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Key Findings

Over the past four decades, more than 320 fatigue-related accidents and incidents have taken nearly 750 lives in airplane crashes alone. The NTSB has issued 138 fatigue-related safety recommendations since 1967. Only 68 have been implemented.
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“The rulemaking process is a very, very circuitous, complicated and time-consuming process,” Dillingham said.

The FAA, for example, twice proposed hours-of-service rule changes for pilots – once in 1972 and again in 1995. Neither was adopted.

The 1995 proposal was withdrawn in 2009. In the intervening 14 years there were no fewer than 97 aviation accidents and incidents in which fatigue was a factor, resulting in nearly 500 deaths.

FAA Administrator Randy Babbitt made fatigue one of the agency’s highest priorities when he assembled a committee shortly after his confirmation in the summer of 2009. This September, the agency issued its new rule proposals that are now in the public comment period.

“We badly need a new flight and duty-time regulation,” Prater of the Air Line Pilots Association told senators last year. “While we have been told it will be done in mid-2010, we have seen too many times in the past that the FAA has not delivered on its promises with regard to pilot fatigue regulations.”

A Culture of Fatigue

No amount of training or experience can overcome the insidious effects of fatigue, as any pilot, truck driver, boat captain or anyone who’s stayed up too late watching TV knows.

“Temporarily, a person who otherwise is very experienced, very well trained, very, very good at what they do — fatigue can make that person stupid,” said Steven Hursh, a fatigue expert at Johns Hopkins University who has developed tools that are intended to track fatigue.

When tired, people react more slowly, struggle with attention lapses and take more unnecessary risks. They also suffer from a narrowed field of focus, or tunnel vision, which limits their ability to competently monitor several things at once — such as the many gauges, switches and control settings of a modern commercial airline cockpit.

The effects of fatigue mirror those of alcohol, as proven in scientific studies around the world. After being awake for as little as 24 hours, a person’s workplace performance can be equivalent to that of someone with a blood-alcohol content of 0.10 percent, equal to or greater than the legal intoxication limit in all 50 states.

What’s most dangerous is that people are unable to recognize their own fatigue. Even worse, they usually can’t register how it’s affecting their performance until it’s too late and something has gone wrong.

At present, one of the few tools investigators have to determine whether fatigue was a factor in an accident is listening to what pilots say on a flight recorder, such as talking about sleep or being tired.

“By the time you feel sleepy or talk about being sleepy, you’re very far gone,” the NTSB’s Brenner said. “You don’t realize how impaired you are. The part of your brain that recognizes what’s happening is impaired.”

The problem is compounded by a culture “that places a lot of value on burning the midnight oil,” said NTSB fatigue transportation research analyst Jana Price.

Most people take pride in working through fatigue, considering it a sign of strength, even if means putting themselves or others in danger, she said. It’s common to hear people brag about how little sleep they got before getting behind the wheel to drive to work in the morning or how late they stayed in the office to finish an important project.

NTSB investigator Malcolm Brenner said public attitudes toward fatigue are about the same as attitudes toward drinking and driving 20 years ago.

“At one time, there was a sense that if you’re under (the influence of) alcohol you can power your way through it, but that’s no longer tolerated,” Brenner said.

Someday in the near future, safety advocates hope that operating under the influence of fatigue will be just as unacceptable.

News21 reporters Ryan Phillips and Ariel Zirulnick and Center for Public Integrity staff members Michael Pell and Nick Schwellenbach contributed to this story.

Sept. 26, 2010

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