ABSTRACT
This study updates the prevalence of operator fatigue as a causative factor in accidents investigated by the National Transportation Safety Board (NTSB) and the associated injury severity in fatigue-related accidents. In total, 394 investigations were analyzed and 12% of them identified fatigue. The prevalence of fatigue varied among the transportation modes, ranging from 28% of aviation to 7% of marine. Most fatigue-related accidents (48%) occurred during late night or morning. Compared to non-fatigued operators, fatigued operators were more involved in severe or fatal injuries (odds ratio [OR] 2.30; 95% confidence interval [CI] [1.66, 2.95]) and injuries to non-operators (OR 3.32; 95% CI [2.70, 3.95]). Obstructive sleep apnea (OSA) was identified as a probable cause, contributing cause or finding in 15% of fatigue-related accidents, and in 85.7% of these accidents the operator met OSA screening criteria. Thus, opportunities remain for preventing fatigue-related accidents, including through more systematic operator screening for OSA.
Acknowledgements
The authors would like to thank Mr Jeffrey Marcus, Chief of the Safety Recommendations Division at the National Transportation Safety Board (NTSB), for his assistance in obtaining data and critical feedback on the publication. The data analysis, findings and conclusions expressed in this article are the responsibility of the authors and do not reflect the official opinion of the NTSB.
Disclosure statement
No potential conflict of interest was reported by the authors.
Notes
1 The NTSB publishes major accident reports and briefs which contain a level of investigation necessary to determine whether fatigue was an issue. Because the NTSB investigates every civil aviation accident, there were more than 8800 aviation accidents investigated during this period. Many of these reports are more limited investigations that do not evaluate whether fatigue was an issue in causing the accident.
2 Unless the investigation identifies fatigue as an issue, the NTSB does not typically make information about BMI and other medical comorbidities/attributes available due to privacy concerns.