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Stressed and Fatigued on the Ground and in the Sky: Changes from 2000 – 2007 in civil aviation workers’ conditions of work

“This study highlights the changes in Civil Aviation workers’ conditions between 2000 and 2007 and is being published just as the Civil Aviation Section of the ITF turns 60 years old.

The first Conference of the Section was held in October 1949 when the jet-propelled civil aircraft was still a few years away from being commercially exploited, and air travel for ordinary people was a prospect only a few visionaries could see. The ITF was just re-starting its activities in earnest following the end of the Second World War, and existing aviation affiliates were already demonstrating their long-term perspective by pressing the ITF to take a “close look not only at working conditions but at safety” in the aviation industry.

Workers today would not recognise the world of civil aviation in existence then. Over the course of the following 60 years, scientific and technological progress made civil air transport a crucial part of the transport mix. Technological progress brought positive changes but also many challenges for aviation employees, and had a profound impact on their working conditions.

The real problem however came with deregulation, starting at the end of the 1970s and eventually leading to the disappearance of thousands of high quality jobs along with most of the ‘legacy airlines’ that provided them. Neo-liberal dogma dictated that the best course for the industry was to privatise and to outsource as many of its operations as possible. Time would unfortunately prove this strategy to be ineffective and potentially dangerous – an ICAO study from 2005 found that too much liberalisation has led to the loss of control over safety.

Unfortunately there has been no let up in the liberalisation and deregulation agenda in the intervening decades. International competition, mergers, alliances, and cost-efficiency strategies are still being pursued relentlessly, increasing the already intense pressure in an industry that is not only characterised by cut-throat competition but which is also painfully exposed to external factors such as security concerns and economic crises. All this of course has had a direct impact on jobs and the working conditions of those employed in the industry.

In this scenario, low-cost carriers push yet further the boundaries of what their workers, and even what passengers will put up with. And they don’t stop there. Local airports and service providers are also forced to lower their charges and to provide ‘flexible’ and cheap labour or face the threat of abandonment by such carriers.

These companies use their workers to the limit in their quest to lower running costs and to advertise the lowest fare. Sadly, many passengers are still taken in by the creative fare structures that obscure the true cost of many flights. And the drive to infinitely lower fares continues, despite concerns about its implications for both passenger and crew safety raised by trade unions.

In the period covered by this study, statistics show that global air passenger traffic, air freight volume and revenues have gone up. However, while the industry has grown, civil aviation workers have faced a steady decline in their conditions in all regions. This groundbreaking study on fatigue by the ITF’s Civil Aviation Section examines the reasons for this in the context of the changes within the industry. One thing is very clear – this is an extremely serious problem for our workers, and we have to fight back.

Stressed and Fatigued on the Ground and in the SkyThis study, while valuable in itself, has a broader importance. The findings will help us to develop an international campaign that addresses the common concern of stress and fatigue but in a way that focuses effectively on the specific needs of each of the three very different groups of civil aviation industry workers: air traffic services and ground staff (whose work involves shift work), and crew members (whose work involves frequent changing of time zones).

Many unions are already involved in national activities to address this problem. An ITF campaign would aim to support those activities and encourage action in countries that aren’t currently involved in such initiatives. An international campaign would also serve to focus international attention. National campaigns would benefit from the effects of major worldwide coordinated actions. Other solutions, such as international minimum standards, will require pressure at the relevant international level.

A global campaign will illustrate the fact that this problem is not confined to one country or group of countries. It is experienced in all countries in all parts of the world.

Gabriel Mocho Rodriguez ITF Civil Aviation Section Secretary”

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A Prospective Cohort Study of Shift Work and Risk of Ischemic Heart Disease in Japanese Male Workers


This study prospectively examined the association between shift work and the risk of ischemic heart disease among Japanese male workers. A baseline survey, which involved 110,792 inhabitants (age range: 40–79 years) from 45 areas throughout Japan, was conducted between 1988 and 1990. The causes of death were identified from death certificates. The analysis was restricted to 17,649 men (age range: 40–59 years) who were employed at the time of the baseline survey. All subjects were asked to indicate the most regular shift work that they had undertaken previously: day work, rotating-shift work, or fixed-night work. The Cox proportional hazards model was used to estimate the risks of shift work for ischemic heart disease. During the 233,869 person-years of follow-up, a total of 1,363 deaths were recorded, 86 of which were due to ischemic heart disease. Compared with the day workers, the rotating-shift workers had a significantly higher risk of death due to ischemic heart disease (relative risk = 2.32, 95% confidence interval: 1.37, 3.95; p = 0.002), whereas fixed-night work was not associated with ischemic heart disease (relative risk = 1.23, 95% confidence interval: 0.49, 3.10; p = 0.658). In addition, subjects with coronary risk factors, such as hypertension, overweight, habitual alcohol consumption, and smoking, were highly susceptible to the effect of rotating-shift work on the risk of death due to ischemic heart disease.

The Whitehall Study

Contact: Professor Michael Marmot
Department of Epidemiology and Public Health
University College London
1-19 Torrington Place
London WC1E 6BT
Tel: 44 171 391 1717
Fax: 44 171 813 0280
Email: Michael@public-health.ucl.ac.uk

The Whitehall study examined mortality rates over 10 years among male British Civil Servants aged 20-64. The study was an attempt to avoid some of the problems created by the use of general social class groupings, e.g., the heterogeneity of occupations within a single class leaves room for differing interpretations. The Whitehall study concentrates on one “industry” in which there is little heterogeneity within occupational grades and clear social divisions between grades (Marmot, Kogevinas and Elston, 1987).

An inverse association between grade (level) of employment and mortality from CHD and a range of other causes was observed (78). Men in the lowest grade (others = messengers, doorkeepers, etc.) had a three-fold higher mortality rate than men in the highest grade (administrators) (Marmot, Shipley and Rose, 1984).

Grade is also associated with other specific causes of death, whether or not the causes were related to smoking (Marmot, Kogevinas and Elston, 1987). While low status was associated with obesity, smoking, less leisure time physical activity, more baseline illness, higher blood pressure, and shorter height (78), controlling for all of these risk factors accounted for no more than 40% of the grade difference in CHD mortality (Marmot, Shipley and Rose, 1984; Marmot, Kogevinas and Elston, 1987). After controlling for standard risk factors, the lowest grade still had a relative risk of 2.1 for CHD mortality compared to the highest grade (Marmot, 1994).

One possible explanation of the remaining grade differences in CHD mortality is grade differences in job control and job support (Marmot, Kogevinas and Elston, 1987). In addition, blood pressure at work was associated with “job stress”, including “lack of skill utilization”, “tension”, and “lack of clarity” in tasks. The rise in blood pressure from the lowest to the highest job stress score was much larger among low grade men than among upper grade men. Blood pressure at home, on the other hand, was not related to job stress level (78).

Thus, a second longitudinal study of British Civil Servants (Whitehall II) was initiated to investigate occupational and other social influences on health and disease (Marmot, 1994). The final sample was 6900 men and 3414 women aged 35-55 in the London offices of 20 civil service departments (Marmot et al., 1991). Employment grade was strongly associated with work control and varied work (measures of decision latitude) as well as fast pace (a measure of job demands) (Marmot et al., 1991; Marmot, 1994). Lack of control on the job is related to long spells of absence (> 6 days) (Marmot, 1994).

In addition, there was no decrease in the difference in prevalence of ischemia depending upon employment category over the 20 years separating Whitehall I and Whitehall II (Marmot et al., 1991). Plasma cholesterol concentrations did not differ by job category, and the small inverse association between job status and blood pressure in men was reduced from that seen in the Whitehall I study. There was a significant inverse relation between BMI and job status, but, especially in men, the differences were small. The risk factor that differed most between employment categories was smoking. Moderate or vigorous exercise was less common among subjects in lower status jobs (Marmot et al., 1991).

PRIM (Project on Research and Intervention in Monotonous Work)

PRIM is a multidisciplinary study undertaken by the National Institute of Occupational Health; the Departments of Occupational Medicine at Glostrup Hospital, Herning Hospital, Arhus Hospital; Centre for Alternative Social Analysis (CASA); Department of Working Environment, Technical University of Denmark (DWE/TU); and the Danish Institute of Physical Education.

The main objectives of the project are:

To study the musculoskeletal and psychosocial effects of the physical and psychosocial risk factors which occur in monotonous and repetitive work, with special emphasis in the joint and interacting effects of these factors.

To develop knowledge about organizational methods which can lead to viable changes in the companies that introduce more variation in the work, and to evaluate the health effects of such interventions.

To study the effects of dynamic and static muscle training on the perception of musculoskeletal pain among workers with monotonous repetitive work.

The project consists of 6 integrated substudies.

Substudies 1 and 5 are mainly concerned with the musculoskeletal and psychosocial effects of monotonous repetitive work. Substudies 2, 3, and 4 carry out and evaluate interventions in the companies, the aim of which are to introduce more variation in the work. Substudy 6 intervenes against the effect of monotonous repetitive work by subjecting the exposed workers to dynamic and static muscle training.

The projects are closely integrated. Firstly, the persons and companies from substudies 2-6 are also included in substudy 1. Thus, the health effects of the interventions will be closely monitored. Secondly, a number of different scientific methods and fields are involved in the data collection. Since data is collected for individuals, it can be analyzed jointly and thus can give an integrated understanding of the studied phenomena.

UCI Firefighter Obesity Research Project: Workplace Assessment to Reduce Disease (FORWARD)

Visit the FORWARD Study Website at: http://www.coeh.uci.edu/forward/

Firefighter Obesity Research: Workplace Assessment to Reduce Disease (FORWARD) is a 2-year project of the UCI-COEH, funded by the Center for Disease Control and Prevention/National Institute for Occupational Safety and Health (Award #: 1 R21 OH009911-01). The study will consider the unique working conditions and health behaviors of firefighters who work on a 24 hour-shift system. This will allow in the end to develop a firefighter-relevant work and health questionnaire along with several recommendations to reduce the obesity risk of firefighters. We propose this as an exploratory study which meets the public safety sub-sector strategic goals 1.4 and 1.5 of the National Occupational Research Agenda (NORA) and the Research to Practice (r2P) initiatives at the National Institute for Occupational Safety and Health.

NIOSH Exploratory and/or Developmental Grant Program (R21) 


PI: Choi, BongKyoo

Co-investigators: Schnall Peter MD, Leslie Israel MD, Marnie Dobson PhD, Pietro Galassetti MD, Dean Baker MD, Paul Landsbergis PhD (consultant).

Project Summary/Abstract

Among 41 male-dominated occupations, firefighters have the third highest prevalence rate of obesity. Few studies have examined the roles of working conditions and health behaviors of firefighters in obesity. In addition, few validated instruments — a methodological prerequisite for obesity studies in firefighters — are available that specifically assess the unique working conditions and health behaviors of firefighters who work on a 24 hour-shift system. Our long-term goals are to elucidate the roles of working conditions and health behaviors in the development of obesity among firefighters and to use this information to design and conduct intervention studies that lower CVD risk factors among firefighters by changing working conditions and health behaviors. The main aims of this proposal are a) to develop and validate a firefighter-relevant work and health questionnaire using qualitative and quantitative methods in firefighters enrolled in the Orange County Fire Authority (OCFA) Wellness Fitness (WEFIT) Program, b) to use this questionnaire in an epidemiological study to explore whether adverse working conditions and health behaviors are risk factors for obesity in firefighters, and c) to explore the interrelations between working conditions and health behaviors as they relate to obesity. A supplementary objective is to evaluate the strengths and weaknesses of Body Mass Index (BMI) as a measurement (commonly used as a surveillance measure of obesity in many WEFIT programs for firefighters) in comparison with skinfold-based body fat percent. For the purposes of this study, we will use a participatory action research (PAR) approach to build a work group of firefighters and researchers to develop and validate a questionnaire for assessing working conditions and health behaviors of firefighters. The developed questionnaire will be completed by about 350 OCFA firefighters over 15 months. A subsample of the firefighters (n=80) will be recruited to complete a 3-day food record and to wear an accelerometer during the same 3 days, and to fill in a short-form of the questionnaire for a one-week test and retest reliability. In addition, for analyses, the records of the WEFIT medical and fitness exams (Body Mass Indexes, body fat %, VO2 max, blood pressures, and blood lipid profiles) of the participants and archival records of 2004-2011 annual calls by each local OCFA fire station will be linked to the exposure profiles. At the end of this project a firefighter-relevant work and health questionnaire will have been developed, along with several recommendations to reduce the obesity risk of OCFA firefighters. We propose this as an exploratory study which meets the public safety sub-sector strategic goals 1.4 and 1.5 of the National Occupational Research Agenda (NORA) and the Research to Practice (r2P) initiatives at the National Institute for Occupational Safety and Health.

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