Approximately 37% o the

surveys included in the analyses contained comments:1,933 paper and 1,506 online.

Comment ampleComments were only included in this study i they

were provided on a completed, eligible survey. To ensurethe sample o comments was representative o the over-

all general survey respondents, two demographic itemsclassifed eligible surveys: 1) type o operation (low-cost,regional, network), and 2) ight attendant seniority level(junior, mid, senior). This resulted in nine dierent po-tential survey classifcations (see Table 1). Two hundredsurveys were randomly selected or each o the specifedsurvey classifcations and selections were balanced bymethod o survey completion: 52% paper, 48% online.A total o 1,800 surveys were then content-coded (936paper, 864 online).

Comment Analysis

Category identication. Few would disagree thatoperational conditions and individual dierences inu-ence atigue. The ight attendant atigue survey wasdesigned to assess each o these relevant contributors(Avers et al., 2009b). A hybrid approach using thesurvey inrastructure and a review o actual commentsproduced the key comment categories or the currentreport. Using this approach, eight broad categories wereidentifed, including: scheduling, health, airline andairline policy, job perormance and satisaction, meals,survey, workload, and break acilities. Several o thelarger categories encompassed a broad variety o topics

or issues. For example, the scheduling category consistso issues such as duty day, rest periods, and reserves.Those issues were organized into subcategories within thelarger category o scheduling. Each category consisted omultiple positive and negative issues identifed by ightattendants. Seventy-eight issues were identifed in total(56 negative, 22 positive). See Appendix A or a complete

Table 1. Comment Breakout by Airline Type and Seniority Level

Airline Type

Low-cost Regional Network CarrierSeniority

Junior 104 104 104

Paper Comments Mid 104 104 104

Senior 104 104 104

936Surveys

Junior 96 96 96

Online Comments Mid 96 96 96

Senior 96 96 96

864Surveys


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list o comment categories and subcategories, as well asall corresponding issues.

Comment evaluation. Once the comment categories

and corresponding issues were identifed, a subset ocommented surveys was used to train our judges. Theour judges were required to complete a 40-hr trainingprogram involving instruction, practice, and eedback.During this training, the judges were amiliarized with theFA comments, corresponding comment categories andissues, and example indicators or each category or issueclassifcation. Once the trained judges were amiliarizedwith the comment categories and issues, they were askedto identiy which categories and issues were present in acommented survey. Specifcally, each o the our judgeswas provided ten identical sets o respondent comments.

Judges independently read comments, underlined sectionso comments that could be categorized, and wrote thecategory or issue code above the underlined section (SeeFigure 1 or example). Codes were entered into a data-base or each judge. Common codes were accepted anddiering codes were resolved through group discussion.No code was accepted until 100% interrater agreementwas obtained.

Overall, a total o 8,760 codes or issues were identi-fed in the comments provided by the 1,800 ight at-tendants included in this sample. The fnal number ounique codes assigned to each survey ranged rom 1 to20 (mean = 4.8; med = 4.0; SD = 3.2). Each code wasapplied only once per survey to avoid inating the valueo comments rom any given ight attendant. O the8,760 codes overall, 8,035 (92%) were negative and 725(8%) were positive a fnding that is not surprising sincepeople tend to ocus on negative inormation more thanpositive (Baumiester, Bratslavsky, Finkenauer, & Vohs,2001; Pratto & John, 1991).

AnalysesThis report outlines the most requently reported

category and corresponding issues and examines potential

dierences amongst the FA groups o this study (typeo operation (3) X seniority level (3)). To address thequestions presented in our study, a series o analyses wasconducted. First, descriptive statistics were applied toevaluate the relative occurrence rate o each broad categoryand the corresponding issues. Second, chi-square analyseswere run to identiy signifcant group dierences or themost highly prioritized issues.

rEsulTs

Overall Frequency of Occurrence

Given the limited qualitative inormation availableregarding ight attendant concerns or issues relating toatigue, one o the primary objectives o this study wasto identiy the issues and their relative requency. A re-quency analysis o the eight broad categories indicatedmore than one-third o the ight attendants in the codedsample commented on scheduling (n = 1,418, 79%),health (n = 1,104, 61%), job perormance and satisaction(n = 643, 36%), and airline and airline policy (n = 587,33%). See Table 2 or the requencies o each categoryacross airline type.

We also examined the top 15 most requently reportedissues across the eight broad categories (issues identifedby at least 10% o the comment sample in this study(n = 180). Chi-square analysis was used to determinewhether the issues were globalized across ight attendantsor specifc to a particular group o ight attendants (type ooperation, seniority level, or type o operation X senioritylevel). See Table 3 or the most requently reported issues.

Across these categories, the top three most requentlyidentifed issues by FAs were within the health category:atigue/exhaustion (n = 803, 45%); and the scheduling

I would just like to say I really enjoy my job100P

. One of my main concerns is that sometimes due to such

extremely long, hard days4

without a sufficient amount of sleep64

and trying to survive on unnutritional

[sic] food74

, I sometimes wonder and am greatly concerned of mine and my crew's ability to react during

an emergency90

. Many, many times we are exhausted82

.

This comment was assigned six codes. The first sentence was coded 100P representing a positive (P)statement about the respondents job satisfaction: I would just like to say I really enjoy my job. The

second underlined section was a negative reference to the length of duty day (4): extremely long, harddays.The third code assigned was 64 for a negative comment about the amount of sleep received. Thenext statement was assigned a 74 regarding the poor nutritional value of available food. The fifth section,greatly concerned of mine and my crew's ability to react during an emergency wascoded a 90 for thenegative impact of fatigue on safety or job performance and the final portion of the comment wasassigned the code 82 representing fatigue or exhaustion.

Figure 1. Example of comment coding procedure.


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Table 2. Frequency of Category Comments by Seniority Level Within Airline Type

Low-cost Regional Network

Category Junior Mid Senior Junior Mid Senior Junior Mid Senior Overall

Scheduling 168 155 162 162 151 165 152 157 146 1418

Health 120 124 123 126 115 119 120 131 126 1104

Job Performance and Satisfaction 80 65 70 79 65 67 78 69 70 643

Airline and Airline Policy 57 68 85 63 73 74 55 72 69 616

Survey 41 46 38 36 40 49 54 53 53 410

Meals 29 40 45 51 47 43 46 42 36 379

Workload 26 34 38 33 26 31 23 39 38 288

Break Facilities 20 23 29 25 20 27 15 42 37 238

Table 3. Frequency of Issue by Seniority Level Within Airline Type

Frequency Low-cost Regional Network

Rank Issue Junior Mid Senior Junior Mid Senior Junior Mid Senior Overall

1 Fatigued/Exhausted 84 87 85 92 86 93 84 98 94 803

2 Rest period too short 73 76 89 63 90 82 84 94 76 727

3 Duty day too long 53 72 75 56 56 75 55 75 50 5674 Inadequate amount of

sleep/rest53 45 47 50 40 45 48 60 51 439

5 Fatigue impact onsafety/jobperformance

46 34 38 30 42 46 45 42 36 359

6 Transportationto/from restaccommodationsshould not beincluded in restperiod

35 41 33 29 50 49 28 34 25 324

7 Appreciation offatigue research/survey

30 38 26 28 32 36 39 40 36 305

8 Long periods withoutfood/No time toeat/No food or wateravailable

25 36 36 43 36 33 28 25 14 276

9 Dissatisfaction withairline/Airline concernfor FA health andwelfare

28 24 36 25 34 37 26 25 25 260

10 Physical healthsuffers due to job

24 22 21 24 17 23 27 39 36 233

11 Dissatisfaction withpay/Pay for time

worked

30 21 24 32 17 17 30 29 32 232

12 Insufficient number ofbreaks/Amount oftime for breaks

18 22 29 22 24 28 17 31 26 217

13 Inconsistent or earlyreports (mixedearly/late)

19 18 26 22 29 25 26 29 19 213

14 Too manylegs/Segments/Swaps

23 22 15 37 26 32 22 17 8 202

15 Impact of delays notconsidered

17 25 33 19 24 30 20 20 14 202


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category: rest period too short (n = 727, 40%) andduty day too long (n = 567, 32%). The least requently

identifed issues were adequate amount o sleep (n =1, 0.1%), satisaction with benefts (n = 1, 0.1%), andgood quality o ood available (n = 1, 0.1%). Althoughthe range in requency is quite diverse, the fndings doappear to be consistent with other reports (Avers et al.,2009b; Enck, Muller-Sacks, Holtmann, & Wegmann,1995; Ewing, 1999; Haugli, Skogstad, & Hellesoy,1994; Hunt & Space, 1994; Nagda & Koontz, 2003;Nesthus et al., 2007; Rayman, 1997; Smolensky, Lee,Mott, & Colligan, 1982; Tashkin, Coulson, Simmons,& Spivey, 1983).

cedulingTable 2 shows the most commonly cited category was

scheduling. The category consisted o fve subcategoriesand 26 issues. Within the scheduling category, the mostcommonly cited issues were rest period too short (n =727, 40%), duty day too long (n = 567, 32%), andtransportation to/rom rest accommodations should notbe included in rest period (n = 324, 18%). Interestingly,each o these issues was inherently tied to current rest andduty time restrictions. A chi-square analysis across typeo operation and seniority level identifed issues withinthe scheduling category that were consistently important

and some that were dierentially important. Three is-sues showed no dierence across type o operation andseniority level: rest period too short (2 = 1.444, p >.05; 2 = 5.764, p > .05; see Figure 2), inconsistent orearly reports (2 = 1.566, p > .05; 2 = .671, p > .05; seeFigure 3), and impact o delays not considered (2 =4.494, p > .05; 2 = 3.758, p > .05; see Figure 4). In otherwords, these three issues were identifed consistently asimportant to FAs across type o operation and senioritylevel. In contrast, some issues were dierentially impor-

tant. Duty day too long was reported less requentlyby junior-level FAs (2 = 7.276, p < .05) across type o

operation (2

= 1.591, p > .05; see Figure 5). Main e-ects or transportation to/rom rest accommodationsshould not be included in rest period were ound orboth type o operation (2 = 9.51,p < .01) and senioritylevel (2 = 6.17, p < .05). Regional FAs identifed thisissue most requently, while network FAs had the ewestcomments about this issue. Overall, junior-level FAs hadthe ewest comments, and mid-level FAs had the mostcomments recommending that transportation to/romrest accommodations should not be included in the restperiod (see Figure 6). A substantial number o ight at-tendants reported insufcient number o breaks/amount

o time or breaks, but senior-level FAs identifed thisissue more requently than junior-level FAs (2 = 5.83,p < .05; see Figure 7). There was no dierence by typeo operation (2 = .262, p > .05). Not surprising, theregional FAs identifed too many legs/segments morerequently than either low-cost or network FAs (2 = 20.62,p < .01). Moreover, junior-level FAs identifed this issuemore than senior-level FAs (2 = 6.23,p < .05; see Figure8). This may be a result o current bid practices. Moresenior FAs have greater opportunities and the ability toselect their ideal schedules typically longer ights withewer segments.

In these comments, FAs discussed excessive lengtho the duty day and indicated that the minimum restperiod should be lengthened. Some suggested the restperiod should be 12 or 14 hr, while others proposedthat rest periods should equal or exceed the length o theprevious and/or ollowing duty day. For example, oneight attendant said, Layover rest periods or scheduledrest periods should never be shorter than the longestduty day. Flight attendants reported that the activitiesrequired during the designated rest periods signifcantly

73

63

84

76

90

94

89

82

76

50

60

70

80

90

100


Junior

Mid

Senior

Numberof

comments

Figure 2. Number of comments for Rest Period too Short by seniority levelacross type of operation.


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19

22

26

18

29 29

26 25

19

0

10

20

30

40

50


Junior

Mid

Senior

Numberofcomments

Figure 3. Number of comments for Inconsistent or Early Reports byseniority level across type of operation.

1719 20

25 24

20

33

30

14

0

10

20

30

40

50


Junior

Mid

Senior

Numberofcomments

Figure 4. Number of comments for Impact of Delays not Considered byseniority level across type of operation.

5356 55

72

56

7575 75

5050

60

70

80

90

100


Junior

Mid

Senior

Numberofcom

ments

Figure 5. Number of comments for Duty Day too Long by senioritylevel across type of operation.


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35

29 28

41

50

3433

49

25

0

10

20

30

40

50


Junior

Mid

Senior

NumberofComments

Figure 6. Number of comments for Transportation to/from RestAccommodations should not be Included in the Rest Period by senioritylevel across type of operation.

18

22

17

2224

3129 28

26

0

10

20

30

40

50


Junior

Mid

Senior

NumberofComments

Figure 7. Number of comments for Insufcient Number of Breaks/Amountof Time for Breaks by seniority level across type of operation.

23

37

2222

26

1715

32

8

0

10

20

30

40

50


Junior

Mid

Senior

NumberofCo

mments

Figure 8. Number of comments for Too many legs/segments byseniority level across type of operation.


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reduced the amount o time available or actual rest orsleep. Activities mentioned included deplaning passen-gers, transportation to/rom accommodations, acquiringa room, fnding ood/eating, decompressing or gettingready or sleep, showering, dressing, and reporting earlyor the next ight. One ight attendant oered the ol-lowing comment:

Currently at [Airline], there are many actions thatoccur ater the aircrat door is opened at the end o aduty period. This includes deplaning all passengers aswell as seeing to special assist paxs, cleaning the aircrat(sometimes), getting out o the airport (can take up to 30minutes in larger airports!), waiting on hotel transporta-tion (never dependable), checking in to hotel and makingsure room is ready (A/C working, not already occupied,etc.). This rest also excludes travel time rom hotel,which is becoming earlier and earlier due to increasedtrafc conditions everywhere.

Overall, FAs expressed the desire or rest periods to

start upon arrival at hotel accommodations or Behindthe Door. See Appendix B or a more comprehensive listo example comments.

Some scheduling issues are independent o currentregulatory restrictions and may vary by company policyor scheduling practices. Currently there are no regulationsregarding the number o segments a ight attendant cany in a day, the number or length o breaks, and schedul-ing o inconsistent or early reporting times.

healtThe second most commonly cited category was health.

This category contained six issues. Within health, themost commonly cited issues were atigued/exhausted(n = 803, 45%), inadequate amount o sleep/rest"(n = 439, 24%), and physical health suers due to job(n = 233, 13%). A chi-square analysis across type o

operation and seniority level or these issues indicatedno signiicant dierences or atigued/exhausted(2 = 1.46,p > .05; 2 = .60,p > .05; see Figure 9) orinadequate amount o sleep/rest (2 = 2.63,p > .05;2 = .31,p > .05; see Figure 10). In other words, ightattendants across type o operation and seniority levelwere concerned with atigue/exhaustion and the lack o

sleep/rest they are routinely able to get. On the otherhand, a signifcant dierence between type o operationwas detected or physical health suers due to job (2= 13.20,p < .01; see Figure 11), such that network ightattendants as a group had more comments regarding theirphysical health suering than either low-cost or regionalight attendants.

Some ight attendants made comments about theprevalence o atigue in the airline industry (e.g., Flightattendant atigue is a serious and constant problem withinthe industry.), while others indicated that they personallysuered rom atigue or exhaustion (e.g., I eel it is aging

me and taking a bigger toll on my health than any other jobI have worked. I would not recommend this job to anyonewho has their physical health as a priority.). Commentsassociated with inadequate amount o sleep/rest were mostrequently associated with reduced sleep due to short lay-overs and early-morning report times, trouble alling asleepwhen atigued or in a dierent time zone, circadian rhythmor body clock disruption, and reported use o sleep aids.

Job Performance and atisfactionThe next most commonly cited category involved is-

sues o job perormance and satisaction. This category

contained three subcategories and eight issues. The mostcommonly cited issues regarding job perormance and sat-isaction were atigue impact on saety/job perormance(n = 359, 20%) and dissatisaction with pay/pay or timeworked (n = 232, 13%). Chi-square analyses revealed

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Figure 9. Number of comments for Fatigued/Exhausted by senioritylevel across type of operation.


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Figure 10. Number of comments for Inadequate Amount of Sleep/Rest byseniority level across type of operation.

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Figure 11. Number of comments for Physical Health Suffers due to Job byseniority level across type of operation.

that there were no signifcant dierences or either othese comments across type o operation or seniority level(2 = 0.17,p > .05, and 2 = 4.76,p > .05, respectively).These results suggested that the impact o atigue onjob perormance or saety and dissatisaction with pay/pay or time worked were a concern or FAs across type

o operation and seniority level (see Figures 12 and 13,respectively). Many ight attendants expressed concernregarding their ability to do their job saely under currentoperational schedules. Some discussed their inability toocus and remember routine tasks, the compromised qual-ity o their perormance, and even their ears regardingtheir ability to respond appropriately in an emergency.

Although at ace value, ight attendant dissatisactionwith pay/pay or time worked appears to be a completelyseparate issue, a closer inspection indicated that it may

be tied to the overarching atigue issues. Some FAsreerenced the amount o pay received; however, themajority o comments within this topic reerenced thejob requirements that are not considered duty time andare, thereore, unpaid. For example, many FAs indicatedthat they are required to report 20 to 30 min prior to

departure time but are not paid until the door closesor until block out when the airplane pulls away romthe gate. For instance, one ight attendant commentedboarding the A/C [aircrat] is the most stressul time oany pairing; to be working or no pay during this time pe-riod is ludicrous, antiquated, and unacceptable, especiallywhen a typical duty day can include up to 5 boardings.FAs reported that their pay stops at block in when thedoor opens. However, many duties are required duringthe time rom report until the FA leaves the aircrat and


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10

the perormance o these duties are o the clock. Someexamples o o the clock duties include stocking thegalley, boarding or deplaning passengers, stowing luggage,and security sweeps. In addition to duties perormed,many FAs elt that long sits at airports between ightsshould be paid given that the FA does not have the abilityto leave the airport and the sits caused long duty daysand increased atigue.

Airline and Airline PolicyThe ourth most commonly cited category concerned

airline and airline policy. This category consisted o threesubcategories and 13 issues. The most commonly citedissue with regard to airline and airline policy was dissat-isaction with airline/airline concern or ight attendanthealth and welare (n = 260, 14%). A chi-square analysisound no signifcant dierences across type o operation

or seniority level (2 = 2.73,p > .05; 2 = 2.71,p > .05; seeFigure 14), suggesting that dissatisaction with the airlineor the airlines concern or FA health and welare was anissue across all groups.

Many FAs suggested that their airlines were not con-cerned or employee health or saety but rather were con-cerned about money. For example, one ight attendantcommented, In the last ew years with the economy wevetaken 40% pay cuts and lost ground in stafng and workrules. We need a ederal mandate to help us because allairline managements push as ar as possible to help withthe bottom line profts.

urveyThe next most commonly cited category was with regards

to the actual survey. This category was comprised o ourissues. The most commonly cited issue with regard to the

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Figure 12. Number of comments for Fatigue Impact on Safety/JobPerformance by seniority level across type of operation.

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Figure 13. Number of comments for Dissatisfaction with Pay/Pay for TimeWorked by seniority level across type of operation.


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Figure 14. Number of comments for Dissatisfaction with Airline/AirlineConcern for Flight Attendant Health and Welfare by seniority levelacross type of operation.

survey they were completing was also the only positive issueto make the top fteen, appreciation o atigue research/survey (n = 305, 17%). A chi-square analysis revealed nosignifcant dierences across type o operation or senioritylevel (2 = 3.18,p > .05; 2 = 1.24,p > .05; see Figure 15).This suggests that across these groups, ight attendants

were generally appreciative o the atigue research thatwas being conducted. For instance, one ight attendantcommented, Thank you or conducting this survey asFlight Attendant health is a growing concern. That said,it should be noted that some were not appreciative o thesurvey albeit very ew (n = 7, 0.4%).

mealsThe sixth most commonly cited category concerned

meals. This category consisted o six issues. The most com-mon o these issues was long periods o time without ood/

no time to eat/no ood or water available (n = 276, 15%).A chi-square analysis revealed a signifcant dierence acrosstype o operation (2 = 13.48,p < .01; see Figure 16). Thisissue was listed most requently by regional FAs ollowedby low-cost. Network carrier FAs made considerably ewernegative statements about long periods without ood. Thisincludes only reerences to the ability to fnd ood or waterand the time to eat. Most comments reerred to obtainingor eating while on duty; however, some FAs indicated thatfnding ood while on layover can be problematic due tothe time o arrival and/or departure and/or the location orest accommodations. One ight attendant commented,No time between ights to eat, not enough water providedin ight to stay hydrated, and short layovers resulting inlost sleep.

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Figure 15. Number of comments for Appreciation of Fatigue Research/Survey by seniority level across type of operation.


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workload and Break FacilitiesThe seventh and eighth categories evidenced in the

comments discussed workload and break acilities. Noneo the issues that were reported in these categories reachedthe 10% responding threshold or urther analysis.

dIsCussION

imitationsBeore turning to the broader implications o the

present report, certain methodological limitations andconceptual issues should be noted. Qualitative studies, in

particular, are methodologically limited by the subjectiveevaluations o researchers or coders. Code determina-tions depend on researcher and coder perceptions andunderstanding o the comments. To minimize the aecto researcher or coder bias, a stringent methodology wasapplied or category development and coding: 1) thecomment categories were largely aligned with the inra-structure o the survey, 2) multiple coders reviewed eachcomment, and 3) no comment code was accepted unless100% interrater agreement was achieved. In addition tothe methodological limitations associated with contentanalysis, the present study should primarily be used as

a supplemental examination o atigue-related issues.In other words, this report does not provide objectiveatigue data, but rather provides context and interpretiveguidance or more objective collections and reports onFA atigue (e.g., Roma, Mallis, & Hursh, 2010; Roma,Mallis, Hursh, Mead, & Nesthus, 2010).

eneral FindingsDespite the noted limitations, we believe that the

results obtained in the present study have some note-worthy implications or understanding atigue in cabincrew operations. Overall, ight attendants consideredatigue to be a signifcant issue, and in act, atigue wasthe most requently identifed issue in the comments. Theprioritization o issues provided by FAs is important orunderstanding the urgency with which they view atigue.Even more important is in knowing that this is an issuethat spans the various types o operations and senioritylevels it is not limited to one subset o the population.

The top fve reported comments all related specifcallyto concerns regarding atigue, atigue contributors, andatigue saety risks. All ight attendants, regardless o typeo operation or seniority level, reported concerns associatedwith being atigued/exhausted, having rest periods thatare too short, inconsistent scheduling or early reports, notconsidering the impact o delays when scheduling, notreceiving adequate sleep/rest, and the impact o atigueon saety/perormance. Given that these issues were alsoidentifed consistently in open-response items, it is notsurprising given that a substantial number o FAs alsoreported their appreciation o the congressionally man-

dated atigue research.Separate rom issues that may be linked directly to

atigue, FAs agreed on two additional points. In particular,ight attendants across type o operation and senioritylevel were dissatisfed with their airline and the concernthe airline demonstrated or their health and welare aswell as the airlines current compensation systems.

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Figure 16. Number of comments for Long Periods of Time without Food/No Time to Eat/No Food or Water Available by seniority level across type ofoperation.


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Flight attendant atigue and many o its contributingactors were identifed consistently, but there were somevariations by type o operation and seniority level.

Type of operations. An examination o the resultsindicated that ight attendants rom regional operationsidentifed three issues more requently than the otheroperations. Specifcally, FAs rom regional operations

expressed signifcantly more concerns regarding toomany legs/segments, long periods o time withoutood/no time to eat/no ood or water available, andtransportation to/rom rest accommodations should notbe included in rest period. The general trend revealedprevalence amongst regionals, ollowed by low-cost, andthen network operations. Apparently, operational con-straints associated with regional airlines introduced somepotential atigue issues that need to be examined. Withthat in mind, it should be recognized that the networkight attendants did report physical health suers dueto job most requently.

eniority level. Interestingly, the results regardingseniority level were a little more varied. Junior-level FAsidentifed too many legs/segments as an issue morerequently than senior-level FAs. While in contrast,senior-level FAs reported insufcient number o breaks/amount o time or breaks more requently. These mayactually be inherently related issues that were reportedsimply in dierent terms by junior- and senior-levelight attendants. Regardless, both o these issues appearto be o concern. The issues regarding duty day lengthand recommendations regarding transportation to/romrest accommodations and its inclusion in the duty day

were reported less requently by junior-level FAs acrosstype o operation and most requently by mid-level FAs.These results seem to indicate that there are dierentialissues by seniority level. This variance may be attributedto a number o actors that could be examined separately.

CONClusIONs

Results o our national survey o ight attendant atigue(Avers et al., 2009b) ound that long duty days, consecu-tive duty days, length o layovers, long delays, breaks, andnutrition were issues o concern. The results o the presentanalysis o FA comments corroborate and emphasize thesame issues. O the atigue actors reportedly having themost pronounced eect on atigue in the survey includedactors associated with length o duty day, missed meals,lack o breaks, short layovers, and number o consecutiveduty days. Many o these same issues were reiterated andrephrased in the current study. Overall, the results romthe survey and our present content analysis o reportedcomments indicate that atigue is an issue o signifcantconcern in ight attendant operations.

Although these fndings do supplement the surveyresults, they also provide a more in-depth perspectiveon the dierent types o operations and their dierentialcontributions to atigue. The results o this study suggestthat ight attendants working or regional airlines maybe experiencing some alternative atigue actors that arenot shared by low-cost and network operations. Seniority

level may play a role, but the underlying reasons are notclear in this study. Future research may examine specifcoperational issues (i.e., number o segments, complexityo the aircrat eet, complexity o position) and how theyimpact atigue. A closer examination into the underlyingcauses or dierences ound by seniority level may alsobe warranted.

rEFErENCEs

Avers, K.B., Hauck, E., Blackwell, L., & Nesthus, T.(2009a). Flight attendant fatigue, part VI: fatigue

countermeasure training and potential benefits(Technical Report No. DOT/FAA/AM-09/20).Washington, DC: Federal Aviation Administration,Oice o Aerospace Medicine.

Avers, K.B., King, S.J., Nesthus, T., Thomas, S., &Banks, J. (2009b). Flight attendant fatigue, partI: national duty, rest, and fatigue survey(TechnicalReport No. DOT/FAA/AM-09/24). Washington,DC: Federal Aviation Administration, Oice oAerospace Medicine.

Baumeister, R.F., Bratslavsky, E., Finkenauer, C., & Vohs,

K.D. (2001). Bad is stronger than good. Review ofGeneral Psychology, 5, 323-370. doi:10.1037/1089-2680.5.4.323

Caldwell, J.A. (2005). Fatigue in aviation. Travel Medicineand Infectious Disease,3, 85-96.

Enck, P., Muller-Sacks, E., Holtmann, G., & Wegmann,H. (1995). Gastrointestinal problems in airlinecrew members. Zeitschrift fr Gastroenterologie,33, 513-516.

Ewing, T. (1999, March 7). Your mind is trying to fight it,

but your body wont move. Retrieved July 29, 2009,rom www.aopis.org/Australia TheAge-Mar99 Yourmind is trying to ight it, but your body wontmove.html

Haugli, L., Skogstad, A., & Hellesoy, O.H. (1994).Health, sleep, and mood perceptions reported byairline crews lying short and long hauls.Aviation,Space, and Environmental Medicine, 65, 27-34.


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Hunt, E.H., & Space, D.R. (1994). The airplane cabinenvironment: Issues pertaining to flight attendantcomfort. Retrieved July 29, 2009, rom www.boeing.com/commercial/cabinair/ventilation.pd

Nagda, N.L., & Koontz, M.D. (2003). Review o studieson light attendant health and comort in airlinercabins.Aviation, Space, and Environmental Medi-

cine, 74, 101-109.

Nesthus, T.E., Schroeder, D.J., Connors, M.M., Rent-meister-Bryant, H.K., & DeRoshia, C.W. (July,2007). Flight attendant fatigue. (Technical ReportNo. DOT/FAA/AAM-07/21). Washington, DC:Federal Aviation Administration, Oice o Aero-space Medicine.

Pratto, F., & John, O.P. (1991). Automatic vigilance: Theattention-grabbing power o negative social inor-mation.Journal of Personality and Social Psychology,61, 380-391. doi:10.1037/0022-3514.61.3.380

Rayman, R.B. (1997). Passenger saety, health, and com-ort: a review.Aviation, Space, and EnvironmentalMedicine, 68, 432-440.

Roma, P.G., Mallis, M.M., Hursh, S.R., Mead, A.M., &Nesthus, T.E. (2010). Flight attendant fatigue rec-ommendation II: Flight attendant work/rest patterns,alertness, and performance assessment. (TechnicalReport No. DOT/FAA/AM-10/22). Washington,DC: Federal Aviation Administration, Oice oAerospace Medicine.

Roma, P.G., Mallis, M.M., & Hursh, S.R. (July 2010).Flight attendant work/rest patterns, alertness, and performance assessment: Initial fatigue modelinganalysis. (Technical Memorandum No. AAM-500/07/2010/01). Oklahoma City, OK: FederalAviation Administration, Oice o Aerospace Medi-cine, Civil Aerospace Medical Institute.

Rosekind, M.R., Gander, P.H., Gregory, K.B., Smith,R.M., Miller, D.L., Oyung, R., Webbon, L.L.,& Johnson, J.M. (1996). Managing atigue inoperational setting 1: physiological considerationand countermeasures. Behavioral Medicine, 21,157-165.

Smolensky, M.H., Lee, E., Mott, D., & Colligan, M.(1982). A health proile o light attendants (FA).Journal of Human Ergology, 11, 103-119.

Tashkin, D.P., Coulson, A.H., Simmons, M.S., & Spivey,G.H. (1983). Respiratory symptoms o light atten-dants during high-altitude light: Possible relation tocabin ozone exposure. InternationalArchives of Oc-cupational and Environmental Health,52,117137.


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A1

APPENDIX A

Categories, Subcategories, and Issues

SCHEDULING

Duty Day

Satisfaction with schedule (not reserve)

Dissatisfaction with schedule (not reserve)Too many consecutive duty daysDuty day too longSatisfaction with high flight hoursDissatisfaction with high flight hoursToo many legs/Segments/SwapsImpact of delays not consideredAirports sits/Ground time too longTurn around/Ground time too shortInconsistent or early reports (mixed early/late)Late/No notification of schedule changesImpact of time zone not considered

Breaks

Adequate number of breaks/Amount of time for breaksInsufficient number of breaks/Amount of time for breaks

CDOs

Satisfaction with CDOs/Red-eyesDissatisfaction with CDOs/Red-eyesSatisfaction with consecutive CDOs/Red-eyesDissatisfaction with consecutive CDOs/Red-eyes

Reserves

Satisfaction with schedule (reserve)Dissatisfaction with schedule (reserve)Too many hours/Days on reserveReserve sits too long/Late trips assignedReserve notification time too short

Rest PeriodsRest period too shortTransportation to/from rest accommodations should not be included in rest period

HEALTH

Fatigued/ExhaustedAdequate amount of sleep/restInadequate amount of sleep/restAir quality unhealthy/Lack of oxygenPhysical health suffers due to jobStressed/Mental health suffers due to job

JOB PERFORMANCE and SATISFACTION

Compensation Satisfaction

Satisfaction with pay/Pay for time worked

Dissatisfaction with pay/Pay for time workedSatisfaction with benefitsDissatisfaction with benefits

Job Satisfaction

Satisfaction with job/Type of workDissatisfaction with job/Type of work


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A2

Safety/Job Performance

Fatigue impact on safety/Job performanceFatigue does not impact safety/Job performance

AIRLINE and AIRLINE POLICY

General

Satisfaction with airline/Airline concern for FA health and welfareDissatisfaction with airline/Airline concern for FA health and welfareDifficulty with commuteDissatisfaction with uniform and shoe requirementsNeed age/weight/height requirementsAble to call-in fatiguedUnable to call-in fatiguedHarassed/threatened when calling-in sickInequity of pilot and FA work/rest rulesAirline uses tricks, coercion, threats to exceed work/rest limits

Training

Training received/Good quality of trainingNo training received/Poor quality of training

Work Environment

Dissatisfaction with Quality/Cleanliness of Work Area/Equipment

SURVEY

Appreciation of fatigue research/surveyNo appreciation of fatigue research/surveySatisfaction with survey content/structure/online functionsDissatisfaction with survey content/structure/online functions

MEALS

No facilities in-flight to store/Prepare personal mealsLong periods without food/No time to eat/No food or water availableAirline provides meals/Bottled waterAirline does not provide meals/Bottled waterGood quality of food availablePoor quality of food available

WORKLOAD

Good staffing FA to passenger ratioPoor staffing FA to passenger ratioCarry-on baggage excessiveToo many added dutiesIncreased number of passengers/Full planesDeal with rude/disgruntled/unruly passengers

BREAK FACILITIES

In-Flight

Availability of in-flight break area/Adequate separation from passengersUnavailability of in-flight break area/Inadequate separation from passengersUncomfortable/insufficient in-flight rest/SeatsAvailability of horizontal rest facilities (bunks)Unavailability of horizontal rest facilities (bunks)

AirportUnavailability of airport break area/Insufficient separation from passengersUncomfortable/insufficient crew room/Seats

Rest Accommodations (hotel)

Good quality/location/comfort of rest accommodationsPoor quality/location/comfort of rest accommodations


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B1

APPENDIX B

Examples of Comments

Duty Days Example Comments

Duty day too long Nobody should be forced to work 14, 16, 18 hours of duty time in a 24

hour period.

We should not be working 16 hours in a duty day. That's crazy.

Too many

legs/segments/swaps

Flight attendants should not have to fly over 4 legs per day. Five legs in

one day is too much 'on duty' time

Six legs a day is too many, often I am the only FA on a 50 seat aircraft,

and it is difficult to not make mistakes by the time you get to the 5th

and 6th legs of the day.

Impact of delays not

considered

Short layovers and several legs in one day are the most common

culprits of increased fatigue. Add to these days, an emergency or delay

and the fatigue increases substantially.

The problem with all the weather delays makes a long duty time

become even longer and then shortens our rest period.

Inconsistent or early reports

(mixed early/late)

the schedule is really inconsistent. An effort should be made to

make an FA's schedule either mainly morning and evening.

Early reports (before 6:35 am) should have duty/block reduced to 10 hr

duty and 7 hr block. If I have to get up at 2:30 am to sign in and then

get a 12 hr duty day followed by 9:45 layover, I'm in trouble.

Breaks

Insufficient number of

breaks/amount of time for

breaks

long flights (over 2 hours) should have a 15 minute break scheduled

once we land. Even if we are late we should get this.

Why do other jobs get required breaks and lunch hours but we don't?

Rest Periods

Rest period too short Layover rest periods or scheduled rest periods should never be shorter

than the longest duty day.

Biggest problem in my opinion; duty time at layover point should start

when arriving at hotel not when plane blocks in!

Transportation to/from rest

accomodations should not be

included in rest period

Also the rest time should start when we get to the hotel and not when

we arrive at the gate on the plane. There are times that we are waiting

for almost an hour for transportation and its completely out of our

control as a crew.

This rest also excludes travel time from hotel, which is becoming

earlier and earlier due to increased traffic conditions everywhere. All of

this equates to about 6 hours of sleep on a 9:45 scheduled overnight IF

that person can fall asleep instantaneousl


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Example Comments

Fatigued/Exhausted Flight Attendant fatigue is a serious and constant problem within the

industry.

Many times I have come from a trip feeling like I should have had

paramedics waiting for me or at least a wheelchair, that's how

exhausted I get.

Inadequate amount of

sleep/rest

Many times, no matter what you do it is impossible to get more than 5

hrs of sleep, and that is just not enough.

when I am so fatigued, its harder for me to fall asleep, which

requires more time for rest.

Physical health suffers due to

job

I feel it is aging me and taking bigger toll on my health than any other

job I have worked. I would not recommend this job to anyone who has

their physical health as a priority.

Flight attendants get sick more than people who work in offices, due to

extremely bad hygiene with passengers. They fly with all sorts of

complaints, flu, bad colds, etc. Unfortunately we pick up these bugs.

Example health issues comments

Example Comments

Dissatisfaction with

airline/airline concern for FA

health and welfare

I believe that our company has no regard for their flight attendants and

their well being, especially in the scheduling department.

I do wish they cared more about us as a flight attendant group and

showed concern over our health and well being. There are individuals

who are the exception and take an interest, but not enough to change

the whole airline's way of thinking.

Example Airline & Airline Policy Issue Comments

Example Comments

Appreciation of fatigue

research/survey

Thank you for conducting this survey as Flight Attendant health is a

growing concern.

I am so grateful that finally someone is doing this study.

Example Survey Issue Comments

Example Comments

Long periods without food/No

time to eat/No food or water

available

We frequently have 4 legs with no time for eating or drinking which

causes fatigue.

No time between flights to eat, not enough water provided in flight to

stay hydrated, and short layovers resulting in lost sleep.

Example Meals Issue Comments

Documents

FAA Flight Attendant Fatigue Oct 11