The Number of Sectors and Other Risk Factors Related to Fatigue Among Shorthaul Commercial Pilots in Indonesia

Background: Fatigue could impair cognitive function in pilots which may lead to accidents in short-haul flight. Theaim of this study was to identify the risk factors related to fatigue among short-haul commercial pilots in Indonesia.Methods: A cross-sectional study with purposive sampling was conducted among Boeing 737 seriestyped-rating pilots taking medical examination at the Civil Aviation Medical Center, Jakarta from May5-26, 2014. Fatigue was measured with Self-Reporting Questionnaire, Fatigue Severity Scale (FSS). Datawere collected using anonymous self-reporting questionnaire on demographics, workload, sleep restriction(Epworth Sleepiness Scale-ESS), personal factors, and managerial support. Linear regression was used toidentify dominant risk factors related to fatigue.Results: During data collection, 785 pilots were taking medical examination, 382 pilots were willing toparticipate, and 239 pilots met the criteria. The FSS mean was 4.66 ± 1.202. The number of sectors in 24hours, flight times of unplanned flights in 30 days, and sleep restriction were dominant factors of fatigue.Each additional sector increased FSS by 0.371 points [regression coefficient (β) = 0.371; P = 0.000].Furthermore, each additional ESS, increased FSS by 0.043 points (β = 0.043; P = 0.008), while eachadditional unplanned flights increased FSS by 0.033 points (β = 0.033; P = 0.000).Conclusions: Additional number of sectors in 24 hours, additional unplanned flight times within 30 days,and sleep restriction increased the risk of fatigue among short-haul commercial pilots in Indonesia. (HealthScience Journal of Indonesia 2015;6:69-75

The Effect of Workload and Other Risk Factors of Metabolic Syndrome Among Short-haul Commercial Pilots in Indonesia

Background: Metabolic syndrome (MS) could cause sudden incapacitation among pilots in Indonesia.The aim of this study was to identify risk factors of MS among short-haul commercial pilots in Indonesia.Methods: A cross-sectional study with purposive sampling was conducted among commercial pilotstaking medical examination at the Civil Aviation Medical Center, Jakarta from July 27-August 30th,2014. Metabolic syndrome was assessed according to the National Cholesterol Education Program AdultTreatment panel III criteria and criteria. Risk factors were collected using anonymous self-reportingquestionnaire. The laboratory data were extracted from medical records. Cox regression was used toidentify dominant risk factors of MS.Results: During data collection, 2135 pilots taking medical examination, Total male Asian pilots metthe inclusion criteria was 864 pilots. Prevalence of MS was 18.28%. Compared to 20-35 year-old group,subjects aged 56-65 years-old had 88% higher risk for MS [adjusted relative risk (RRa) = 1.88; P = 0.019].In term of number of sectors in the last 24 hours, compared to 0-3 sectors, subjects who had 6-7 sectors inthe last 24 hours had 66% higher risk for MS (RRa = 1.66; P = 0.033), while subjects who had 8 or moresectors in 24 hours had 82% more risk for MS (RRa = 1.82; P = 0.072).Conclusions: The pilot aged 56-65 years-old, who had 6 or more sectors in the last 24 hours, had higherrisk for metabolic syndrome among short-haul commercial pilots in Indonesia. (Health Science Journalof Indonesia 2015;6:81-6

Mutations in PPCS, encoding phosphopantothenoylcysteine synthetase, cause autosomal-recessive dilated cardiomyopathy.

Coenzyme A (CoA) is an essential metabolic cofactor used by around 4% of cellular enzymes. Its role is to carry and transfer acetyl and acyl groups to other molecules. Cells can synthesize CoA de novo from vitamin B5 (pantothenate) through five consecutive enzymatic steps. Phosphopantothenoylcysteine synthetase (PPCS) catalyzes the second step of the pathway during which phosphopantothenate reacts with ATP and cysteine to form phosphopantothenoylcysteine. Inborn errors of CoA biosynthesis have been implicated in neurodegeneration with brain iron accumulation (NBIA), a group of rare neurological disorders characterized by accumulation of iron in the basal ganglia and progressive neurodegeneration. Exome sequencing in five individuals from two unrelated families presenting with dilated cardiomyopathy revealed biallelic mutations in PPCS, linking CoA synthesis with a cardiac phenotype. Studies in yeast and fruit flies confirmed the pathogenicity of identified mutations. Biochemical analysis revealed a decrease in CoA levels in fibroblasts of all affected individuals. CoA biosynthesis can occur with pantethine as a source independent from PPCS, suggesting pantethine as targeted treatment for the affected individuals still alive