the mouse that quibbles

the mouse that quibbles

Sunday, October 25, 2009

Dead Tired

cross-posted at C&L

Since the Bush administration’s legacy left the country suffering the worst economic crisis since the Great Depression, the number of unemployed has increased by 7.6 million to 15.1, and the official unemployment rate is just under 10%, For so many, just having a job – any crappy, horrible, badly-paid job – is better than no job at all. So few people are paying much attention to what is happening, and has been happening for quite some time, to those who are employed in what should be ‘good’ jobs; the increasing pressure on workers to work longer and harder, for less and less. Or else.

But sometimes the ‘or else’ isn’t just about losing your job. Let’s face it; there are some jobs where chronic fatigue and burnout are more hazardous than others. Flying for an airline for one. A few days ago, Northwest Flight 188 from San Diego to Minneapolis overflew the airport by more than 150 miles, out of radio contact with air traffic controllers for 80 minutes. Something sure as hell went very wrong 37,000 feet in the air with 147 unsuspecting passengers sitting in the back seats, and speculation is running rife about how two experienced and highly qualified pilots could possibly fly past their destination without either noticing. The chatter on just about every airline pilot forum is the same – suspicion falling on the most likely reason – the pilots simply… fell asleep. Luckily, no one died, except possibly two pilots’ careers.

Would be nice to think this was a one-off aberration. It’s not. A couple weeks ago, a Delta 767 with 195 passengers and crew landed in Atlanta on a taxiway instead of the runway, and investigators suspect fatigue as a factor; the crew had flown 10 hours and was landing at night. The third pilot, doing a checkride, had become ill during the flight, and was being cared for in the cabin as the other two pilots, distracted and tired, landed the jet on the wrong strip of asphalt. Not exactly the checkride they were hoping for.

Nor is it the first time a flight crew has fallen asleep at the controls. Both the pilot and co-pilot of a go! airline flight dozed off at 21,000 feet while flying to Hilo last year, with air traffic controllers trying to contact the plane for 25 minutes before the pilots woke up, realized they’d overshot the airport and were heading out to sea. Both pilots lost their jobs. Yet complaints of pilot fatigue is not new for go!’s parent company, Mesa Air in Phoenix. Dallas television station WFAA-TV reported as far back as 2006 that flight schedules were so tight pilots were exhausted, some even camping in their aircraft to catch a few hours of sleep.

Last year, after a Shuttle America regional jet slid off the end of a snowy runway in Cleveland, investigators cited the captain’s fatigue as a crucial factor. The National Transport Safety Board criticized the captain for not removing himself from duty, despite suffering from fatigue… but as we’ve read here before, Michael Moore was handed a letter sent to the F/O on his flight, the airline warning the pilot he’d taken three sick days in the past year, and had better not take another. Or else. It isn’t just financial need forcing pilots to fly past their physical limits, it’s their bosses.

It seems the industry is still struggling with the lessons of Colgan Air Flight 3407. 24-year-old co-pilot Rebecca Shaw had travelled all night as a passenger on FedEx planes from Seattle to Newark – she was so tired she complained of feeling ill, but with only earning $15,800 the year before, she couldn’t afford not to fly. Even while working as a pilot, she had moonlighted as a waitress in a Virgina coffee shop. The captain, Marvin Renslow, had napped on a sofa in the airport crew lounge before the flight. Both pilots were overtired, underpaid and unprepared for the weather conditions as the airline had considered the simulator training too expensive. Shaw, Renslow and 49 passengers died when the plane’s wings iced up and dropped them onto a house in Buffalo, New York.

Would be nice to think this might just be a problem for pilots. It’s not. In March, 2006, an air traffic controller in Chicago with only four hours sleep between shifts cleared two jets for take-off on the same runway. The pilots managed to spot each other in time. In 2004, an ATC in Los Angeles with only five hours of sleep between shifts did the same thing, with the plane on approach pulling up 12 seconds before it would have collided with one on the ground. In Denver, two weeks after 9/11, an ATC with less than two hours sleep between shifts cleared a Boeing 757 for take off… on a runway that had been closed for construction. Three months before, an ATC working his third shift in two days cleared two planes for the same runway, the pilot in the landing plane slamming on the brakes to avoid colliding with a jet crossing the runway. No one died.

But it was only a matter of time. In 2006, a lone air traffic controller in Lexington, Kentucky with only a two-hour nap between shifts cleared Comair Flight 5191 for take-off. He wasn’t watching when it turned onto the wrong, fatally short, runway. In the dark, the pilot didn’t realize and crashed into trees, killing 49 people on board. ‘Controllers are absolutely more tired now than they have ever been, and it's because they are forced to work overtime,’ said Doug Church, spokesman for the National Air Traffic Controllers Association. ‘This is an understaffed system, and the FAA is lying when they say it's not.’ Record numbers of ATCs are quitting, with the remainder making up staffing shortages. A GAO report cites ATC fatigue as a major reason for the sharp increase in near catastrophic mistakes.

It would be nice to think this is just a problem for the airlines. It’s not. MTA bus drivers are moonlighting with second jobs, working over the allowed 10 hours a day, getting traffic tickets without their employers finding out. Four drivers were involved in incidents on days they worked over 10 hours. Three drivers who held second jobs had avoidable crashes. And in April this year, a bus crash in California’s Sierra Nevada killed one person and injured twenty-four, with investigators suspecting driver fatigue may have contributed to the fatal accident.

It would be nice to think maybe it’s just the transport industry in general with the problem. It’s not. Doctors, unions and other medical experts have been urging hospitals to cut down on the compulsory hours for residents working at least 80 hours a week at most training hospitals, many 30 hours straight without a break. Doctors in training who fall asleep during surgery or while examining patients make four times more errors that cause deaths than their better-rested colleagues. ‘The evidence demonstrates that academic medicine is failing both doctors and patients by routinely requiring exhausted doctors to work marathon shifts,’ says Charles Czeisler, Baldino Professor of Sleep Medicine. ‘The human brain simply does not perform reliably for 24 consecutive hours without sleep.’

It’s not just doctors. University of Pennsylvania researchers tracked 393 hospital nurses and found about 40 percent were working shifts on average in excess of 12 and a half hours, every nurse working at least 55 minutes longer than scheduled, and a third working overtime every single day over the four week study. Fatigue in nursing staff considerably raised the risk of dispensing the wrong medicine or the wrong dosage.

But the crushing hours worked by doctors and nurses in hospitals is unlikely to change any time soon. A study commissioned by the Rand Corporation has claimed that giving new doctors enough rest to avoid chronic fatigue while they train would cost hospitals $1.6 billion dollars, as extra personnel would have to be hired to fill in for them. It’s just not ‘cost-effective.’ Besides, says Dr. Teryl Nuckols, most errors don’t actually harm a patient. I guess she didn’t read the U.S. Institute of Medicine report in 1999 on between 48,000 and 98,000 Americans dying each year from preventable medical errors ranging from drug overdoses to nosocomial infections, due in large part to resident doctors exhausted and overwhelmed by long hours, mental fatigue and high levels of stress.

Emergency dispatchers are also falling asleep on the job, the most notable public scrutiny falling on dispatcher Ron Kronenberger, who answered a 911 call from Ryan Widmer, accused of killing his wife. In the 911 call, Kronenburger sounded as if he were groggy, at one point asking Widmer if he were his wife’s mother. The county’s investigation found Kronenberger habitually slept on duty, as did another Warren County dispatcher, Shawn Mason. People don’t normally sleep on the job because they’re lazy, or they’ve got nothing better to do. They fall asleep because they’re tired.

And it’s a problem for the police. A survey of police found 85 percent have inadvertently fallen asleep while on duty due to lack of sleep. The normal 8-hour shift is rare in any police force, most police officers working ten, eleven, even twelve hour shifts, often without a break. A sheriff’s deputy fell asleep at the wheel during a 12 and a half hour shift, veered across a lane to run into and kill two bicyclists in Cupertino and severely injure a third. ‘Our cops are ticking time bombs for lack of sleep,’ says retired CHP captain Gordon Graham.

And it’s a problem for firemen. Fire Station No. 203 at Standage and University Drive is one of the busiest in the country, but like too many firestations have seen the city cut services as the budget tightens, firefighters stretched longer hours and doing more with fewer resources, leading to chronic fatigue. ‘When you get overstressed with your resources and are extended you are going to lose,’ Mesa fire Capt. Ralph Churchman said. ‘And in this business, it is lives.’

And it’s a problem for the military. Recently, the Navy had a ship run aground because the captain had barely slept in days and the two qualified lookouts who were supposed to be with him were busy elsewhere helping out a woefully undermanned crew. Sailors are routinely standing a watch, then going to work, then standing another watch, with most junior officers getting only three to four hours of sleep a day.

Actually, it’s a problem for all of us. Nearly 40 percent of all US workers are fatigued, costing billions of dollars in lost productivity. For U.S. employers, the overall cost for lost productivity due to fatigue is more than $136 billion per year, with 84% of that lost productivity not due to absenteeism, but simply reduced performance while at work. Employers squeezing more work out of their employees, and employees willing to work harder, for longer, and for less, have resulted in 70 million U.S. workers being clinically exhausted. The estimated cost of accidents where workers could not remain alert or awake ranged from $50 billion to over $100 billion annually. For some, the cost is more than money - in one incident, a worker fell asleep in a crane cab while working the third of three consecutive 13 hour shifts. When he woke up, he exited from the wrong side of the cab and fell 35 feet to his death.

You’d think that business might understand that overly tired employees are hurting their bottom line. But times are tough, jobs are scarce, and big business is not in the business of seeing human beings as anything more than interchangeable cogs in a machine to be used and discarded at will. Worker protections hard-won by unions – minimum wages, maximum hours, health and safety on the job – have been systematically dismantled, from Reagan breaking the spirit of air traffic controllers in the 1970s to WalMart breaking the backs of workers not allowed to unionize today. So while I have the greatest sympathy for the growing number of those with no jobs, it’s possibly more critical that we recognize there’s a lethal cancer invading the vast majority of those who do have jobs, as the top 1% of the Have Mores wring more and more blood out of those Americans who actually make things and make things work. And that’s not just making us tired.

It’s making us dead tired.

Update: The NTSB has issued an update on the investigation into Flight 188 that overflew the Minneapolis airport. The pilots were extensively interviewed, denying they had fallen asleep, or were involved in any altercation; instead, it appears both pilots were using personal laptops to discuss the new monthly crew flight scheduling system in effect as a result of the airline merger, and became so engrossed that they lost track of time. The use of personal computers on the flight deck is prohibited by company policy. The co-pilot, Richard Cole, has since made yet another error in judgement, attempting to downplay the incident as ‘innocuous’. Personally, I'd rather not be a passenger with pilots so busy trying to figure out a complicated company schedule that they forget they're actually flying a plane, which I think goes slightly beyond 'innocuous'; on the other hand, what sort of scheduling is so complicated it baffles even the people who have to use it? But any way you slice it, these guys are toast.

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