Survey of Israeli Air Force line commander support for fatigue prevention initiatives

Background: Sustained and continuous high intensity military operations have increased in scope in recent years. These mandate ever more sophisticated efforts to prevent and ameliorate aviator fatigue. Successful implementation of new fatigue countermeasures requires thorough pretesting among experienced aviator opinion leaders: base and squadron commanders. Methods: An anonymous and voluntary survey questionnaire containing background material and Likert-scale questions regarding 14 primary through tertiary fatigue prevention initiatives current in the aeromedical literature or unique to the IAF was distributed to all base and flight squadron commanders in the IAF. Results: Of the commanders, 38% returned fully completed questionnaires. The most popular primary prevention initiatives (garnering 87% support) dealt with reservist aviators: 1.) requiring reserve pilots to arrive at the squadron at least 3 h before night flights to facilitate napping time, and 2.) improving scheduiing coordination of those reservists employed as civilian aircrew. The chief (88% support) secondary prevention countermeasure endorsed was to utilize stimulant drugs such as caffeine or amphetamines to sustain the alertness of fatigued aviators. Leading the list of tertiary prevention initiatives (75% support) was the suggestion that squadrons debrief the incidence of aviator fatigue, as well as their success in the area of time-management when debriefing high tempo exercises and operational missions. Conclusions: Commanders differentially supported a wide range of fatigue countermeasures. Use of stimulant drugs achieved the broadest support. Instituting specific measures to facilitate alertness in reservist aviators was also a priority. Surveying the degree of commander support for new fatigue prevention initiatives provides the basis for prioritization of scarce resources, should improve line cooperation, and provides important experience-proven feedback for researchers and policy-makers.