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Are you suffering from burnout?

by Claire Coombes Human Factors Scientist

If I were to say that people with high levels of psychological wellbeing generally work better, live longer and have happier lives, I doubt many would find it particularly groundbreaking. It would also probably come as no surprise that pressures, strains and stresses within the workplace have long been identified as important factors affecting physical and mental health. These findings make sense, and are helpfully backed up by many academic papers.

But, beyond these broad conclusions, what can we say about the influence of working conditions when it comes to issues of ‘wellbeing’ and ‘burnout’ for pilots in commercial aviation? What are the longer-term physical and mental costs associated with the types of operation pilots are carrying out? And, perhaps more of a theoretical question: how might these costs be detrimental to safety in ways that are not immediately obvious to either employees or the operators?

These are the kinds of questions that members have been asking BALPA to investigate, particularly given increasing rostering pressures since the introduction of EASA FTLs, and what many describe as a step-change in the intensity of the type of work they are now doing on a daily basis.

Wellbeing and burnout in aviation

What often stops industries from tackling issues such as work-related burnout is the lack of an agreed definition – or a clear measurement unit – that can quantify or do justice to all aspects of these complex psychological and physical phenomena. This problem is not a new one. Indeed, since the 1930s, there have been systematic attempts to define precisely what ‘stress’ means and how it should be measured, and there is still no consensus. There is even less agreement on acceptable physical measures of stress that can practically be monitored in the real world.

The downside, shared by other similar phenomena – burnout, cumulative fatigue and so on – is that individuals are left without an effective way to describe or measure the very real feelings of strain and exhaustion they may be experiencing, or to know what they need to do to recover. Additionally, organisations may see the issues as being too complex even to begin to engage with.


Despite these complexities, we believe we can make some progress in this area. Following a strong steer from our membership, we have begun by focusing on the issue of burnout. Last year, we contacted leading academic Professor Eva Demerouti, who specialises in research on the effects of work characteristics on occupational wellbeing. Prof Demerouti and colleagues have developed a measure for burnout that has become established in organisational research, and has been used to characterise burnout in various other industries.

The measure includes items that assess exhaustion and disengagement from work, seen as the two core dimensions of burnout (see box, right). An advantage of using this definition is that it is used by other professional bodies such as the British Medical Association to assess the incidence of burnout in the medical workforce. This means scores among the UK pilot membership can be more meaningfully compared with benchmark groups from other sectors sharing similar levels of job demands.

 

With Prof Demerouti, we created a questionnaire that could quantify aspects of working conditions that pilots experience and assess how they score on more established measures of wellbeing and burnout. Full members of BALPA received an invitation to take part in the questionnaire last summer, with a total of 1,147 pilots taking part. For certain measures, the researchers were able to compare the scores of British pilots both with scores of Dutch pilots flying long-haul flights, and with medical specialists.

The six headline findings were:

A high proportion of pilots are reporting symptoms of burnout

Some 19 per cent of BALPA pilots show symptoms of burnout – compared with around four per cent in other organisations – and 88 per cent of respondents frequently see fellow pilots as already being fatigued when they start their working shift.

Compared with Dutch pilots and medical professionals, British pilots fare worse

British pilots generally score higher on burnout, fatigue and sleepiness problems, and lower on health compared with Dutch pilots and medical professionals. This is both with respect to the exhaustion that pilots experience, and their disengagement from work. However, British pilots are happier with their life than these benchmarks. The researchers explain these results by the finding that British pilots appear to have greater job demands – workload, private-life-to-work conflict, work-to-private-life conflict, future insecurity – which together act to degrade health and energy without sufficient time or resource for recovery.

In addition to experiencing higher job demands, British pilots were found to experience less social support and development opportunities than Dutch pilots. Lack of job support may also partially explain the British pilots’ higher burnout scores.

Pilots on scheduled short-haul operations are particularly affected

Looking at employment conditions, pilots operating short-haul scheduled flights score higher on their experience of job demands, while their wellbeing scores were lower compared with pilots operating long-haul flights.

Pilots flying more hours across the year are more exhausted and report more degraded health

Pilots who fly more than 650 hours in the year report higher scores on exhaustion and fatigue and lower scores on health than pilots flying up to or less than 650 hours. Disengagement is higher in the groups of pilots flying more than 750 flight hours compared, with groups of pilots flying up to or less than 750 flight hours. When pilots fly for more than 800 hours, they have higher scores on exhaustion and fatigue compared with groups of pilots flying up to or less than 750 hours. In future, it would also be helpful to look at shorter time frames – for example, across a week or month.

Pilots in their mid-30s to mid-40s tend to show greater burnout scores

Pilots aged between 35 and 44 years often report lower scores on wellbeing – but higher scores on exhaustion and disengagement – for both long-haul and short-haul flights. This group also appears to experience more job demands and lower job resources, suggesting burnout may be a particular concern for this age group.

‘Evening-types’ tend to suffer more from exhaustion.

Evening-type pilots – those who tend to feel and function better later in the day – suffer more from exhaustion and fatigue than morning or neutral types. It was found that being a morning person was more beneficial in coping with fatigue compared with being an evening-type person.

A pilot’s age was also related to self-reported fatigue, with pilots aged between 45 and 54 – and who operate short-haul flights – reporting the highest levels of fatigue.

Where to from here?

These findings, when set against the findings of other occupational groups,  suggest that British pilots may suffer far higher levels of burnout than population norms. For example, in a study among more than 13,000 employees from several occupations, Bakker, Schaufeli and van Dierendonck (2000) found that 4%  profiled high burnout symptoms. Although Bakker et al. found that some occupations had a higher risk to burnout, (e.g. health care professionals with 11-14% burnout),  none of the occupational groups that participated in that study exceeded 14%. These figures are hence substantially lower than percentages of burnout found among pilots in this study. As such, the issue cannot continue to be ignored.

Going forward the prevention of burnout in the workforce, and its corollary of promoting mental resilience and wellbeing on the job, will require much greater engagement from stakeholders in the aviation industry. We are not alone in thinking this. For example, we know from a recent survey BALPA conducted with 42 Aviation Medical Examiners that 88% agree that airlines need to do more to promote wellbeing and prevent burnout amongst their employees.

This study also highlights the need to develop more sophisticated ways of assessing and communicating the mental health needs of all pilots. This is both with respect to identifying cases which meet clinical diagnosis, and exploring the most appropriate ways for individuals to receive help or treatment if needed. Just as there has been a shift towards preventative health measures for physical health problems (note the public health bulletins on eating healthily, exercise, and creating behaviour change initiatives) there too needs to be a greater focus on how issues of mental ill health and burnout may be prevented in the aviation environment. We hope that initiatives such as peer intervention models being rolled out across airlines will act as the first step in this endeavour.