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Zhao S, Ait-Belaid K, Shen Y, Zhou K. The neurological effects of acute physical exhaustion on inhibitory function. Physiol Behav 2024; 284:114641. [PMID: 39019134 DOI: 10.1016/j.physbeh.2024.114641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 07/11/2024] [Accepted: 07/13/2024] [Indexed: 07/19/2024]
Abstract
OBJECTIVE We aimed to investigate the neural mechanisms underlying the inhibitory function performance of maritime Search and Rescue (SAR) personnel in states of physical exhaustion. BACKGROUND SAR missions pose serious challenges to the cognitive function of SAR personnel, especially in extreme environments and physical exhaustion. It is important to understand SAR personnel's cognitive performance and neural activity under exhaustion to improve the efficiency of task execution and ensure work safety. METHOD Twenty-six maritime SAR personnel were recruited to simulate boat operations until they reached a self-imposed state of exhaustion. The exhaustion state was monitored by maximum heart rate and subjective fatigue scale. Two event-related potentials, N200 and P300, were measured during a Go-Nogo task before and after a session of acute exhaustive tasks. RESULTS After exhaustion, a marked reduction in accuracy, a notable increase in N200 amplitude, and a substantial decline in P300 amplitude under the Nogo condition were observed compared to the baseline phase. Pre- and post-exhaustion comparisons using standardized low-resolution brain electromagnetic tomography revealed reduced activations in the right middle temporal gyrus's N200 component after exhaustion in SAR personnel during the Nogo condition. CONCLUSION The results suggest that acute physical exhaustion significantly impacts the inhibition ability of SAR personnel, prolonging the conflict monitoring phase and weakening the response inhibition phase. These findings provide valuable insights into how physical exhaustion affects cognitive functions critical to the safety and effectiveness of SAR operations, and can inform strategies to improve training and equipment to enhance performance under extreme conditions.
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Affiliation(s)
- Shanguang Zhao
- Department of Physical Education, Shanghai Maritime University, Shanghai, China
| | - Khaoula Ait-Belaid
- Wolfson School of Mechanical, Electrical and Manufacturing Engineering, Loughborough University, UK
| | - Yanqing Shen
- School of Physical Education and Sport, Henan University, Kaifeng, China.
| | - Ke Zhou
- School of Physical Education and Sport, Henan University, Kaifeng, China
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Dong W, Fang W, Qiu H, Bao H, Li Y. High-speed train drivers' human error under fatigue and stress: the role of situation awareness and individual differences. ERGONOMICS 2024:1-19. [PMID: 38950888 DOI: 10.1080/00140139.2024.2369207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 06/11/2024] [Indexed: 07/03/2024]
Abstract
Fatigue and stress are critical variables that impair railway train drivers' safety performance, and individual differences may influence these effects. This study investigates how fatigue and stress affect high-speed train drivers' human error and the role of individual differences. We hypothesised that situation awareness (SA) mediates the effects of fatigue and stress on human error, and individual differences (age and work experience) moderate these effects. We surveyed 1,391 male drivers from eight Chinese railway bureaus and used PROCESS Macro for data analysis. The results revealed that fatigue and stress increased human error, directly and indirectly through SA. Age and work experience moderated the effect of fatigue and stress on SA, respectively. Older drivers had better SA under high fatigue, while more experienced drivers had better SA under high stress. These findings can inform more tailored safety management strategies to lower human error and enhance the safety of high-speed train operations.
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Affiliation(s)
- Wenli Dong
- School of Automation and Intelligence, Beijing Jiaotong University, Beijing, China
| | - Weining Fang
- School of Mechanical, Electronic and Control Engineering, Beijing Jiaotong University, Beijing, China
| | - HanZhao Qiu
- School of Mechanical, Electronic and Control Engineering, Beijing Jiaotong University, Beijing, China
| | - Haifeng Bao
- School of Mechanical, Electronic and Control Engineering, Beijing Jiaotong University, Beijing, China
| | - Yanjie Li
- School of Mechanical, Electronic and Control Engineering, Beijing Jiaotong University, Beijing, China
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3
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Sun HL, Chen P, Zhang Q, Si TL, Li YZ, Zhu HY, Zhang E, Chen M, Zhang J, Su Z, Cheung T, Ungvari GS, Jackson T, Xiang YT, Xiang M. Prevalence and network analysis of internet addiction, depression and their associations with sleep quality among commercial airline pilots: A national survey in China. J Affect Disord 2024; 356:597-603. [PMID: 38484881 DOI: 10.1016/j.jad.2024.03.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/28/2024] [Accepted: 03/09/2024] [Indexed: 05/08/2024]
Abstract
OBJECTIVE Airline pilots are members of a unique occupational group that is often confronted with sleep routine disruptions, yet relatively few studies have examined their mental health status. This study assessed the prevalence and network structure of internet addiction, depression and sleep quality problems in commercial airline pilots. METHOD A total of 7055 airline pilots were included in analyses. Internet addiction and depression were measured with the Internet Addiction Test (IAT) and 9-item Patient Health Questionnaire (PHQ-9), respectively. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). The network model was constructed based on an Ising model and its association with sleep quality was evaluated using a flow procedure. RESULTS Internet addiction, depression and sleep quality were common among airline pilots. The prevalence of internet addiction was 8.0 % (95 % CI: 7.3-8.6 %), while the rates of depression and poor sleep quality were 23.3 % (95 % CI: 22.3-24.2 %) and 33.0 % (95 % CI: 31.9-34.1 %), respectively. In the depression and internet addiction network model, "Fatigue" (PHQ4; Expected Influence (EI): 2.04) and "Depressed/moody/nervous only while being offline" (IAT20; EI: 1.76) were most central symptoms while "Fatigue" (PHQ4; Bridge EI: 1.30) was also the most important bridge symptom. The flow network model of sleep quality with internet addiction and depression showed that "Appetite" (PHQ5) had the strongest positive association with poor sleep quality. CONCLUSION Internet addiction, depression and sleep quality were common among airline pilots and warrant regular screening and timely treatment. Strategies to improve sleep hygiene may be useful in preventing onsets or exacerbations in depression and internet addiction among airline pilots.
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Affiliation(s)
- He-Li Sun
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, SAR; Centre for Cognitive and Brain Sciences, University of Macau, Macao, SAR.
| | - Pan Chen
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, SAR; Centre for Cognitive and Brain Sciences, University of Macau, Macao, SAR.
| | - Qinge Zhang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Tong Leong Si
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, SAR.
| | - Yan-Zhang Li
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, SAR.
| | - Han-Yu Zhu
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, SAR.
| | - Erliang Zhang
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China.
| | - Minzhi Chen
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China.
| | - Jie Zhang
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China.
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China.
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, SAR.
| | - Gabor S Ungvari
- Section of Psychiatry, University of Notre Dame Australia, Fremantle, Australia; Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia
| | - Todd Jackson
- Department of Psychology, University of Macau, Macao, SAR.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, SAR; Centre for Cognitive and Brain Sciences, University of Macau, Macao, SAR.
| | - Mi Xiang
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China; Hainan Branch, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya & School of Public Health, Shanghai, China.
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Sauvet F, Beauchamps V, Cabon P. Sleep Inertia in Aviation. Aerosp Med Hum Perform 2024; 95:206-213. [PMID: 38486319 DOI: 10.3357/amhp.6343.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Abstract
INTRODUCTION: Sleep inertia is the transition state during which alertness and cognitive performance are temporarily impaired after awakening. Magnitude and time course of sleep inertia are characterized by high individual variability with large differences between the cognitive functions affected. This period of impairment is of concern to pilots, who take sleep or nap periods during on-call work hours or in-flight rest, then need to perform safety-critical tasks soon after waking. This review analyzes literature related to sleep inertia and countermeasures applicable for aviation.METHODS: The large part of scientific literature that focuses on sleep inertia is based on studies in patients with chronic sleep inertia. We analyzed 8 narrative reviews and 64 papers related to acute sleep inertia in healthy subjects.DISCUSSION: Sleep inertia is a multifactorial, complex process, and many different protocols have been conducted, with a low number of subjects, in noncontrolled laboratory designs, with questionnaires or cognitive tests that have not been replicated. Evidence suggests that waking after sleep loss, or from deeper stages of sleep, can exacerbate sleep inertia through complex interactions between awakening and sleep-promoting brain structures. Nevertheless, no meta-analyses are possible and extrapolation to pilots' performances is hypothetical. Studies in real life or simulated operational situations must be conducted to improve the description of the impact of sleep inertia and kinetics on pilots' performances. Taking rest or sleep time remains the main method for pilots to fight against fatigue and related decreases in performance. We propose proactive strategies to mitigate sleep inertia and improve alertness.Sauvet F, Beauchamps V, Cabon P. Sleep inertia in aviation. Aerosp Med Hum Perform. 2024; 95(4):206-213.
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An X, Lian J, Xu L, Peng Z, Chen S, Cheng MY, Shao Y. Changes in electroencephalography microstates are associated with reduced levels of vigilance after sleep deprivation. Brain Res 2024; 1825:148729. [PMID: 38128810 DOI: 10.1016/j.brainres.2023.148729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 11/30/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023]
Abstract
Total sleep deprivation (TSD) negatively affects cognitive functions, especially vigilance attention, but studies on vigilance changes in terms of electroencephalography (EEG) microstates after TSD are limited. This study investigates the impact of TSD on vigilance attention, EEG microstates and its relationship. Thirty healthy adult males completed a psychomotor vigilance task (PVT) before, 24 h after, and 36 h after TSD while their EEG was recorded during rest. Microstate analysis revealed significant changes in the occurrence and contribution of microstate class B after TSD. Moreover, changes in the probability of transitioning between microstate classes A and D were observed, correlating with decreased vigilance. Specifically, a positive correlation was found between transitioning from class B to class C and vigilance, while a trend of negative correlation was observed between transitioning between classes A and D and vigilance. These findings indicate abnormal activity in the salience network and dorsal attention network following sleep deprivation. TSD impairs vigilance attention, as demonstrated by the effects on EEG microstate class B and the transitions between classes A and D. The study suggests its potential as an early warning indicator for predicting vigilance attention after sleep deprivation.
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Affiliation(s)
- Xin An
- School of Psychology, Beijing Sport University, Beijing 100084, China
| | - Jie Lian
- School of Psychology, Beijing Sport University, Beijing 100084, China
| | - Lin Xu
- School of Psychology, Beijing Sport University, Beijing 100084, China
| | - Ziyi Peng
- School of Psychology, Beijing Sport University, Beijing 100084, China
| | - Shufang Chen
- School of Psychology, Beijing Sport University, Beijing 100084, China
| | - Ming-Yang Cheng
- School of Psychology, Beijing Sport University, Beijing 100084, China.
| | - Yongcong Shao
- School of Psychology, Beijing Sport University, Beijing 100084, China.
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Wingelaar-Jagt YQ, Wingelaar TT, Riedel WJ, Ramaekers JG. Comparison of effects of modafinil and caffeine on fatigue-vulnerable and fatigue-resistant aircrew after a limited period of sleep deprivation. Front Physiol 2024; 14:1303758. [PMID: 38260091 PMCID: PMC10800817 DOI: 10.3389/fphys.2023.1303758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/19/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction: Literature suggests pilots experience fatigue differently. So-called fatigue-resistant or -vulnerable individuals might also respond differently to countermeasures or stimulants. This study, which is part of a larger randomized controlled clinical trial, aims to investigate the effect of caffeine and modafinil on fatigue-resistant and -vulnerable pilots. Methods: This study included 32 healthy employees of the Royal Netherlands Air Force, who completed three test days, separated by at least 7 days. After a regular work day, the subjects were randomly administered either 300 mg caffeine, 200 mg modafinil or placebo at midnight. Hereafter the subjects performed the psychomotor vigilance test (PVT), vigilance and tracking test (VigTrack) and Stanford sleepiness scale (SSS) six times until 8 a.m. the next day. Subjects were ranked on the average number of lapses on the PVT during the placebo night and divided into three groups: fatigue-vulnerable (FVUL), -intermediate (FINT) and -resistant (FRES), with 11, 10 and 11 subjects in each group, respectively. Area under the curve (AUC) of the PVT, VigTrack and SSS during the test nights were calculated, which were used in univariate factorial analysis of variance (ANOVA). Tukey's HSD post hoc tests were used to differentiate between the groups. Results: A significant effect of treatment was found in the ANOVA of both PVT parameters, VigTrack mean reaction time and SSS. There was a statistically significant effect of fatigue group on all PVT parameters and VigTrack mean percentage omissions, where FINT and FRES scored better than FVUL. There was a significant interaction effect between treatment and fatigue group for PVT number of lapses. This is congruent for the AUC analyses in which for all parameters (except for the SSS) the performance of the FVUL group was consistently worse than that of the FINT and FRES groups. Discussion: This study demonstrates that the performance of individuals with different fatigue tolerances are differently affected by simulants after a limited period of sleep deprivation. The classification of fatigue tolerance through PVT lapses when sleep deprived seems to be able to predict this.
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Affiliation(s)
- Yara Q. Wingelaar-Jagt
- Center for Man in Aviation, Royal Netherlands Air Force, Soesterberg, Netherlands
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | | | - Wim J. Riedel
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Johannes G. Ramaekers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
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Reijmerink IM, van der Laan MJ, Wietasch JKG, Hooft L, Cnossen F. Impact of fatigue in surgeons on performance and patient outcome: systematic review. Br J Surg 2024; 111:znad397. [PMID: 38097353 PMCID: PMC10771255 DOI: 10.1093/bjs/znad397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/29/2023] [Accepted: 11/05/2023] [Indexed: 01/07/2024]
Abstract
BACKGROUND While fatigue is an inevitable aspect of performing surgical procedures, lack of consensus remains on its effect on surgical performance. The aim of this systematic review was to assess the effect of non-muscular fatigue on surgical outcome. METHODS MEDLINE and Embase were searched up to 17 January 2023. Studies on students, learning, duty-hour restrictions, muscle fatigue, non-surgical or subjective outcome, the weekend effect, or time of admission were excluded. Studies were categorized based on real-life or simulated surgery. The Cochrane risk-of-bias tool was used to assess RCTs and the Newcastle-Ottawa scale was used to assess cohort studies. Due to heterogeneity among studies, data pooling was not feasible and study findings were synthesized narratively. RESULTS From the 7251 studies identified, 134 studies (including 1 684 073 cases) were selected for analysis (110 real-life studies and 24 simulator studies). Of the simulator studies, 46% (11 studies) reported a deterioration in surgical outcome when fatigue was present, using direct measures of fatigue. In contrast, only 35.5% (39 studies) of real-life studies showed a deterioration, observed in only 12.5% of all outcome measures, specifically involving aggregated surgical outcomes. CONCLUSION Almost half of simulator studies, along with one-third of real-life studies, consistently report negative effects of fatigue, highlighting a significant concern. The discrepancy between simulator/real-life studies may be explained by heightened motivation and effort investment in real-life studies. Currently, published fatigue and outcome measures, especially in real-life studies, are insufficient to fully define the impact of fatigue on surgical outcomes due to the absence of direct fatigue measures and crude, post-hoc outcome measures.
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Affiliation(s)
- Iris M Reijmerink
- Department of Surgery, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Maarten J van der Laan
- Department of Surgery, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - J K Götz Wietasch
- Department of Anaesthesiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Lotty Hooft
- Cochrane Netherlands, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Fokie Cnossen
- Department of Artificial Intelligence, Bernoulli Institute of Mathematics, Computer Science and Artificial Intelligence, University of Groningen, Groningen, The Netherlands
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Wirdnam M, Ferrar K, Mayes S, MacMahon C, Cook J, Rio E. "A sprained ankle is the biggest sign of mental fatigue": A qualitative study of the perceptions and experiences of mental fatigue in professional ballet. Phys Ther Sport 2024; 65:154-161. [PMID: 38218024 DOI: 10.1016/j.ptsp.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 12/05/2023] [Accepted: 12/18/2023] [Indexed: 01/15/2024]
Abstract
Mental fatigue is known to influence endurance, skill, and tactical performance in sport. Research investigating the impact of mental fatigue on tasks that combine physical, cognitive, and aesthetic performance such as professional ballet does not exist. OBJECTIVE To understand the perceptions and experiences of mental fatigue in professional ballet. DESIGN Qualitative, focus groups and semi-structured interviews. SETTING The Australian Ballet. PARTICIPANTS Thirty-nine professional ballet dancers (53% of the company) and six dance staff members aged 18 years or above (53% female). MAIN OUTCOME MEASURES N/a. RESULTS The average focus group and interview length was 48 ± 7 min and 41 ± 8 min. Key categories were; (1) Dancers and dance staff perceive that new learning contributes to mental fatigue, (2) Dancers perceive changes to their mood and perception of effort when they are mentally fatigued, and (3) Dancers and dance staff perceive that mental fatigue negatively affects their physical and cognitive performance and, increases their risk of injury. CONCLUSION This is the first study where participants associated mental fatigue with injury risk and provides a springboard to measure the impact of mental fatigue on learning, injury, and performance in professional ballet.
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Affiliation(s)
- Matthew Wirdnam
- School of Allied Health, Physiotherapy, La Trobe University, Plenty Road & Kingsbury Dr, Bundoora, VIC, 3086, Australia; The Australian Ballet, Kavanagh Street, Southbank, VIC, 3006, Australia.
| | - Katia Ferrar
- Sports & Exercise Medicine Research Centre, La Trobe University, Plenty Road & Kingsbury Dr, Bundoora, VIC, 3086, Australia; The Australian Ballet, Kavanagh Street, Southbank, VIC, 3006, Australia; South Australian Health & Medical Research Institute, North Terrace, SA, 5000, Australia
| | - Susan Mayes
- School of Allied Health, Human Services and Sport, La Trobe University, Plenty Road & Kingsbury Dr, Bundoora, VIC, 3086, Australia; The Australian Ballet, Kavanagh Street, Southbank, VIC, 3006, Australia. https://twitter.com/S_Maysey
| | - Clare MacMahon
- School of Sports & Exercise Science, La Trobe University, Plenty Road & Kingsbury Dr, Bundoora, VIC, 3086, Australia. https://twitter.com/ProfJillCook
| | - Jill Cook
- Sports & Exercise Medicine Research Centre, La Trobe University, Plenty Road & Kingsbury Dr, Bundoora, VIC, 3086, Australia
| | - Ebonie Rio
- Sports & Exercise Medicine Research Centre, La Trobe University, Plenty Road & Kingsbury Dr, Bundoora, VIC, 3086, Australia; The Australian Ballet, Kavanagh Street, Southbank, VIC, 3006, Australia. https://twitter.com/tendonpain
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Morais GCDF, Dantas da Silva Junior E, Bruno Silva de Oliveira C, Rodrigues-Neto JF, Laino Fulco U, Ivan Nobre Oliveira J. Modafinil: A closer look at its theoretical toxicological potential. J Psychopharmacol 2023; 37:945-947. [PMID: 37435726 DOI: 10.1177/02698811231187127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/13/2023]
Affiliation(s)
| | | | | | | | - Umberto Laino Fulco
- Department of Biophysics and Pharmacology, Federal University of Rio Grande do Norte, Natal, Brazil
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10
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Chu V, Newman DG. Exercise Effect on Mental Health in Isolating or Quarantining Adults. Aerosp Med Hum Perform 2023; 94:686-695. [PMID: 37587629 DOI: 10.3357/amhp.6073.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
INTRODUCTION: In response to coronavirus disease 2019 (COVID-19), travelers are typically subject to quarantine, which is often associated with poorer mental health (MH). While the protective benefits of community-based exercise are widely recognized, the degree to which this extends to the confined setting is unknown. This systematic review aims to evaluate the effect of exercise on MH in isolating or quarantining adults.METHODS: A literature search of Ovid MEDLINE, APA PsycInfo, and the Cochrane Database of Systematic Reviews limited to January 2019-September 2021 inclusive yielded five eligible studies.RESULTS: Data comprised a total of 2755 college and university students, most of whom were confined. Depending on the scale used, 24.9-76.7% of respondents demonstrated impaired MH, which improved with physical activity (PA), especially when regular and moderate or vigorous. The frequency, duration, and participants of exercise increased as lockdown progressed. One study showed that while sleep, diet, and PA all have an impact on MH, PA was the factor most strongly correlated with MH.DISCUSSION: Physical fitness should be optimized before and maintained during quarantine while exercise space and equipment should be accessible. Importantly, the sustainability of persistent quarantine must be considered given the pervasiveness of COVID-19.Chu V, Newman DG. Exercise effect on mental health in isolating or quarantining adults. Aerosp Med Hum Perform. 2023; 94(9):686-695.
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11
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Ouyang Y, Liu M, Cheng C, Yang Y, He S, Zheng L. Monitoring Inattention in Construction Workers Caused by Physical Fatigue Using Electrocardiograph (ECG) and Galvanic Skin Response (GSR) Sensors. SENSORS (BASEL, SWITZERLAND) 2023; 23:7405. [PMID: 37687860 PMCID: PMC10490619 DOI: 10.3390/s23177405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/17/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023]
Abstract
Physical fatigue is frequent for heavy manual laborers like construction workers, but it causes distraction and may lead to safety incidents. The purpose of this study is to develop predictive models for monitoring construction workers' inattention caused by physical fatigue utilizing electrocardiograph (ECG) and galvanic skin response (GSR) sensors. Thirty participants were invited to complete an attention-demanding task under non-fatigued and physically fatigued conditions. Supervised learning algorithms were utilized to develop models predicting their attentional states, with heart rate variability (HRV) features derived from ECG signals and skin electric activity features derived from GSR signals as data inputs. The results demonstrate that using HRV features alone could obtain a prediction accuracy of 88.33%, and using GSR features alone could achieve an accuracy of 76.67%, both through the KNN algorithm. The accuracy increased to 96.67% through the SVM algorithm when combining HRV and GSR features. The findings indicate that ECG sensors used alone or in combination with GSR sensors can be applied to monitor construction workers' inattention on job sites. The findings would provide an approach for detecting distracted workers at job sites. Additionally, it might reveal the relationships between workers' physiological features and attention.
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Affiliation(s)
- Yewei Ouyang
- Department of Architecture and Civil Engineering, City University of Hong Kong, Kowloon, Hong Kong, China
| | - Ming Liu
- Key Laboratory of Physical Fitness and Exercise Rehabilitation of Hunan Province, College of Physical Education, Hunan Normal University, Changsha 410012, China
| | - Cheng Cheng
- Key Laboratory of Physical Fitness and Exercise Rehabilitation of Hunan Province, College of Physical Education, Hunan Normal University, Changsha 410012, China
| | - Yuchen Yang
- Key Laboratory of Physical Fitness and Exercise Rehabilitation of Hunan Province, College of Physical Education, Hunan Normal University, Changsha 410012, China
| | - Shiyi He
- Key Laboratory of Physical Fitness and Exercise Rehabilitation of Hunan Province, College of Physical Education, Hunan Normal University, Changsha 410012, China
| | - Lan Zheng
- Key Laboratory of Physical Fitness and Exercise Rehabilitation of Hunan Province, College of Physical Education, Hunan Normal University, Changsha 410012, China
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12
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Zhang C, Wang X, Ding Z, Zhou H, Liu P, Xue X, Wang L, Jiang Y, Chen J, Shen W, Yang S, Wang F. Study on tinnitus-related electroencephalogram microstates in patients with vestibular schwannomas. Front Neurosci 2023; 17:1159019. [PMID: 37090804 PMCID: PMC10118047 DOI: 10.3389/fnins.2023.1159019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 03/16/2023] [Indexed: 04/08/2023] Open
Abstract
Tinnitus is closely associated with cognition functioning. In order to clarify the central reorganization of tinnitus in patients with vestibular schwannoma (VS), this study explored the aberrant dynamics of electroencephalogram (EEG) microstates and their correlations with tinnitus features in VS patients. Clinical and EEG data were collected from 98 VS patients, including 76 with tinnitus and 22 without tinnitus. Microstates were clustered into four categories. Our EEG microstate analysis revealed that VS patients with tinnitus exhibited an increased frequency of microstate C compared to those without tinnitus. Furthermore, correlation analysis demonstrated that the Tinnitus Handicap Inventory (THI) score was negatively associated with the duration of microstate A and positively associated with the frequency of microstate C. These findings suggest that the time series and syntax characteristics of EEG microstates differ significantly between VS patients with and without tinnitus, potentially reflecting abnormal allocation of neural resources and transition of functional brain activity. Our results provide a foundation for developing diverse treatments for tinnitus in VS patients.
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Affiliation(s)
- Chi Zhang
- The First Medical Center, Chinese PLA General Hospital, Beijing, China
- Zhan Tan Temple Outpatient Department, Central Medical Branch of PLA General Hospital, Beijing, China
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
| | - Xiaoguang Wang
- Zhan Tan Temple Outpatient Department, Central Medical Branch of PLA General Hospital, Beijing, China
| | - Zhiwei Ding
- The First Medical Center, Chinese PLA General Hospital, Beijing, China
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLA, Beijing, China
| | - Hanwen Zhou
- The First Medical Center, Chinese PLA General Hospital, Beijing, China
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLA, Beijing, China
| | - Peng Liu
- The First Medical Center, Chinese PLA General Hospital, Beijing, China
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLA, Beijing, China
| | - Xinmiao Xue
- The First Medical Center, Chinese PLA General Hospital, Beijing, China
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLA, Beijing, China
| | - Li Wang
- The First Medical Center, Chinese PLA General Hospital, Beijing, China
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLA, Beijing, China
| | - Yuke Jiang
- The First Medical Center, Chinese PLA General Hospital, Beijing, China
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLA, Beijing, China
| | - Jiyue Chen
- The First Medical Center, Chinese PLA General Hospital, Beijing, China
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLA, Beijing, China
| | - Weidong Shen
- The First Medical Center, Chinese PLA General Hospital, Beijing, China
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- The Sixth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Shiming Yang
- The First Medical Center, Chinese PLA General Hospital, Beijing, China
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- The Sixth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Fangyuan Wang
- The First Medical Center, Chinese PLA General Hospital, Beijing, China
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- The Sixth Medical Center, Chinese PLA General Hospital, Beijing, China
- *Correspondence: Fangyuan Wang,
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13
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Marqueze EC, de Sá e Benevides EA, Russo AC, Fürst MSG, Roscani RC, Guimarães PCV, Salim CA. Organizational Risk Factors for Aircrew Health: A Systematic Review of Observational Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3401. [PMID: 36834104 PMCID: PMC9960399 DOI: 10.3390/ijerph20043401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/12/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
Addressing the field of health and safety at work, the primary objective of the present systematic review was to analyze the organizational risk factors for aircrew health according to professional category (flight attendants and pilots/co-pilots) and their consequences. The secondary objective was to identify the countries in which studies were carried out, focusing on the quality of content of the publications. The Medline/Pubmed, Cochrane, Web of Science, and Scopus databases were searched for eligible studies according to PRISMA statements. The risk of bias and the methodological quality of the studies were assessed using the Newcastle-Ottawa scale and Loney tools. Of the 3230 abstracts of articles screened, 36 studies met the inclusion criteria. Most of the research conducted on risk factors for the work organization of aircrew was carried out in the United States and the European Union and had moderate or low-quality methodology and evidence. However, the findings are homogeneous and allow the most prevalent organizational risk factors for the health of aircrew to be determined, namely, high work demand, long hours, and night work. Consequently, the most pervasive health problems were sleep disturbances, mental health disorders, musculoskeletal disorders, and fatigue. Thus, the regulation of the aircrew profession must prioritize measures that minimize these risk factors to promote better health and sleep for these professionals and, consequently, to provide excellent safety for workers and passengers.
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Affiliation(s)
- Elaine Cristina Marqueze
- Fundação Jorge Duprat Figueiredo de Segurança e Medicina do Trabalho—Fundacentro, São Paulo 30180-100, Brazil
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Li W, Cheng S, Wang H, Chang Y. EEG microstate changes according to mental fatigue induced by aircraft piloting simulation: An exploratory study. Behav Brain Res 2023; 438:114203. [PMID: 36356722 DOI: 10.1016/j.bbr.2022.114203] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 11/04/2022] [Accepted: 11/04/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND A continuous flight task load can induce fatigue and lead to changes in electroencephalography (EEG). EEG microstates can reflect the activities of large-scale neural networks during mental fatigue. This exploratory experiment explored the effects of mental fatigue induced by continuous simulated flight multitasking on EEG microstate indices. METHODS Twenty-four participants performed continuous 2-hour aircraft piloting simulation while EEG were recorded. The Stanford sleepiness scale (SSS) and critical flicker fusion frequency (CFF) were measured before and after the task. Microstate analysis was applied to EEG. Four microstate classes (A-D) were identified during the pre-task, post-task, beginning, and end phases. The effects of mental fatigue were analyzed. RESULTS Compared with the pre-task, the post-task had a higher global explained variance (GEV) and time parameters of class C but lower occurrence and coverage of class D. The end had a higher GEV but lower duration and coverage of class D than at the beginning. After 2 h of multitasking, the transition probability between A and D, and between B and D decreased but between A and C increased. Subjective fatigue scores were negatively correlated with occurrence and coverage of class D. Task performance was negatively correlated with duration and coverage of class C but positively correlated with duration and occurrence of class B. CONCLUSION Time parameters and transition probability of EEG microstates can detect mental fatigue induced by continuous aircraft piloting simulation. The global brain network activation of mental fatigue can be detected by EEG microstates that can evaluate flight fatigue.
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Affiliation(s)
- Wenbin Li
- Department of Aerospace Hygiene, Faculty of Aerospace Medicine, Air Force Medical University, Xi'an, China
| | - Shan Cheng
- Department of Aerospace Medical Equipment, Faculty of Aerospace Medicine, Air Force Medical University, Xi'an, China
| | - Hang Wang
- Department of Aerospace Ergonomics, Faculty of Aerospace Medicine, Air Force Medical University, Xi'an, China.
| | - Yaoming Chang
- Department of Aerospace Hygiene, Faculty of Aerospace Medicine, Air Force Medical University, Xi'an, China.
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15
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Wingelaar-Jagt YQ, Bottenheft C, Riedel WJ, Ramaekers JG. Effects of modafinil and caffeine on night-time vigilance of air force crewmembers: A randomized controlled trial. J Psychopharmacol 2023; 37:172-180. [PMID: 36515156 PMCID: PMC9912306 DOI: 10.1177/02698811221142568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Fatigue remains an important factor in major aviation accidents. Stimulants may counteract fatigue's adverse effects, with modafinil as a promising alternative to caffeine. However, the effect of a single dose of modafinil after a limited period of sleep deprivation remains unknown. AIMS This study aims to determine the effect of 200 mg modafinil on vigilance during a limited period of sleep deprivation compared to 300 mg caffeine and placebo. METHODS Thirty-two volunteers of the Royal Netherlands Air Force (RNLAF) were double-blindly administered modafinil, caffeine, and placebo on three non-consecutive trial days after being awake for median 17 h. Afterwards, subjects completed six series of the Vigilance and Tracking test (VigTrack), psychomotor vigilance task (PVT), and Stanford Sleepiness Scale (SSS), yielding six primary endpoints. RESULTS This study revealed statistically significant effects of caffeine and modafinil compared with placebo on all endpoints, except for VigTrack mean tracking error. PVT results were less impaired 2 h after administration, followed by VigTrack parameters and SSS scores 2 h thereafter. Compared with caffeine, modafinil significantly improved PVT and SSS scores at 8 h after administration. CONCLUSIONS The present study demonstrates that 200 mg modafinil and 300 mg caffeine significantly decrease the effects of a limited period of sleep deprivation on vigilance compared with placebo. Although PVT parameters already improved 2 h after administration, the most notable effects occurred 2-4 h later. Modafinil seems to be effective longer than caffeine, which is consistent with its longer half-life.
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Affiliation(s)
- Yara Q. Wingelaar-Jagt
- Center for Man in Aviation, Royal
Netherlands Air Force, Utrecht, The Netherlands
- Department of Neuropsychology and
Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University,
Maastricht, The Netherlands
| | - Charelle Bottenheft
- TNO Netherlands Organization for
Applied Scientific Research, Utrecht, The Netherlands
| | - Wim J. Riedel
- Department of Neuropsychology and
Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University,
Maastricht, The Netherlands
| | - Johannes G. Ramaekers
- Department of Neuropsychology and
Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University,
Maastricht, The Netherlands
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16
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Wilson D, Driller MW, Johnston B, Gill ND. A Contactless App-Based Intervention to Improve Health Behaviors in Airline Pilots: A Randomized Trial. Am J Prev Med 2023; 64:666-676. [PMID: 36641335 DOI: 10.1016/j.amepre.2022.12.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 12/19/2022] [Accepted: 12/20/2022] [Indexed: 01/15/2023]
Abstract
INTRODUCTION There is a need for enhanced preventive health care among airline pilots to mitigate the prevalence of cardiometabolic health risk factors. DESIGN A randomized, waitlist-controlled trial was utilized to evaluate the effectiveness of a smartphone-based app intervention for improving health behaviors and cardiometabolic health parameters. SETTING/PARTICIPANTS A total of 186 airline pilots (aged 43.2±9.1 years; male, 64%) were recruited and participated in the trial during 2022. INTERVENTION This intervention was a personalized, 16-week smartphone-based app multicomponent physical activity, healthy eating, and sleep hygiene intervention. MAIN OUTCOME MEASURES Outcome measures of objective health (Cooper's 12-minute exercise test, resting heart rate, push ups, plank isometric hold, body mass), subjective health (self-rated health, perceived psychological stress and fatigue), and health behaviors (weekly physical activity, sleep quality and duration, fruit and vegetable intake) were collected at baseline and after intervention. The waitlist control completed the same measures. RESULTS Significant interactions for time Χ group from baseline to 16 weeks were found for all outcome measures (p<0.001). Significant between-group differences for positive health changes in favor of the intervention group were found after intervention for all outcome measures (p<0.05, d=0.4-1.0) except for self-rated health, body mass, and Pittsburgh Sleep Quality Index score. CONCLUSIONS Study findings show that an app-based health behavior intervention can elicit positive cardiometabolic health changes among airline pilots over 16 weeks, associated with trivial to large effect sizes. TRIAL REGISTRATION The trial protocol was prospectively registered at The Australian New Zealand Clinical Trials Registry (ACTRN12622000288729).
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Affiliation(s)
- Daniel Wilson
- Te Huataki Waiora School of Health, The University of Waikato, Hamilton, New Zealand; Faculty of Health, Education and Environment, Toi Ohomai Institute of Technology, Tauranga, New Zealand.
| | - Matthew W Driller
- Sport and Exercise Science, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Ben Johnston
- Aviation and Occupational Health Unit, Air New Zealand, Auckland, New Zealand
| | - Nicholas D Gill
- Te Huataki Waiora School of Health, The University of Waikato, Hamilton, New Zealand; New Zealand Rugby, Wellington, New Zealand
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Salihu AT, Hill KD, Jaberzadeh S. Neural mechanisms underlying state mental fatigue: a systematic review and activation likelihood estimation meta-analysis. Rev Neurosci 2022; 33:889-917. [PMID: 35700454 DOI: 10.1515/revneuro-2022-0023] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 04/26/2022] [Indexed: 12/14/2022]
Abstract
Sustained performance of cognitive tasks could lead to the development of state mental fatigue characterized by subjective sensation of mental weariness and decrease in cognitive performance. In addition to the occupational hazards associated with mental fatigue, it can also affect physical performance reducing endurance, balance, and sport-specific technical skills. Similarly, mental fatigue is a common symptom in certain chronic health conditions such as multiple sclerosis affecting quality of life of the patients. Despite its widely acknowledged negative impact, the neural mechanisms underlining this phenomenon are still not fully understood. We conducted a systematic review and activation likelihood estimation (ALE) meta-analysis of functional neuroimaging studies investigating the effect of mental fatigue due to time-on-task (TOT) on brain activity to elucidate the possible underlying mechanisms. Studies were included if they examined change in brain activity induced by experimental mental fatigue (TOT effect) or investigated the relationship between brain activity and subjective mental fatigue due to TOT. A total of 33 studies met the review's inclusion criteria, 13 of which were included in meta-analyses. Results of the meta-analyses revealed a decrease in activity with TOT in brain areas that constitute the cognitive control network. Additionally, an increased activity with TOT, as well as negative relationship with subjective mental fatigue was found in parts of the default mode network of the brain. The changes in cognitive control and the default mode networks of the brain due to state mental fatigue observed in this study were discussed in relation to the existing theories of mental fatigue.
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Affiliation(s)
- Abubakar Tijjani Salihu
- Monash Neuromodulation Research Unit, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Australia
| | - Keith D Hill
- Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, School of Primary and Allied Health Care, Monash University, Frankston, Australia
| | - Shapour Jaberzadeh
- Monash Neuromodulation Research Unit, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Australia
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18
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Damato EG, Fillioe SJ, Margevicius SP, Mayes RS, Somogyi JE, Vannix IS, Abdollahifar A, Turner AM, Ilcus LS, Decker MJ. Increased Serum Levels of Proinflammatory Cytokines Are Accompanied by Fatigue in Military T-6A Texan II Instructor Pilots. Front Physiol 2022; 13:876750. [PMID: 35574470 PMCID: PMC9097024 DOI: 10.3389/fphys.2022.876750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 03/24/2022] [Indexed: 12/01/2022] Open
Abstract
Tactical aviation imposes unprecedented physical challenges including repetitive exposure to hypergravity, hyperoxia, increased work of breathing, and profound cognitive workloads. Each stressor evokes outcomes ranging from musculoskeletal duress and atelectasis to physical and cognitive fatigue, the latter among the foremost threats to aviators. Whereas sleep loss is traditionally considered the primary cause of fatigue in aviators, converging experimental, observational, and medical studies have identified biochemical mechanisms promoting onset of fatigue. Those mechanisms, which fundamentally differ from sleep loss, revolve around increased proinflammatory cytokines, produced and released in response to tissue injury, chronic inflammatory disorders, allergens, or physical duress. This study’s objective was to inform our understanding of potential relationships between serum levels of proinflammatory cytokines and onset of fatigue within a cohort of aviators who experience multiple high-performance sorties on a daily basis. Methods: Active duty and reservist T-6A Texan II instructor pilots were studied on three separate days across their week-long flying schedule. Data collected included a physical assessment, subjective fatigue levels, venous blood samples for measures of chemistry and serum analytes, and urine samples for specific gravity. Results: Twenty-three persons were studied, of which 22 fulfilled minimum study requirements of completing two sorties. The study cohort was comprised of primarily males, age 37.95 ± 4.73 years with a BMI of 26.63 ± 3.15 kg/m2. Of 37 measurable serum analytes, 20 differed significantly (p < 0.05) between baseline values with those measured at the study endpoint. Thirteen of the aviators reported increased fatigue scores across their flying schedule whereas nine did not. Eleven blood serum analytes were associated with increasing levels of fatigue. Discussion: Fatigue in aviators has been attributed almost solely to sleep loss, nocturnal sorties, or disrupted circadian rhythmicity. In contrast, our study findings suggest an alternative mechanism that can promote onset of fatigue: increased blood levels of proinflammatory cytokines. Specific mechanisms triggering synthesis and release of those cytokines and other analytes are yet to be determined. However, their expression patterns suggest responses to both chronic and acute inflammation, hyperoxia, or bronchopulmonary responses to inspiration of dry gas, positive airway pressure, or perhaps atelectasis.
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Affiliation(s)
- Elizabeth G. Damato
- Department of Physiology and Biophysics, School of Medicine, Case Western Reserve University, Cleveland, OH, United States
- Naval Medical Research Unit Dayton, Dayton, OH, United States
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, United States
| | - Seth J. Fillioe
- Department of Physiology and Biophysics, School of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Seunghee P. Margevicius
- Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Ryan S. Mayes
- 711th Human Performance Wing, U. S. Air Force School of Aerospace Medicine, Dayton, OH, United States
| | | | - Ian S. Vannix
- Department of Physiology and Biophysics, School of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Alireza Abdollahifar
- Department of Physiology and Biophysics, School of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Anthony M. Turner
- 711th Human Performance Wing, U. S. Air Force School of Aerospace Medicine, Dayton, OH, United States
| | | | - Michael J. Decker
- Department of Physiology and Biophysics, School of Medicine, Case Western Reserve University, Cleveland, OH, United States
- Naval Medical Research Unit Dayton, Dayton, OH, United States
- *Correspondence: Michael J. Decker,
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The Prevalence of Cardiometabolic Health Risk Factors among Airline Pilots: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084848. [PMID: 35457715 PMCID: PMC9030706 DOI: 10.3390/ijerph19084848] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 04/10/2022] [Accepted: 04/12/2022] [Indexed: 02/08/2023]
Abstract
Background: The occupational demands of professional airline pilots such as shift work, work schedule irregularities, sleep disruption, fatigue, physical inactivity, and psychological stress may promote adverse outcomes to cardiometabolic health. This review investigates the prevalence of cardiometabolic health risk factors for airline pilots. Methods: An electronic search was conducted utilizing PubMed, MEDLINE (via OvidSP), CINAHL, PsycINFO, SPORTDiscus, CENTRAL, and Web of Science for publications between 1990 and February 2022. The methodological quality of included studies was assessed using two quality assessment tools for cross-sectional and clinical trial studies. The prevalence of physiological, behavioral, and psychological risk factors was reported using descriptive analysis. Results: A total of 48 studies derived from 20 different countries, reviewing a total pooled sample of 36,958 airline pilots. Compared with general population estimates, pilots had a similar prevalence for health risk factors, yet higher sleep duration, lower smoking and obesity rates, less physical activity, and a higher overall rate of body mass index >25. Conclusions: The research reported substantial prevalence >50% for overweight and obesity, insufficient physical activity, elevated fatigue, and regular alcohol intake among pilots. However, the heterogeneity in methodology and the lack of quality and quantity in the current literature limit the strength of conclusions that can be established. Enhanced monitoring and future research are essential to inform aviation health practices and policies (Systematic Review Registration: PROSPERO CRD42022308287).
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