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Of particular interest in the Rosekind study

was the report that shift workers report a significant decrement in their productivity as compared to their “9-to-5” counterparts. This is cause for particular concern for air medical flight crews, who routinely operate in the nocturnal environment. One of the significant factors affecting alertness in any person is sleep debt, defined as the difference between how much sleep you personally require to be alert and attentive and how much sleep you actually obtain. For example, if you normally require eight hours of sleep and received only seven last night, you are running a sleep debt of one hour. Unfortunately, sleep debt will continue to build (over a week that one hour/night builds into a 7 hr sleep debt) until you compensate with a longer, deeper sleep period. This cumulative sleep debt phenomenon can wreak havoc with EMS flight crews. A recent National EMS Pilots Association (NEMSPA)

survey con-

ducted among nearly 700 EMS pilots revealed that many would have a significant cumulative sleep debt by the end of a seven night series of shifts, which could easily exceed five to ten hours. The resulting degradation in performance, in some cases, can be equivalent to being legally drunk.

PRICE OF FATIGUE Industry as a whole pays a high price for

fatigued workers. As reported in a recent study conducted by Dr. Mark Rosekind and colleagues, productivity losses due to fatigue costs U.S. busi- nesses anywhere

employee annually . Depending upon how well those employees actually do sleep, nearly one in six fall into the higher loss/cost category. While the financial consequence of lower productivity

from $1,293 to $3,156 per

than 8 in 10 of those surveyed revealed that fatigue had affected their flight performance.

due to a reduced attention span, poor decision making, loss of memory and overall loss of moti- vation is certainly cause for alarm and would make any fiscally responsible manager take note, the direct impact to safety is even more frighten- ing. While poor decision-making in an office environment may result in the careless purchase of a sub-standard photocopier, poor decision- making in a helicopter cockpit can many times be lethal.


It should be no surprise that combining shift

work with a high stress aviation environment could increase operational risk during night operations to an unacceptable level.

So what do we do?




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