If being concerned about the mechanical status of an airplane, the credentials of the Pilots, bad weather, or running out of coffee at 35,000 feet aren’t enough to freak you out before your next flight, lucky for you I have another worry to add to your list: extremely ill pilots operating the aircraft and sick flight attendants ensuring your safety in the cabin (“ill”, i.e. physical and/or mental illnesses).

Flying when ill is a safety risk

During our fairly extensive training process, we as flight attendants are repeatedly advised not to fly when ill (as are pilots).

Of course, this seems logical, as flying ill basically boils down to being a safety issue for all concerned. I don’t want to infect my passengers (who could then potentially infect countless others) as I serve them food and beverages, I don’t want to pass out during a flight, and I sure as h*ll don’t want a pilot with a 102-degree fever flying a plane that I am in. I may be going out on a limb here to assume as much, but I’m guessing that you, the passenger, probably feel the same way.

So you say no biggie, it’s an easy fix, right? Just call off! Well, not so fast - we (the entire flight crew) are actually penalized for calling off when ill. I am sure any prudent person reading this is thinking to themselves, “but wait, didn’t you just tell us that the airlines advise you not to fly while sick?” Yes, yes I did.

Hence the dichotomy.

Pilots penalized for staying home sick

The overall message is one of both confusion and conflict. On the one hand, you are advised by your airline to stay home when sick (yes, even for a cold), while on the other you are disciplined for doing so. This discipline of which I speak being “up to and including termination.” At some airlines, if you call in sick as few as seven times within a 12-month period, you will be terminated.

Oh great, yet another added stressor for those of us with an already massive responsibility on our shoulders, i.e., passengers lives, multi-million dollar aircraft, etc. You get the idea.

It is also extremely important to point out that a valid excuse from your physician or treating hospital (or both), is of no importance to the airline.

You could be flying and call off mid-trip with a massive headache that turns out to be a brain tumor, yet you will still be disciplined. Unfortunately, the example mentioned actually happened at one American airline. Twice.

Mauled by dog - scared of losing job

I personally know a flight attendant who while walking to her car to drive to work was mauled by a runaway dog. She was so frightened of calling off that she continued on and showed up for her trip, complete with a large laceration to her arm through three layers of clothing and she still has the scar to show for it. There were also injuries to her neck and head. After the day’s flights, our captain took the flight attendant to the emergency room where she was treated.

When the flight attendant advised her supervisor of what had occurred, the response was “Oh, so you’re walking around with a torn coat?” (Being in a compliant uniform is paramount in this business). The flight attendant did not call off and worked the entire 4-day trip.

So please keep in mind that when my colleagues and I call off sick with a doctor’s excuse we are still penalized and disciplined. It is incredibly saddening that CEOs are exploiting the fact that their employees are afraid of the current state of our economy and the difficulty in obtaining a different job. I don’t think I need to quote unemployment rates to you. I suspect that I am not alone in knowing people who are unemployed or underemployed at the moment who are struggling to get by.

What are the regulations?


"A. Responsibility of Operators and Flight crew Members. Title 14 CFR part 61, § 61.53 and 14 CFR part 63, § 63.19 preclude required flight crew members from flight duty while they have a known medical or physical deficiency. These sections rely solely on the ability of flight crew members to honestly determine their medical fitness. It is incumbent on individual airmen to be certain that they have no illness or physical impairment that would affect their medical fitness for flight. The NTSB believes that air carrier operators should share the responsibility for verifying flight crew members medical fitness for flight duty.

However, it is not always easy for operators to determine the extent of a crewmember’s medical fitness. In order to maintain the highest level of safety, required flightcrew members must not fly under conditions that would make them unable to meet the requirements for their current medical certificate. This decision should not be influenced by fear of company reprisals."

"B. POI Responsibility. POIs [principal operations inspectors] should encourage their assigned air carriers to have established sick leave policies and procedures, especially those concerning the release of flightcrew members from duty when they develop sudden temporary illnesses, such as colds, flu, or fevers. These policies and procedures should not discourage flightcrew members from taking sick leave when they are ill."

Pilots also have an “I’m Safe” checklist that is to be performed before they even sit behind the controls of any aircraft.

“I’m Safe” is a mnemonic used by pilots to make sure they are fit to fly and is interpreted as [the following definitions have been taken directly from the FAA Risk Management Handbook FAA-H-8083-2]:

  • Illness. Am I sick? Illness is an obvious pilot risk.
  • Medication. Am I taking any medicines that might affect my judgment or make me drowsy?
  • Stress. Am I under psychological pressure from the job? Do I have money, health, or family problems? Stress causes concentration and performance problems.
  • Alcohol. Have I been drinking within 8 hours? Within 24 hours? As little as one ounce of liquor, one bottle of beer, or four ounces of wine can impair flying skills. Alcohol also renders a pilot more susceptible to disorientation and hypoxia.
  • Fatigue. Am I tired and not adequately rested? Fatigue continues to be one of the most insidious hazards to flight safety, as it may not be apparent to a pilot until serious errors are made.
  • Emotion. Have I experienced any emotionally upsetting event?

So not only are you as a crewmember fighting the symptoms of your illness, but you are also fighting your company regarding its attendance policy.

While flying you are experiencing stress, worrying about how you will be disciplined if you call off sick or fatigued. To me, it seems that every item (except for alcohol) on the IMSAFE checklist is affected when a pilot is ill.

The pilot's perspective

I spoke with a commercial airline pilot about these issues. Upon the condition that his identity remains anonymous, he had the following to share regarding fatigue.

"Despite the many multi-faceted studies and research done on the issue of fatigue, it remains a complicated subject and will probably continue to receive meticulous scrutiny in the future. The FAA is trying to tackle some of the long-standing issues of fatigue with new scientific research, and a number of airlines in the United States have adapted a fatigue risk management program to help mitigate some of the concerns expressed by crewmembers and pilot unions.

Although these programs seem to be a step in the right direction, there are still some legitimate concerns that have yet to be addressed."

The pilot went on to say, "One such concern is that of alternating work periods. The current system allows for duty periods to be fairly liberal and unbalanced, as long as the minimum rest requirements have been complied with. For example, a pilot may start a four-day trip with a very early morning report time for the first two days. Then, the following two days may have report times later in the afternoon, finishing the work day fairly late into the evening. In the span of this four-day trip, the pilot has had to shift from an early morning work period to a late night work period.

This is undoubtedly not ideal for the body and to suddenly alter the body’s circadian rhythm seems to be conducive to fatigue. However, this particular example is a very common scheduling practice in the airlines today, and one of many different scenarios that only contribute to the ever-evolving field of fatigue management."

"Only time will tell if the new proposed regulations will help crewmembers with fatigue management, but one thing is for certain: an effective fatigue policy must be non-punitive in nature, and pilots must have the freedom to determine their own condition to perform flying duties without any threat of an administrative action."

I have added this pilot’s concerns because illness leads to fatigue, fatigue leads to illness, and both can ultimately cause devastating results.

It is also important to understand that due to the nature of our profession, pilots, flight attendants, and others who work in the Aviation industry are more susceptible to contracting an illness. We are constantly exposed to coughs, sneezes, and multiple airborne illnesses in cabins with recirculated air. In addition, as referenced by the pilot in the quote above, due to the nature of our business, we experience inconsistent sleeping patterns, which are often exacerbated by schedules that require us to fly between different time zones.

Drug and treatment limitations for air crew

Pilots and flight attendants are bound by the same attendance policies as those in other industries. However, what makes this more of an issue for those of us in aviation is that due to federal regulations, we are unable to take medications such as Sudafed or DayQuil or most of the other over-the-counter standards that people rely on (the list of what we cannot take before or during a flight includes many OTC and prescription meds and is quite extensive).

This is a safety issue for us and for you (remember the warning on the package that says not to operate heavy machinery?) So while John Q. Public can pop some pills to help him get through his workday, flight attendants and pilots are legally prevented from doing so.

As far as the typical “you chose this” retort that I expect to hear, yes, I did indeed sign up for this job. And I enjoy being a flight attendant. Wanting to shine a light on the risks to the public, wanting safer working conditions, wanting a fair, livable wage has nothing to do with whether or not I like my job. If no one speaks out, nothing will change. The things I talk about (some will say complain or even b*tch about here) are often public safety issues. I’m concerned about myself, my family, my coworkers, and my passengers.

As a side note here, if you can find for me even one person who can honestly say that they have zero complaints about their job, working conditions or environment, then please have them pass me a big ol’ pitcher of that Kool-Aid they’ve been drinking.

It’s also important to keep in mind that when I signed up for this gig, I was unaware that I would be exposed to such working conditions. I was unaware that I would be fighting for a fair livable wage (my first officer friends and I are eligible for food stamps). I was unaware of the impending recession. I was also unaware that my company would intentionally stall contract negotiations.

Again, speaking out in order to remedy these issues does not mean I need to leave my profession. Just because I signed up for the job willingly does not mean I have to sit back and silently allow my safety and the safety of the flying public to be at risk.

*Disclaimer: This article is not representative of any specific airline, but a combination of unnamed airlines (many which are regionals) located within the United States*