BACKGROUND: Airline crew are being exposed to extended workdays and compressed work periods, with quick returns between duties, implying a heightened physiological and psychological strain that may lead to sleep deprivation and fatigue. The aim of the study was assessment of the effect of an extended day of flight duty and a compressed work week with regard to recovery, cumulative fatigue, and neurobehavioral performance.METHODS: We followed 18 pilots and 41 cabin crewmembers during four consecutive days of flight duty, comprising a total of ≥ 39 h, where the first day was ≥ 10 h. Information on demographics, work characteristics, health status, and physical activity was collected at baseline. Subjects completed logs for the first and fourth workday, including the Samn-Perelli Fatigue Checklist at three time points during these workdays. Two computer-based neurobehavioral tests were completed the evening prior to the first shift, and after the first and the fourth day of the work period.RESULTS: Number of flight sectors during the work period was 10-20. Self-reported fatigue levels increased during the workdays. Neurobehavioral test-scores did not deteriorate. The effects of each additional flight sector during the work period was elevated reaction times (RT) both among cabin crewmembers (B = 5.05 ms, 95% CI 0.6, 9.5) and pilots (B = 4.95 ms, 95% CI 0.4, 9.5). Precision was unaffected.DISCUSSION: Airline pilots and cabin crewmembers seem to obtain satisfactory sleep before and during the period of 4 consecutive days. The association between multiple flight sectors and increased fatigue supports previous findings.Goffeng EM, Wagstaff A, Nordby K-C, Meland A, Goffeng LO, Skare Ø, Lilja D, Lie J-AS. Risk of fatigue among airline crew during 4 consecutive days of flight duty. Aerosp Med Hum Perform. 2019; 90(5):466-474.

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