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

Background: Sustained and continuous high intensity military operations hav e increased in scope in recent years. These mandate ever more sophisticated efforts to prevent and ameliorate aviator fatigue. Successful implementati on of new fatigue countermeasures requires thorough pretesting among experi enced aviator opinion leaders: base and squadron commanders. Methods: An an onymous and voluntary survey questionnaire containing background material a nd Likert-scale questions regarding 14 primary through tertiary fatigue pre vention 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. Th e most popular primary prevention initiatives (garnering 87% support) dealt with reservist aviators: 1.) requiring reserve pilots to arrive at the squ adron at least 3 h before night flights to facilitate napping time, and 2.) improving scheduling coordination of those reservists employed as civilian aircrew. The chief (88% support) secondary prevention countermeasure endor sed was to utilize stimulant drugs such as caffeine or amphetamines to sust ain the alertness of fatigued aviators. Leading the list of tertiary preven tion initiatives (75% support) was the suggestion that squadrons debrief th e incidence of aviator fatigue, as well as their success in the area of tim e-management when debriefing high tempo exercises and operational missions. Conclusions: Commanders differentially supported a wide range of fatigue c ountermeasures. Use of stimulant drugs achieved the broadest support. Insti tuting specific measures to facilitate alertness in reservist aviators was also a priority. Surveying the degree of commander support Tor new fatigue prevention initiatives provides the basis for prioritization of scarce reso urces, should improve line cooperation, and provides important experience-p roven feedback for researchers and policy-makers.