ATS.OR.310 Stress

EXPLANATION OF THE FUNDAMENTALS OF STRESS

(a)Introduction

(1)The job of an air traffic controller is considered to be responsible and demanding, and at times can lead to the experience of high levels of stress. The combination of skills and knowledge required to complete air traffic control tasks is wide. Visual spatial skills, perception, information processing, image and pattern recognition, prioritising, logical problem-solving, application of rules and procedures and decision-making form core skills to which we can add interpersonal communication, teamwork and technical vocabulary usage.

(2)Air traffic control also requires to constantly adapt to an ever-changing traffic picture and work environment within restricted time constraints. This has the potential to lead to considerable work pressure. In contrast, there may be times when traffic flows are low and controllers experience relatively low levels of activity. For some controllers, this may bring its own kind of stress due to the increased efforts required to maintain vigilance under light traffic load.

(3)Thus, the work of an air traffic controller has the potential to induce high levels of stress; however, the stress experienced by controllers is always unique to the individual and their interaction with their environment.

(4)‘Stress’ is a term that is in common use within everyday language and can mean different things to different people depending on the context in which it is used. In lay terms, stress is often used to describe an external pressure experienced by an individual whilst at the same time encompassing the subjective experience of this pressure. Usually the term is used in a negative way. In this sense, the lay use of the term ‘stress’ encompasses both the cause and the effect, and this can lead to confusion as to its meaning.

(b)Technical definitions of stress

(1)Even in its technical use, the word ‘stress’ is sometimes used when the term ‘stressor’ (or pressure) would be more appropriate, referring to the cause of a stress experience. Stressors can be internal (cognitive or physical) or external (environmental) to the individual and may be defined as any activity, event or other stimulus that causes the individual to experience stress.

(2)It is helpful to clarify the way the term ‘stress’ and other technical terms are used. For the purposes of this guidance material, stress is defined following the Transactional Model of Stress. This views stress as the outcomes experienced by an individual when faced with a potentially stressful event. The experience of the event as negatively stressful (distress), neutral or positive (eustress) is based on the individual’s perception of their ability to manage the event. Under this definition, stress is a manifestation in the individual of usually negative effects, which can lead to a decrease in performance and negative health effects.

(3)A stressor can also act to improve performance when it is a stimulus to increase arousal and improves the outputs of an individual in the short to medium term. Too much arousal paradoxically leads to an inverse effect and subsequent detriment in performance.

(4)Acute stress is, as its name suggests, episodic and occurring for short periods of time. In most cases, the cause of the stress is eliminated by the air traffic controller taking action to manage the situation leading to stress. High levels of acute stress may lead to hyper-arousal and may leave an air traffic controller feeling exhausted. It is important to identify work situations that lead to this acute stress and manage this within the work schedule.

(5)Chronic stress differs from acute stress only in that it is ongoing and even low levels of continuous chronic stress can lead to performance degradation and serious health implications, if it is not addressed. Chronic stress is insidious in its nature and a sufferer may become so accustomed to the sensations that they are unaware of the long-term negative effects. Chronic stress commonly leads to a sense of inability to cope.

(6)Both acute and chronic stresses have the potential to lead individuals into hyper-aroused states which may result in panic where task and skill performance, planning, reasoning and judgement are significantly impaired. In such instances, a well-practised but incorrect action, for that particular circumstance, may be performed when an alternative and more appropriate response is required.

(7)Chronic stress may result in a condition known as burnout. Burnout is generally identified by the following characteristics: disaffection with the job leading to a decrease in motivation with an associated decrease, perceived or otherwise, in performance.

(c)Sources of stress Broadly speaking, the stress experienced by an air traffic controller at work is a function of their underlying background levels of stress, related to lifestyle, health and well-being, personality, organisational/work environment, levels of satisfaction with life generally, and the acute stress imposed by and operational conditions at any given time. There are three major sources of stress: environmental, work-related, and personal.

(1)Environmental/physical stressors

(i)Physical stressors are underlying conditions that can either be internal to the body (e.g. pain, hunger, lack of sleep, exhaustion), or external environmental factors (e.g. noise pollution, overcrowding, excess heat). The common factor among all of these stressors is that they all create a physically uncomfortable environment that can cause stress. Stress is not solely dependent on the intensity of a stimulus, but also on the duration of exposure. For example, a low-pitched but persistent noise can cause as much stress as a sudden loud noise.

(ii)In the air traffic control room, some common environmental/physical stressors could be:

(A)uncomfortable temperature;

(B)cramped workspace;

(C)air quality;

(D)lighting conditions; and

(E)intrusive noise or vibration.

(2)Work-related stressors

(i)Stress in the workplace can come from a variety of sources besides physical stimuli. Some of these include:

(A)continuing high levels of workload near or above the maximum traffic handling capacity of an air traffic controller;

(B)a heterogeneous traffic mix where aircraft have varying levels of equipment and considerable variability in pilot skills;

(C)unsuitable or unreliable equipment;

(D)inappropriate, vague procedures;

(E)complex equipment which is insufficiently understood or mistrusted;

(F)supervision of trainees or less experienced colleagues;

(G)workload and task breakdown not being matched to the level of technical skill of the controller, lack of support or too much support (interference);

(H)role ambiguity, where it is unclear where the responsibilities lie;

(I)interpersonal conflict with colleagues, other professionals;

(J)poor management relations (social dialogue), working conditions, e.g. rostering; and

(K)unusual or emergency situations.

(ii)Incidents, including emergencies and accidents, that lead controllers to feel that they are not coping may lead to the experience of critical incident stress; this, in turn, may impair performance in varying degrees.

(3)Personal stressors

(i)Personal stressors include the range of events that occur throughout people’s lives but external to the workplace. The belief that such stressors can be left at home, however, is a myth, and these personal stressors accompany air traffic controllers to work every day.

(ii)Personal issues such as health, personal life, living situation and major life events (deaths, births, marriages, and moving house) add to the background level of stress that individuals have to cope with. Where these are excessive, they can interfere with work due to the distraction they cause and the mental effort they require to resolve them.

(iii)Stress is also considered to have a contagious quality, which happens when a stressed person or stressed persons create stressful situations for those around them.

(d)Signs of stress in the individual Signs of stress are many and varied. Some of the most commonly observed are shown below:

(1)Physiological

(i)Cardiovascular: increased pulse rate, elevated blood pressure, chest pains;

(ii)Respiratory: shortness of breath, tightness of chest, hyperventilation, dizziness;

(iii)Gastrointestinal: loss of appetite, gas pain, abdominal cramps, indigestion, diarrhoea, nausea;

(iv)Sweaty palms;

(v)Aching neck, jaw and back muscles;

(vi)Trembling;

(vii)Sleep disturbance, tiredness;

(viii)Itching;

(ix)Getting easily startled;

(x)Susceptibility to minor illnesses; and

(xi)Other: headaches, muscular tension, general weakness, psychosomatic symptoms.

(2)Psychological

(i)Emotional: anger, guilt, mood swings, low self-esteem, depression and anxiety;

(ii)Concentration problems, forgetfulness;

(iii)Pessimism;

(iv)Difficulty in making decisions;

(v)Irritability;

(vi)Loss of interest;

(vii)Loss of self-control; and

(viii)Loss of confidence.

(3)Behavioural

(i)Self-medication, drugs or alcohol;

(ii)Excess fatigue;

(iii)Sleep disruption;

(iv)Social withdrawal;

(v)Absenteeism;

(vi)Staff turnover rates; and

(vii)Job performance decrements.

(e)Impact of stress on air traffic controllers’ performance of air traffic control tasks Any source of stress has the potential to create unique subjective experiences in different individuals, and these may be positive or negative experiences or something in between.

(f)Negative experiences of stress There is a number of ways in which stress experienced by air traffic controllers can be manifested in the performance of air traffic control tasks. Some of these are listed in Table 1, but, in general terms, performance of tasks decreases due to the detrimental effects that high levels of stress can have on perception, awareness, decision-making and judgement. In the longer term, health and well-being may also be compromised, leading to decreased performance of air traffic controllers. Table 1 below shows the effects on air traffic controller performance which can be linked to stress and which can potentially have very significant implications for the safety performance of an operation.

Table 1: Effects of stress on physical and mental performance of air traffic control tasks

(g)Mitigation of stress in the individual and the organisation Air traffic control service providers have a duty to take care of their employees and the customers of their services. They should aim at mitigating the negative effects of stress. This is best achieved by ensuring that a range of preventative measures as well as countermeasures are in place. These include:

(1)adoption of a stress policy and/or a critical incident stress management policy within the organisation;

(2)completion of regular risk assessment of sources of occupational stress and its effects on individuals and operations;

(3)employee stress level monitoring;

(4)adoption of stress intervention/mitigation/prevention practices and, where the organisation identifies a source of stress, use of a stress team/committee;

(5)stress management training for all levels of employees;

(6)education and prevention programmes on stress; and

(7)staff support mechanisms (e.g. peer counselling, professional support from health practitioners, critical incident stress management (CISM) programmes);

(8)adequate rostering allowing time to evacuate stress; and

(9)promotion of sports or relaxation activities.

STRESS MANAGEMENT POLICY

(a)The air traffic controllers’ stress management policy should:

(1)declare the commitment to proactively and systematically monitor and manage stress, and describe the expected benefits for the safety of operations;

(2)be signed by the accountable manager;

(3)reflect organisational commitments regarding the implementation of a critical incident stress management programme;

(4)be communicated, with visible endorsement, throughout the air traffic control service provider;

(5)include the commitment to:

(i)provide appropriate resources;

(ii)consider the best practices;

(iii)enforce stress management programme(s) as a responsibility of managers, staff involved in stress management and air traffic controllers;

(6)be periodically reviewed to ensure it remains relevant and appropriate.

(b)In accordance with the policy in point (a), the air traffic control service provider should establish and implement:

(1)procedures for critical incident stress management;

(2)principles and procedures to enable stress reporting;

(3)principles and procedures for occurrence investigation and analysis to consider stress as contributing factor; and

(4)method(s) for the identification and management of the effect of air traffic controllers’ stress on the safety of operations.

CRITICAL INCIDENT STRESS MANAGEMENT The purpose of critical incident stress management (CISM) programmes is to prepare an organisation for the potential aftermath of an incident. These programmes come in a number of different forms, but have the added benefit of providing education on the effects of stress, how stress affects performance and stress management, even when the incident is relatively minor and perhaps personal to the individual. Guidance for the implementation of a CISM programme may be found in the EUROCONTROL document: ‘Human Factors — Critical Incident Stress Management: User Implementation Guidelines’, edition 2.0 of 24 October 2008.

INFORMATION AND EDUCATION PROGRAMMES Scientific material proposed as guidance for information and education programmes on stress may be found in the EUROCONTROL document ‘Human Factors Module — Stress’, edition 1.0 of 15 March 1996.