31 Fatigue - FAA.doc
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1、3.1Fatigue:Definition of sleepPhysiology of sleepSleep disordersCircadian rhythm and circadian desynchronosis (including jet lag)Definition of fatigueCauses of fatiguePredisposing and contributing factors (individual, environmental, operational)Symptoms, signs, and performance effects of fatiguePrev
2、ention and countermeasuresINSTRUCTION“I departed from a parallel taxiway instead of the runway. I never thought I could ever do such a stupid, unsafe maneuver. Leading factor: fatigue; Second: “That will never happen to me” attitude; Third: complacency; Fourth: weather; Fifth: I was in a hurry to ge
3、t home. We had already been up more than 24 hours even though, technically, we were legal This event has cautioned me about two things: 1) fatigue is insidious, and 2) Im not as good as I thought I was, but Ill get better-for sure.”-Anonymous corporate pilot, quotation in Callback, NASAs Aviation Sa
4、fety Reporting System bulletin, Number 277, October 2002.INTRODUCTION Since World War II, flight operations have been increasingly performed over longer distances, longer intervals, and across multiple time zones. The biology governing the performance of men and women has not changed, however. The t
5、iming, quality and quantity of sleep needed may vary among individuals, but among all people, unalterable physiological needs and constraints exist. Efforts are being made within aerospace to design and employ behavioral and pharmacological interventions to overcome the effects of fatigue and sleepi
6、ness in personnel required to operate in a sleep deprived condition and at times when they would normally be sleeping. Complicating matters, however, is that ultra long haul aircraft that can fly 20 hours non-stop are in development, necessitating the need for more augmented or dual crews with appro
7、priate sleeping compartments. The development and implementation of automated flight systems may result in new opportunities for crew resource management (CRM), allowing for fewer pilots to be in the cockpit and more time for alternate pilots to get adequate sleep. Unfortunately, the more automated
8、systems may also promote complacency and inattention because there is not enough to keep the operators engaged with the aircraft.Aviation accidents are caused by human error 80% of the time. The role of fatigue and circadian rhythm disorders (desynchronoses) in these mishaps is probably underestimat
9、ed. The accident rate for long haul commercial flights is higher than for short and medium haul flights, leading to speculation that fatigue and sleepiness plays a more significant role with the larger transmeridian changes. It has been estimated that 15-20% of all transportation accidents are relat
10、ed to fatigue, which surpasses that of alcohol and drugs1. Recognition of the causes and signs of fatigue is central to safe and effective air operations. Every flight operation has its own tempo, time required to perform the major tasks, personnel structure, and number of personnel. There are a num
11、ber of different aerospace scenarios, ranging from ferrying operations to air rescue, combat and space flight. Prevailing cultural attitudes may pose a hindrance to adequate resting and napping. Our society now sleeps about an hour or two less on average than our ancestors a century ago. Sleep and t
12、he demand for productivity are at odds, and adult napping is virtually frowned upon. The sleep culture of modern society has fundamentally changed and as a result, fatigue-related problems have reached significant proportions in the population. Technological changes have led to sleep requirements be
13、ing pushed down on the needs scale. One-third of adults in a recent survey reported significant daytime sleepiness on the Epworth Sleepiness Scale, and 6% indicated they were severely sleepy2. Forty percent of adults indicated they were so sleepy during the day that it interfered with their daily ac
14、tivities, and 18% said they suffered from this type of problem several days a week. More than half the people surveyed also reported that chronic sleepiness adversely affected their mood, energy levels, concentration ability, and overall health, as well as their ability to pursue personal interests
15、and maintain quality relationships with their family and friends. Obviously, daytime sleepiness exerts a negative impact on mental and physical well-being and general productivity. A National Sleep Foundation (www.sleepfoundation.org) sponsored survey found that the U.S. workforce complains that on-
16、the-job concentration, problem-solving, interpersonal relationships, and performance suffer because of fatigue. Both personal and on-the-job safety is adversely affected by sleepiness. Improperly managed pilot and air traffic controller fatigue can become a significant problem in flight environments
17、 that require alertness, complex judgment, and quick reactions. Fatigue touches every aspect of life in modern society, including aviation sectors in which requirements for unpredictable and extended work episodes often occur at times when alertness tends to be most compromised.CAUSES AND EFFECTS OF
18、 SLEEP DEPRIVATION AND DESYNCHRONOSESThe Role of the Body Clock: The internal circadian clock, located in the suprachiasmatic nucleus of the hypothalamus, is one of two principal physiological determinants of waking alertness and performance4. The circadian clock controls the 24-hour rhythm for a wi
19、de range of functions, including performance, alertness, behavior, and mood. One prominent circadian pattern is exhibited by the sleep/wake cycle, with biological programming for a consolidated period of daytime wakefulness and nighttime sleep, recurring in a regular 24-hour pattern. Alertness and t
20、he ability to perform are related to two basic neurophysiological forces: the bodys circadian pacemaker (or biologic clock) and the drive or need for sleep (based on the length of previous wakefulness). Sleepiness cycles over a 24-hour period, and during this period, humans are programmed for two se
21、parate time frames of physiological sleepiness and two windows of alertness. For most, maximal sleepiness occurs at the lowest point of the circadian cycle, typically from about 3 to 5 AM, when the lowest levels in many functions are observed, such as temperature, mood, and performance. A second int
22、erval of sleepiness occurs at about 3 to 5 PM. The two windows of intrinsic alertness occur at approximately 9 to 11 AM and 9 to 11 PM. Several factors affect the specific timing of these episodes of alertness and sleepiness and the degree of change observed during these times. The ability to adapt
23、to a new time zone or shiftwork pattern takes up to 3 weeks, depending on individual differences, the frequency and magnitude of the time shifts. Environmental (light, activity) and social factors (sleep habits, social interactions, work schedule) may either assist or prevent the accommodation to a
24、new schedule. Constantly changing shifts are more disruptive because people rarely remain on the schedule long enough to adjust.Abruptly changing to a new schedule or time zone can result in both internal and external desynchronization. External desynchronization involves the internal clock being ou
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