Fit for Flight? Inappropriate Presenteeism Among Swedish Commercial Airline Pilots and Its Threats to Flight Safety

ABSTRACT Objective: The purpose of this cross-sectional survey study was to investigate the prevalence of presenteeism, attending work when ill, among Swedish commercial airline pilots and how presenteeism relates to mental health and flight safety. Background: Pilots are regulated to refrain from duty when their mental or physical state could endanger safety. Still, the human factor is the greatest contributor to aviation accidents, and mishaps are attributed to human unfitness (physical or mental state of the operator), suggesting that pilots might engage in presenteeism. Presenteeism and its consequences have been studied across several occupational groups, but until now pilots have been neglected. Method: Data were collected using an online self-report questionnaire (N = 1,133) consisting of items investigating presenteeism, mental health, and self-reported error rates. Results: Results demonstrated that 63% of the pilots exhibited acts of inappropriate presenteeism in the past year. Inappropriate presentee pilots and pilots with poor recovery in terms of feelings of rest, physical and mental tiredness, and work-related worry, were also more likely to report committing 5 or more errors when on flight duty in the past 12 months. This relationship was not mediated by mental health, as shown in previous research. Conclusion: This study indicates that pilots operate in states that could jeopardize flight safety and that current regulations might be insufficient to ensure safe flight operations.