Factors Associated with Operational Fatigue in Pilots and Flight Attendants: A Systematic Review
Keywords:
Operational fatigue, aviation personnel, occupational health, systematic reviewAbstract
Operational fatigue represents a relevant occupational health concern among aviation personnel, as it may affect alertness, performance, and decision-making during flight operations. The aim of this systematic review was to identify and synthesize the available scientific evidence on the main factors associated with operational fatigue in pilots and flight attendants. A systematic literature review was conducted in accordance with the PRISMA 2020 statement. The search was performed in PubMed using terms related to operational fatigue, aviation, pilots, flight attendants, and associated factors. Studies published between 2016 and 2026, in English or Spanish, that assessed operational fatigue and its associated factors in pilots and/or flight attendants were included.
A total of 60 records were initially identified; 34 articles were assessed in full text, and 13 studies met the inclusion criteria for qualitative synthesis. Of these, five were conducted exclusively among pilots, three among flight attendants, and five included both occupational groups. The most consistently reported associated factors were sleep restriction or poor sleep quality, circadian rhythm disruption, prolonged working hours, night work or early-start duties, insufficient recovery between duty periods, and operational workload. Additional factors included flight duration, long-haul operations, the number of flight sectors, sleep disorders, and certain individual habits. Sleep restriction or poor sleep quality was the most frequently reported factor across the studies analyzed.
The findings indicate that operational fatigue is a multifactorial phenomenon involving the interaction of sleep-related factors, circadian rhythm disruption, and work organization. These results highlight the importance of strengthening fatigue risk management strategies, optimizing duty scheduling, ensuring adequate recovery periods, and promoting healthy sleep habits. The synthesized evidence may provide a foundation for the development of preventive programs and future research in occupational health and aviation.
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Copyright (c) 2026 Teresa de Jesús Gallardo Olvera, Vicente Lozada Balderrama, Armando Rodríguez López (Autor/a)
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