A new study suggests that inappropriate presenteeism — working in spite of being sick, having poor mental health, or feeling fatigued — is fairly common among Swedish commercial airline pilots. The findings appear in The International Journal of Aerospace Psychology.

“Market liberalization has during the last decades created a quest for enhanced effectiveness and competitiveness, leading to increased work demands for employees in the aviation industry,” said study author Filippa Johansson of Karolinska Institutet.

“Pilots are to refrain from flight duty on occasions when their mental or physical state may endanger flight safety. After the Germanwings flight crash, in which the co-pilot deliberately crashed the aircraft into the Alps, several questions were raised regarding the health of commercial pilots and their self-declaration of unfitness. That’s why we decided to investigate pilot health and presenteeism.”

For their study, the researchers surveyed 1,133 people in Sweden who were currently working as a pilot at a commercial airline. Johansson and her colleagues found that 54% of pilots reported flying despite it being legitimate to take sick leave on at least one occasion in the past 12 months.

In addition, 63% percent reported flying on at least one occasion in spite of feeling tired, fatigued, or unfit for other reasons and pilots who engaged in inappropriate presenteeism were more likely to report a history of committing errors in the cockpit.

The researchers also found that pilots with more flight experience were less likely to engage in presenteeism.

“Despite recurrent medical examinations pilots tend to experience anxiety and depressive symptoms as frequently as the general population. Pilots are legally required to stay at home when unfit for flight, however, presenteeism seems to be as prevalent among pilots as among the general population, suggesting that pilots do not always comply with regulations. Our data also show that attending work in unfit states have a negative impact on flight safety,” Johansson told PsyPost.

“We hope that our work will provide information for decision makers within the aviation industry and hopefully be of aid to safety work in airlines and consequently, increase flight safety in Sweden.”

The study — like all research — includes some limitations. It is unclear how well the results generalize to airline pilots in other countries. The study also did not directly address pilots’ motivations for presenteeism.

“We are currently trying to answer the question why pilots attend work when unfit. Being a pilot is special in the sense that classical reasons for sickness presenteeism may not be applicable. Pilots cannot themselves determine their pace of work, they do not have to make up for missed work, and they cannot adapt their work to their current mental or physical state,” Johansson said.

“Preliminary results indicate that safety culture, job insecurity and financial issues can explain why some pilots take off in unfit states. For future studies, we would also like to more carefully look at different sorts of inappropriate and sickness presenteeism to more accurately be able capture and combat reasons for presenteeism.”

The study, “Fit for Flight? Inappropriate Presenteeism Among Swedish Commercial Airline Pilots and Its Threats to Flight Safety“, was authored by Filippa Johansson and Marika Melin.

