Stressors effect mental health of cabin crews

Superior university, Lahore

Muhammad Abdullah Ijaz* Shahbaz Rasool Talha Ajab Shan

Abstract:
The article is covering the relationship of stressors like depression, anxiety, stress,
unemployment and working condition with mental health of the cabin crews. We made this
relationship by using SPSS and made different statistical analysis and decide that these stressors
are affecting mental health of the cabin crews. In the research we found that young cabin crews
are more affected by these stressors because they have serious concerns with their job for
making their future bright and broad. We used cluster method for collecting data and samples.
Covid-19 has made a deep impact on cabin crews and the whole industry and left in a drastic
situation, as it pays negative impact on the working ability of the cabin crews and other
employees. In aviation industry we are working with the lives of passengers and being a cabin
crew you have a serious responsibility because the controls of flight are all under cabin crew’s
authority. A little mistake can change the whole scenario of the industry, because that mistake
costs many lives. The employees who are mentally unhealthy don’t have any space. Also, the
unemployment make the employees mentally disturb and made their efficiency to work down.
The industry is in need of financial help and to regain its old worth and charm which it has in the
fast. Hoping for the better regainment of the industry soon and the individuals who got
unemployed will be employed soon in future.

Keywords: mental health, anxiety, depression, stress, cabin crews, unemployment, working
condition, covid-19.

Introduction:
Flight attendants face unique health problems as part of their job. McNeely and colleagues, for
example, evaluated the health of cabin attendants and discovered much greater sleep disorders,
melancholy, anxiety, and exhaustion than in the general population (McNeely et al., 2014,
2018). Night work, an early start time, lengthy flight hours, extensive time shifts, and biorhythm
disturbance all contribute to fatigue. In the case of domestic flights, a very early start or
extremely late finish of duty, as well as irregularly constructed duty schedules, have been noted
as issues (Ono et al., 1991). Cabin staff on overseas flights experience less stress and weariness
than their national counterparts (MacDonald et al., 2003; Nagda and Koontz, 2003). In general,
irregular working hours caused by shift work and/or night employment might raise the
likelihood of physical and psychological issues (Barton, 1994). Subjective stresses, in addition to

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external stressors, are important (Frese and Zapf, 1988). Following plane accidents, cabin
attendants are more vulnerable to anxiety and post-traumatic stress disorder (Dyregrov et al.,
1992; Marks et al., 1995). Although the great majority of flights are uneventful, up to 37% of
cabin crew experience anxiety before takeoff.Both cognitive and physical overloads, according
to Suvanto and Ilmarinen (1989), represent the beginning of flight-related occupational stress.
According to a Norwegian poll, barely half of flying cabin crew workers were pleased with their
social support

Work-related emotionality is expressed in unique requirements, such as cultural and language

variations between cabin workers and passengers, and emotional tiredness increases with age.
The current study explored the relationship between numerous condition characteristics such as
exhaustion or workload and symptoms of depression, anxiety, and stress in a May 2019 sample.

Because conditions for flight attendants altered substantially as a result of the COVID-19
pandemic, an extra survey was done in April 2020 to study the impact of the crisis on elements
of mental health, including changes in sadness, anxiety, and stress symptoms.

Since the beginning of 2020, the COVID-19 epidemic has spread from China to the rest of the
world. The initial infectious wave in Europe peaked in April. Following a brief respite throughout
the summer, a second wave of considerably greater infection levels descended on the continent
with the arrival of the cold season in late October. According to WHO estimates as of November
15, 2020, approximately 53 million individuals worldwide have been verified to be sick, with
over 1,300,000 deaths. Many governments have instituted curfews, contact prohibitions,
shuttered restaurants, schools, kindergartens, nurseries, borders, and travel restrictions in effort
to contain the virus. Indeed, the economic implications of pandemic containment strategies
vary greatly among businesses. Online commerce and other digital businesses have reaped
significant benefits. The airline sector, on the other hand, has been badly impacted by the
limitations, not only because of legal travel prohibitions but also because of voluntary
restrictions, such as substituting business visits with online meetings.

The financial implications for these firms are severe; several airlines are already bankrupt. In
contrast to other nations, however, larger corporations in Germany have (so far) abstained from
firing employees.

Instead, businesses are turning to tools like "Kurzarbeit" (short-term labour), in which the
Federal Employment Agency (unemployment insurance) compensates employees temporarily
and thereby relieves the firms financially.

Lufthansa, as well as other airlines, have announced 5 months of part-time employment.

Short-term work is defined as a decrease in working hours (down to nil in extreme situations),

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with the accompanying loss of salary partially reimbursed by a state insurance plan (to which
employees and employers have already contributed). However, the short-term labour allowance
is much smaller than the ordinary net salary, and because this is a temporary solution, more
layoffs are possible.

How are flight attendants, the industry's largest staff group, dealing with this crisis? One
possible assumption is that the scenario is seen favorably since adversely perceived working
circumstances and effects like as weariness, jet lag, and physical and mental demands are
reduced. At the same time, kids have lots of spare time and may resume more regular sleeping
patterns. However, this is mitigated by the burden of insufficient childcare (with schools,
kindergartens, and nurseries closing), significant financial losses, the possible fear of contracting
SARS CoV-2 along with a severe course of the disease, concerns about relatives and friends, and
uncertainty about their employment.

Research problem:
The work performance of an employee is affected by many mental stressors like stress
depression, anxiety, working conditions, unemployment etc. these can drastically affect and
destroy a workers working ability. To overcome this situation what should have to be done.

Significance:
The issue is too significant in the aviation industry because as we know covid has affected many
of the airlines airports and others. Because there was no passenger for whom they have to keep
employees in the firm. Many of the airlines got bankrupted and remove their employees. Also
the airline those were working, their employees were in a situation of distress because they
were facing fear of unemployment. Due to this particular fear their working ability goes down
and mental health becomes worse. Due to bad mental health chances of making more and more
mistakes rises up. And a slightest mistake in aviation industry causes not only damage loss of
property, money etc, but it cost precious and innocent lives which are asset in the industry. On
basis of these lives the industry is working. That is why mental health is very significant in the
aviation industry.

Hypothesis:

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 1- Stress has no adverse effect on mental health.
2- Depression has positive impact on mental health
3- Working condition plays positive role in mental health.
4- Unemployment keeps an employee mentally satisfied
5- Anxiety doesn’t affect working ability of an employee.

Research framework:

Stress:
Stress is a serious issue that creates a deep impact on the performance of the cabin crews.
When you are in stress you are unable to work fast and act quickly on certain instructions. Stress
makes you physically unhealthy and disturbs your peace of mind. In aviation industry we want
vigilant and active persons who can work in any kind of conditions. The stress can be happen by
different things and different life scenarios. The one who has to work in the industry must be far
from these stressors. But in fact, many of the cabin crews and other employees had a lot of
stress in the recent times when the industry goes down. And the fear to be unemployed rises in
the cabin crews and other workers.

Depression:

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After you fall in stress that stress leads a person towards depression. A thoughtful mind will get
high level of depression and become annoyed of the scenarios he is facing. This situation leads
him to make mistakes during the work and a little mistake made by the cabin crew leads to the
disaster in aviation and we have seen that in the past many times. So, in light of this a
depressed individual is a humongous threat to the aircraft, airline or even the entire aviation
industry.

Working condition:
Working condition is very important for an employee work performance. In the scenario of
cabin crews it is honestly very important, because a cabin crew travels from one destination to
another. They have to stand all the time, be vigilant and keep the bulls eye on every moment
and action of the passengers and have to keep check and balance to conduct a safe and sound
flight. All these things require a lot of efforts and hardship which ultimately makes a flight crew
tired and fed up of the routine. This tiredness creates a stress and the performance goes down
ultimately.

Unemployment:
The term unemployment is now became a big stressor for the aviation employees in past couple
of years. This issue is benchmarked after the pandemic covid-19, when the entire aviation
industry was undergoing by a huge set back. The whole industry was facing over capacity issue,
in which the available seats were more than the available no of passengers. This means that due
to lockdown the whole world was stuck in their houses a very little amount of people were
travelling around the globe under critical circumstances. So, facing the issue of low passenger
rate the airlines send most of their employees to their home for a long leave and limited their
salary and employee expense. Only a limited amount of worker was left at work who is enough
to deal with a short no of passengers. Also the workers who were working at that time was
mentally upset because the fear of being unemployed at any time. As, we have seen many
airlines got bankrupted many big airlines even got bankrupted and shut their business off. So,
this unemployment fear make the employee stressed depressed and tensed for their jobs and
fear of how they will lead their livings. This fear leads to the mistakes and in aviation a little
mistakes leads to a huge disaster which we have sighted many times during the covid period.

Mental health:
The conclusion of the above discussed points is that they all lead to the disorder in mental
health. Mental health of an aviation worker must be in its full, because they have a huge
responsibility. They are dealing not only with the passengers but they are dealing with the lives.
An aircraft carrying 120 passengers from one place to another, eventually it is not just carrying

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120 passengers on board but 120 souls. So, on this perspective a worker must be in full senses
and vigilant and active. A slightest mistake not just cause damage to the aircraft, building, cargo
or other or make loss in form of money but it cost precious and innocent lives. That is why
mental state of an employee is too important.

Methodology:
In our research we surveyed many employees of different airlines and collect the reviews of
them on how much mental health is important in aviation and for the cabin crews which are our
main target in this research. We use cluster and random method of sampling. In statistics cluster
sampling method means that a large group of people divided in small clusters and then select a
random cluster to collect the sample. We have foresighted male and female both cabin crews of
different age and color creed and mentality. Even we noticed there are different nationals in the
cabin crews of the different airlines.

Statistics procedures:
In statistical procedures we plot the values in SPSS and make different analysis in support of our
research and to check whether the hypotheses are true or not. We make correlation analysis in
contrast of the variables and plot dummy variables for the accuracy in the calculations dummy
variables are the inside factors of the main variables. Also odds ratio were calculated and other
necessary calculations were made in support of the article.

Analysis:
Correlation analysis has been made of the samples that have been collected while surveying.
We expected at the start of this study that the specific stresses of flight attendants would
connect with an accumulation of psychological issues in this group of personnel.

S. No. M SD Depression Anxiety Stress

1. Fear of job 4.27 1.59 0.406** 0.295** 0.360**

loss
2. Existential 4.00 1.66 0.432** 0.356** 0.409**
fears
3. Existential
fears 1.99 1.07 0.080** 0.109** 0.124**
before corona
4. Change in the
personal 2.99 1.03 −0.445** −0.277** −0.393**
situation
5. Change in
personal
situation
after corona 3.77 1.39 −0.164** −0.083** −0.166**

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 Correlation analysis-1

Significant positive relationships exist between depression, anxiety, and stress symptoms and
subjective stressors, such as time pressure and job intensity, exhaustion, the psychological and
physical demands of the flight profile, and the responsibilities of on-call duty. There was a
negative link between the working environment and the capacity to cope effectively with
physical variables such as fluctuating cabin pressure, air conditioning, or noise. Only symptoms
of sadness are associated with monotony, underload, or a lack of professional difficulties,
whereas symptoms of anxiety and stress are associated with overload. The sensation of support
from coworkers and admiration from the supervisor is adversely connected with stress
symptoms, and it is also negatively correlated with depression symptoms. Difficulties speaking
with passengers connect positively with sadness and stress, whereas a good impression of the
duty roster design correlates adversely with depression and stress. There were no correlations
established between the capacity to make rapid choices, the needs for a flawless look,
friendliness, or a perpetual grin, and the frequency of on-board breaks and retreats. Depression
and stress are positively associated with irregular eating habits and negatively associated with
possibilities to take a brief break during a turnaround. Apart from the positive link between
extreme turbulence and stress symptoms, there are no significant relationships with regard to
severe events. For example, emergency landings or death on board had no relationship with
symptoms of depression, anxiety, or stress.

Negative evaluation direction

Time pressure/work intensity 2.77 0.64 0.210* 0.245* 0.329**

Overload 0.90 0.77 0.139 0.238* 0.280**
Underload/monotony 1.89 0.89 0.362** 0.046 0.164
Physical strains 2.82 1.00 0.129 0.199* 0.214*
Fatigue 2.09 0.78 0.483** 0.360** 0.529**
Flight profile (psychol. demands) 1.90 1.03 0.425** 0.309** 0.519**
Flight profile (physical demands) 2.43 1.00 0.374** 0.305** 0.361**
On-call duty 2.84 1.08 0.294** 0.321** 0.454**
Communication with guests 1.11 0.80 0.201* 0.166 0.233*

Correlation analysis-2

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Employees who were still flying and those who had to stay at home indicated notable
disparities. Employees who continued to fly had considerably lower mean values for depression
and stress, although with a less effect strength. On the other hand, coworkers who were still
flying experienced much greater clinical anxiety symptoms.

A comparison of samples before and after the COVID-19 pandemic revealed a substantial group
difference in the categories anxiety, sadness, and stress.

S. No (0) Yes (1) Depression Anxiety Stress

No
1. Severe turbulences 40 65 −0.004 0.178 0.205*
2. Emergency landings 90 15 0.021 −0.060 −0.002
3. Death on board 84 21 −0.182 −0.012 −0.038
4. Contact with time zone 41 64 0.059 0.074 0.160
differences

Correlation analysis-3

Still Non-flyingb
flyinga
M SD M SD T d

Depression 5.66 4.95 6.61 4.93 −2.17* 0.19

Anxiety 2.86 3.67 2.70 3.20 0.50 0.05
Stress 6.12 4.91 7.01 4.97 −2.03* 0.18
Clinically relevant Incidence % Incidence % χ2 Odds
symptoms Ratioc
Depression 25/146 17.1 230/972 23.7 3.08 1.50
Anxiety 30/146 20.5 130/972 13.4 5.33* 0.60
Stress 27/146 18.5 238/972 24.5 2.52 1.43

Correlation analysis-4

May April 2020b

2019a

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 M SD M SD T d

Depression 3.58 4.24 6.49 4.94 −6.62*** 0.63

Anxiety 1.96 2.49 2.72 3.26 −2.90** 0.26
Stress 4.62 3.73 6.90 4.97 −5.79*** 0.52
Clinically relevant Incidence % Incidence % χ2 Odds
symptoms Ratioc
Depression 8/105 7.6 256/1119 22.9 13.21*** 3.60
Anxiety 6/105 5.7 161/1119 14.4 6.13* 2.77
Stress 8/105 7.6 266/1119 23.8 14.41*** 3.78

Correlation analysis-5

Discussion:
The findings demonstrate that, as a result of the COVID-19 epidemic, the mental health of
aircraft cabin crews has worsened dramatically, reaching a level of clinically noticeable
individuals previously observed exclusively among outpatients in psychotherapy clinics (Nilges
and Essau, 2015). Those who continued to travel throughout the crisis experienced much more
clinically significant anxiety symptoms. A fear of SARS-CoV2 infection is a feasible explanation.
The words coronaphobia (Asmundson and Taylor,2020) and COVID-19 anxiety (Elhai et al., 2020)
have been coined to describe this phobia. In Japan, there is a link between the quantity of
anti-COVID-19 actions done and employee anxieties and concerns about the disease.

Despite the fact that flight attendants' routine jobs include a variety of potentially stressful
aspects, the frequencies of clinical abnormalities are comparable to the healthy reference
sample (Nilges and Essau, 2015). Good personnel selection, which includes, for example, stress
resistance as a selection factor, can also explain the overall low level of depression, anxiety, and
stress. (Herpertz et al., 2016). Self-selection may also play a part, both during job application
and in determining whether or not to continue in the employment. Younger persons were more
impacted by symptoms of sadness, anxiety, and stress than older adults. One possible
explanation is that younger people have a longer professional career ahead of them and hence
regard the implications of losing their work to be more significant.

Work's protective aspects, for example, are considered in Jahoda's concept of latent deprivation
(Jahoda, 1981). Work has five key psychological roles, according to this model: it controls time,
imparts status, produces purpose, facilitates social relationships, and integrates into societal
goals. Unemployment can harm mental health by removing these hidden functions of work. The
results revealed not only the protective nature of job activity, but also that it compensates for
various work-related stresses. Starting points for workplace health and safety might include, for
example, allowing for turnaround breaks and encouraging regular eating habits. Another

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purpose may be to increase managers' awareness of employee support and gratitude.

The current crisis necessitates financial assistance for businesses and individuals via
governmental institutions (Holtemöller et al., 2020). Furthermore, occupational health
protection, career identity, and persuasive occupational safety ideas to avoid infection appear to
be of the utmost importance in combating long-term psychological disorders in the workforce
and society. During this crisis, healthcare systems emphasized COVID-19 treatment in an
unprecedented degree.

According to the findings of this study, healthcare institutions must also prepare for a surge in
mental illness, and society must immediately take significant preventative efforts (see also
Holmes et al., 2020).

Conclusion:
After all the analysis and detailed discussion it is proved that the depression, stress, anxiety,
unemployment and stress are affecting mental health and destroy the performances of the
cabin crews and other employees as well. The hypothesis for analysis we made are proved
wrong and instead of that the results are in favor of the variables that they are the performance
deficient stressors. Also we saw that the values before covid and after covid are different. And it
is proved that covid-19 leaves a lasting impact on the industry and the mental health of the
employees. Also it is seen that younger crew members are more affected by these stressors,
which is a different talk to do. Hoping for the better regainment of the industry soon and the
individuals who got unemployed will be employed soon in future.

References:
Antony, M. M., Bieling, P. J., Cox, B. J., Enns, M. W., and Swinson, R. P. (1998). Psychometric properties
of the 42-item and 21-item versions of the depression anxiety stress scales in clinical groups and a
community sample. Psychol. Assess. 10:176. doi: 10.1037/1040-3590.10.2.176

Asmundson, G. J. G., and Taylor,S. (2020). Coronaphobia: fear and the 2019- nCoV outbreak. J. Anxiety
Disord. 70:102196. doi: 10.1016/j.janxdis.2020.102196

Barton, J. (1994). Choosing to work at night: a moderating influence on individual tolerance to shift
work. J. Appl. Psychol. 79, 449–454. doi: 10.1037/0021-9010.79.3.449

Cerami, C., Santi, G. C., Galandra, C., Dodich, A., Cappa, S. F., Vecchi, T., et al. (2020). Covid-19 outbreak
in Italy: are we ready for the psychosocial and the economic crisis? Baseline findings from the PsyCovid

10 | Page
study.Front. Psychiatry 11:556. doi: 10.3389/fpsyt.2020.00556

McNeely, E., Gale, S., Tager, I., Kincl, L., Bradley, J., Coull, B., et al. (2014). The self-reported health of
U.S. flight attendants compared to the general population. Environ. Health 13:13. doi:
10.1186/1476-069X-13-13

McNeely, E., Mordukhovich, I., Staffa, S., Tideman, S., Gale, S., and Coull, B. (2018). Cancer prevalence
among flight attendants compared to the general population. Environ. Health 17:49. doi:
10.1186/s12940-018-0396-8

Milner, A., Page, A., and LaMontagne, A. D. (2014). Cause and effect in studies on unemployment,
mental health and suicide: a meta-analytic and conceptual review. Psychol. Med. 44, 909–917. doi:
10.1017/S0033291713001621

Nagda, N. L., and Koontz, M. D. (2003). Review of studies on flight attendant health and comfort in
airliner cabins. Aviat. Space Environ. Med. 74, 101–109.

Nilges, P., and Essau, C. (2015). Depression, anxiety and stress scales: DASS--A screening procedure not
only for pain patients. Schmerz 29, 649–657. doi: 10.1007/s00482-015-0019-z

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