Related articles in KJASEM
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Editorial2023-09-30
편집자 주: 33권 3호
Editorial for Vol. 33, No. 3
Korean J Aerosp Environ Med 2023; 33(3): 63-64 https://doi.org/10.46246/KJAsEM.230020Abstract : This issue of Volume 33, Issue 3 contains 6 papers, 4 original and 2 review articles. The first paper analyzes communication errors between domestic air traffic controllers and pilots and highlights the importance of adhering to the International Civil Aviation Organization standard language. The second paper analyzes trends in bacterial dysentery outbreaks in South Korea and Japan from 2016 to 2020, highlighting the need for robust information systems. The third paper analyzes human papillomavirus vaccination trends and shows a gradual recovery in vaccination rates after the COVID-19 pandemic. The fourth paper analyzes 24 years of trends in aviation medical examinations, highlighting the impact of the COVID-19 pandemic and the increase in the proportion of female pilots. The fifth paper explores the potential applications of blockchain technology in the aviation industry, presenting several use cases. The final paper analyzes medical error cases using the SHELL model and highlights the systemic problems of medical institutions in Korea. The journal covers a wide range of topics related to aerospace and human factors, and each paper presents important issues and suggestions for improvement in the field.
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Original Article2024-03-31
Air Traffic Control Threats to Pilots through Line Operations Safety Audits
Korean J Aerosp Environ Med 2024; 34(1): 19-22 https://doi.org/10.46246/KJAsEM.240005Abstract : Purpose: The purpose of this study is to understand the air traffic control (ATC) threats that cause airline pilots to commit errors during normal operations by identifying the prevalence of ATC threats to reduce ATC communication errors for safe flights. This study deals with ATC communication threats effect on the human performance of pilots through LOSA (line operations safety audit) implemented by Airlines. Methods: This study deals with ATC communication threats effect on the human performance of pilots through LOSA implemented by two domestic Airlines. Results: The prevalence of ATC threats shows that there are 60% of flights with at least one ATC-related threat. The frequent ATC threats have been identified as difficulties in understanding controller accents, changes of the runway, errors by ATC controllers, difficult clearance of altitude change and multiple clearances in one call. The most prevailing ATC threats occurred during the Descend, Approach & Land phase of the flight. Conclusion: In order to prevent accidents related with ATC and improve threats and human errors in the actual environment of pilots, it is necessary to identify and analyze the actual threats and errors in the cockpit regarding ATC. It is required to improve the management of ATC threats proactively. According to LOSA result, ATC threats are a frequent threat to pilots, and the most frequent type of ATC for pilots is difficult Accent or language to understand controller. These findings could be trained in the simulators and cockpit in a similar environment and workload as in actual flight for effective countermeasures.
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Original Article2024-06-30
한국군 공중근무자의 악성 종양 관련 비행적성자문 결과 분석
Analysis of Aeromedical Consultation Related to Malignant Tumor of Korean Military Flight Crews
Korean J Aerosp Environ Med 2024; 34(2): 40-43 https://doi.org/10.46246/KJAsEM.240014Abstract : Purpose: The objective of this study was to assess the frequency and management protocols for malignant tumors among cases referred for aeromedical consultation. Methods: The research analyzed data collected from aeromedical consultations conducted between January 2014 and December 2022. Parameters examined included demographic information such as sex, age, flight crew classification, and diagnosis. Results: Out of the cases reviewed, 31 patients were diagnosed with malignant tumors, with an average age at diagnosis of 38.5 years, and a male predominance of 26 cases. The most commonly diagnosed malignancies were thyroid cancer, lung cancer, kidney cancer, stomach cancer, and colon cancer. During the initial aeromedical consultation, 22 cases were temporarily grounded while 8 received waivers. Conclusion: Given the potential rise in malignant tumor incidence among flight crews due to advancements in medical technology facilitating early detection, it is imperative to emphasize regular check-ups and carefully evaluate aeromedical suitability for flying.
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Most Articles
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Original Article2023-06-30
비행훈련 시 학생조종사 인적요인 영향에 대하여
The Influence of Human Factors in Flight Training
Abstract : Purpose: Most aviation accidents are caused by human factors, and in recent years in Korea, human factors have been identified as the cause of 70% of aviation accidents. Human factors that influence pilots in the aviation field are closely linked to judgment ability and are crucial factors directly impacting flight proficiency. Methods: To explore the human factors that may affect student pilots during flight training, a survey was conducted among flight instructors holding pilot certificates. Results: The results aim not only to identify the human factors that can influence flight performance during training but also to establish a direction for safety by addressing the human factors related to student pilots, with the goal of maintaining safety. Conclusion: Understanding the human factors that affect student pilots, who will be responsible for transporting hundreds of passengers in the future, is essential for cultivating safety knowledge and risk management skills, making it a highly important matter for accident prevention.
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Original Article2023-03-31
항공학과 학생들의 MBTI 성격 유형별 조직몰입 및 팀워크 역량 차이분석
Analyzing the Differences in Organizational Commitment and Teamwork Competence by MBTI Personality Type of Aviation Department Students
Abstract : Purpose: For students who have already decided on their career path by entering the aviation departments, this study aims to analyze organizational commitment and teamwork relationships using the Myers-Briggs Type Indicator (MBTI) personality type as a tool. Methods: In order to investigate the career choices of aviation workers according to MBTI personality types, a survey was conducted targeting enrolled in and graduating from the aviation departments, and organizational commitment and teawork were analyzed using SPSS WIN 21.0. Results: Sening, Feeling, and Perceiving were mainly found in students who chose cabin crew as their career, whereas students in department of flight crew and aviation maintenance showed high level in Instuition, Thinkg, and Juding. As a result of the analysis, the MBTI type for each career path of aviation students was mainly ENTP for flight crew students, ESFP for cabin crew students, and INTP for aviation maintenance students. Conclusion: Even if students make their choice based on advice, subjective and objective judgments in choosing a career path, there are cases in which the chosen job does not suit them. Therefore, it is hoped that various indicators such as the MBTI will be used to help studnes choose their career path.
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Case Report2023-12-31
Deterioration and Recurrence in Flight Passengers with Ischemic Stroke: An Evidence Based Case Report
Abstract : Ischemic stroke is a cerebrovascular disease characterized by a sudden neurological deficit due to thrombotic or embolic event. The physiological changes during in-flight related to high altitude, hypobaric hypoxic, is a condition that can affect blood circulation in the brain. There was limited evidence to prove the possibility of clinical condition deterioration and/or new onset of recurrent stroke among commercial flight passengers with ischemic stroke. This evidence-based case report aims to determine the possibility of clinical condition deterioration and/or new onset of recurrent stroke on commercial flight passengers with history of ischemic stroke related to hypoxia hypobaric during the in-flight or post-flight period. Three relevant articles were found in PubMed, EMBASE, Cochrane, and Ingenta library databases. After critical appraisal, all of the relevant articles were shown to be valid, important, and applicability with the level of evidence ranging from III–IV. There were no studies that reported a clinical condition deterioration and/or a new onset of recurrent stroke among commercial flight passengers with ischemic stroke. However, two studies reported a new case of ischemic stroke during in-flight with unknown etiology. Commercial flight passengers with history of ischemic stroke didn’t show any clinical condition deterioration and/or a new onset of ischemi stroke during in-flight or post-flight.
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Review Article2023-09-30
항공분야에서의 블록체인 기술 현황
Blockchain: An Overview and Its Applications in Aviation
Abstract : Blockchain is a type of distributed database managed through multiple network transaction details (P2P, Peer to Peer), and transaction information is stored on multiple computers (nodes) connected to the blockchain network instead of storing it in one server. It is an algorithm that binds transaction details to form blocks, connects multiple blocks like a chain, and then copies and distributes them by a large number of people. In the case of the aviation industry, it is worth making full use of blockchain technology to revolutionize existing systems and business processes in terms of cost and transaction transparency, so blockchain can become one of the innovative technologies that will change the paradigm of the aviation industry. As the blockchain market is still in an immature stage and the development of technology is expected in the future, it is necessary to prepare support measures to lead and preempt the global blockchain market in the future through development support and cooperation that can be actively used in the field.
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Review Article2023-09-30
SHELL 모델에 근거한 의료사고 인적요인 분석의 탐색적 연구
An Exploratory Study on Human Factor Analysis of Medical Accidents Using the SHELL (Software, Hardware, Environment, Liveware) Model
Abstract : The SHELL (Software, Hardware, Environment, Liveware) model is one of the models for determining the cause of aviation accidents. The human factors of medical accidents are analyzed through the SHELL model. This study is a case study that analyzed a total of three cases, including two medical accident court precedents and one large fire at a medical institution. In the human factor analysis of cases 1 and 2, the main factors were that liveware (human) violated the duty of care and did not follow the guidelines of the institution. The large fire incident in the hospital in Case 3 was caused by a lack of awareness of the safety of managers, the installation of illegal facilities and environments, lack of medical staff’s response and training, and the condition of patients who were mostly elderly. The liveware at the center of the SHELL model is the most important human factor, and the environment, facilities, and equipment surrounding liveware must be supplemented to prevent future medical accidents.
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Review Article2023-06-30
한국공군의 예측적 안전관리를 위한 FOQA 시스템 고찰 연구
A Study on the Flight Operations Quality Assurance System for Predictive Safety Management of the Republic of Korea Air Force
Abstract : In 1962, British Airways implemented Flight Operations Quality Assurance (FOQA) for the first time in order to reduce the rate of increase in aviation accidents, which could increase due to the expansion of the aviation industry and the increase in traffic. After that, in 1995, it was developed for the purpose of collecting/analyzing flight data on technical defects and dangerous situations that occur in actual flights through voluntary participation programs by U.S. airlines. In the private sector, it has been regulated and operated in most countries since early 2000 according to the recommendations of International Civil Aviation Organization (ICAO) and Federal Aviation Administration. In addition, civil airlines are required to conduct FOQA as part of Safety Management System in accordance with ICAO ANNEX-6. The U.S. Air Force benchmarks the FOQA safety program in the civilian sector and applies it under the name of Military FOQA. Therefore, in the Republic of Korea Air Force, there is a need to ensure flight safety in an objective and scientific way by deriving event parameters for the introduction of the flight data analysis system in order to perform predictive safety management in accordance with the trend of the times.
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Review Article2023-03-31
The Improvement of Pilot Fatigue Management
Abstract : The fatigue of pilots is the most threatening factor in aviation safety internationally, requiring continuous management. In order to prevent aircraft accidents that may occur due to fatigue, this paper analyzes fatigue-related accident cases and previous research and suggests ways to improve the fatigue management of pilots. Problems in major fatigue accidents were active communication failure, lack of leadership of the captain, inadequate contingency management, lack of workload management, and the most important factors in accidents were inadequate decision making of continuing an approach without going around. It is necessary to proactively improve and establish go-around culture in the organization and manage human factors with training and procedures of Threat and Error Management and Crew Resource Management. In order to fundamentally prevent accidents related to fatigue fundamentally, it is necessary to establish Fatigue Risk Management and Safety Management System, and identify the actual threats and errors in the cockpit of the aircraft.
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Review Article2020-04-30
Effects of Microgravity on Human Physiology
Abstract : The fatigue of pilots is the most threatening factor in aviation safety internationally, requiring continuous management. In order to prevent aircraft accidents that may occur due to fatigue, this paper analyzes fatigue-related accident cases and previous research and suggests ways to improve the fatigue management of pilots. Problems in major fatigue accidents were active communication failure, lack of leadership of the captain, inadequate contingency management, lack of workload management, and the most important factors in accidents were inadequate decision making of continuing an approach without going around. It is necessary to proactively improve and establish go-around culture in the organization and manage human factors with training and procedures of Threat and Error Management and Crew Resource Management. In order to fundamentally prevent accidents related to fatigue fundamentally, it is necessary to establish Fatigue Risk Management and Safety Management System, and identify the actual threats and errors in the cockpit of the aircraft.
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Original Article2020-04-30
항공종사자 건강증진활동계획에 반영되어야 할 근거자료: 3년간의 항공신체검사 결과 분석
Analysis of Three Years of Airmen Medical Certificate for Preparing Aviation-related Health Promotion Plan
Abstract : The fatigue of pilots is the most threatening factor in aviation safety internationally, requiring continuous management. In order to prevent aircraft accidents that may occur due to fatigue, this paper analyzes fatigue-related accident cases and previous research and suggests ways to improve the fatigue management of pilots. Problems in major fatigue accidents were active communication failure, lack of leadership of the captain, inadequate contingency management, lack of workload management, and the most important factors in accidents were inadequate decision making of continuing an approach without going around. It is necessary to proactively improve and establish go-around culture in the organization and manage human factors with training and procedures of Threat and Error Management and Crew Resource Management. In order to fundamentally prevent accidents related to fatigue fundamentally, it is necessary to establish Fatigue Risk Management and Safety Management System, and identify the actual threats and errors in the cockpit of the aircraft.
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Review Article2020-04-30
한국형 기내 의학적 상황 대처 방안 안내서
Korean Guideline for Managing In-flight Medical Events
Abstract : The fatigue of pilots is the most threatening factor in aviation safety internationally, requiring continuous management. In order to prevent aircraft accidents that may occur due to fatigue, this paper analyzes fatigue-related accident cases and previous research and suggests ways to improve the fatigue management of pilots. Problems in major fatigue accidents were active communication failure, lack of leadership of the captain, inadequate contingency management, lack of workload management, and the most important factors in accidents were inadequate decision making of continuing an approach without going around. It is necessary to proactively improve and establish go-around culture in the organization and manage human factors with training and procedures of Threat and Error Management and Crew Resource Management. In order to fundamentally prevent accidents related to fatigue fundamentally, it is necessary to establish Fatigue Risk Management and Safety Management System, and identify the actual threats and errors in the cockpit of the aircraft.
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Review Article2020-08-31
피로위험관리를 위한 조종사 피로측정방법 고찰
A Study on the Pilot Fatigue Measurement Methods for Fatigue Risk Management
Abstract : The fatigue of pilots is the most threatening factor in aviation safety internationally, requiring continuous management. In order to prevent aircraft accidents that may occur due to fatigue, this paper analyzes fatigue-related accident cases and previous research and suggests ways to improve the fatigue management of pilots. Problems in major fatigue accidents were active communication failure, lack of leadership of the captain, inadequate contingency management, lack of workload management, and the most important factors in accidents were inadequate decision making of continuing an approach without going around. It is necessary to proactively improve and establish go-around culture in the organization and manage human factors with training and procedures of Threat and Error Management and Crew Resource Management. In order to fundamentally prevent accidents related to fatigue fundamentally, it is necessary to establish Fatigue Risk Management and Safety Management System, and identify the actual threats and errors in the cockpit of the aircraft.
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Original Article2020-08-31
최근 5년간 국적항공사 조종사의 항공신체검사 부적합 판정결과
Survey of Medically Disqualified Airline Pilots in Korea: 2015~2019
Abstract : The fatigue of pilots is the most threatening factor in aviation safety internationally, requiring continuous management. In order to prevent aircraft accidents that may occur due to fatigue, this paper analyzes fatigue-related accident cases and previous research and suggests ways to improve the fatigue management of pilots. Problems in major fatigue accidents were active communication failure, lack of leadership of the captain, inadequate contingency management, lack of workload management, and the most important factors in accidents were inadequate decision making of continuing an approach without going around. It is necessary to proactively improve and establish go-around culture in the organization and manage human factors with training and procedures of Threat and Error Management and Crew Resource Management. In order to fundamentally prevent accidents related to fatigue fundamentally, it is necessary to establish Fatigue Risk Management and Safety Management System, and identify the actual threats and errors in the cockpit of the aircraft.
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Review Article2023-03-31
중대재해처벌법 시행에 따른 항공분야 위험성 평가 기법 연구
A Study on the Risk Assessment Technique of Aviation Sector in the Serious Accidents Punishment Act
Abstract : The fatigue of pilots is the most threatening factor in aviation safety internationally, requiring continuous management. In order to prevent aircraft accidents that may occur due to fatigue, this paper analyzes fatigue-related accident cases and previous research and suggests ways to improve the fatigue management of pilots. Problems in major fatigue accidents were active communication failure, lack of leadership of the captain, inadequate contingency management, lack of workload management, and the most important factors in accidents were inadequate decision making of continuing an approach without going around. It is necessary to proactively improve and establish go-around culture in the organization and manage human factors with training and procedures of Threat and Error Management and Crew Resource Management. In order to fundamentally prevent accidents related to fatigue fundamentally, it is necessary to establish Fatigue Risk Management and Safety Management System, and identify the actual threats and errors in the cockpit of the aircraft.
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Original Article2022-04-30
Epidemiological Aspects of Hepatitis E Virus Infections between South Korea and Japan
Abstract : The fatigue of pilots is the most threatening factor in aviation safety internationally, requiring continuous management. In order to prevent aircraft accidents that may occur due to fatigue, this paper analyzes fatigue-related accident cases and previous research and suggests ways to improve the fatigue management of pilots. Problems in major fatigue accidents were active communication failure, lack of leadership of the captain, inadequate contingency management, lack of workload management, and the most important factors in accidents were inadequate decision making of continuing an approach without going around. It is necessary to proactively improve and establish go-around culture in the organization and manage human factors with training and procedures of Threat and Error Management and Crew Resource Management. In order to fundamentally prevent accidents related to fatigue fundamentally, it is necessary to establish Fatigue Risk Management and Safety Management System, and identify the actual threats and errors in the cockpit of the aircraft.
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Review Article2023-09-30
SHELL 모델에 근거한 의료사고 인적요인 분석의 탐색적 연구
An Exploratory Study on Human Factor Analysis of Medical Accidents Using the SHELL (Software, Hardware, Environment, Liveware) Model
Abstract : The SHELL (Software, Hardware, Environment, Liveware) model is one of the models for determining the cause of aviation accidents. The human factors of medical accidents are analyzed through the SHELL model. This study is a case study that analyzed a total of three cases, including two medical accident court precedents and one large fire at a medical institution. In the human factor analysis of cases 1 and 2, the main factors were that liveware (human) violated the duty of care and did not follow the guidelines of the institution. The large fire incident in the hospital in Case 3 was caused by a lack of awareness of the safety of managers, the installation of illegal facilities and environments, lack of medical staff’s response and training, and the condition of patients who were mostly elderly. The liveware at the center of the SHELL model is the most important human factor, and the environment, facilities, and equipment surrounding liveware must be supplemented to prevent future medical accidents.
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Original Article2023-03-31
항공학과 학생들의 MBTI 성격 유형별 조직몰입 및 팀워크 역량 차이분석
Analyzing the Differences in Organizational Commitment and Teamwork Competence by MBTI Personality Type of Aviation Department Students
Abstract : Purpose: For students who have already decided on their career path by entering the aviation departments, this study aims to analyze organizational commitment and teamwork relationships using the Myers-Briggs Type Indicator (MBTI) personality type as a tool. Methods: In order to investigate the career choices of aviation workers according to MBTI personality types, a survey was conducted targeting enrolled in and graduating from the aviation departments, and organizational commitment and teawork were analyzed using SPSS WIN 21.0. Results: Sening, Feeling, and Perceiving were mainly found in students who chose cabin crew as their career, whereas students in department of flight crew and aviation maintenance showed high level in Instuition, Thinkg, and Juding. As a result of the analysis, the MBTI type for each career path of aviation students was mainly ENTP for flight crew students, ESFP for cabin crew students, and INTP for aviation maintenance students. Conclusion: Even if students make their choice based on advice, subjective and objective judgments in choosing a career path, there are cases in which the chosen job does not suit them. Therefore, it is hoped that various indicators such as the MBTI will be used to help studnes choose their career path.
-
Review Article2023-06-30
한국공군의 예측적 안전관리를 위한 FOQA 시스템 고찰 연구
A Study on the Flight Operations Quality Assurance System for Predictive Safety Management of the Republic of Korea Air Force
Abstract : In 1962, British Airways implemented Flight Operations Quality Assurance (FOQA) for the first time in order to reduce the rate of increase in aviation accidents, which could increase due to the expansion of the aviation industry and the increase in traffic. After that, in 1995, it was developed for the purpose of collecting/analyzing flight data on technical defects and dangerous situations that occur in actual flights through voluntary participation programs by U.S. airlines. In the private sector, it has been regulated and operated in most countries since early 2000 according to the recommendations of International Civil Aviation Organization (ICAO) and Federal Aviation Administration. In addition, civil airlines are required to conduct FOQA as part of Safety Management System in accordance with ICAO ANNEX-6. The U.S. Air Force benchmarks the FOQA safety program in the civilian sector and applies it under the name of Military FOQA. Therefore, in the Republic of Korea Air Force, there is a need to ensure flight safety in an objective and scientific way by deriving event parameters for the introduction of the flight data analysis system in order to perform predictive safety management in accordance with the trend of the times.
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Review Article2022-12-31
우주환경과 우주의학
Space Environment and Space Medicine
Abstract : The space environment is a harsh space for humans who have evolved for a long time by adapting to the earth environment. The cosmic conditions that humans experience in outer space including the moon and Mars, such as altered gravity, exposure to cosmic radiation, changes in atmospheric pressure, and lunar dust, not only make the human body uncomfortable but also threaten survival. Space medicine is one of a field of environmental medicine that aims to clarify the physiology and response of body to these harmful space conditions. The primary purpose of space medicine is to protect the health and life of astronauts, and to support mission performance to succeed in space exploration. In addition, it contributes to mankind by utilizing and industrializing the knowledge and technology acquired in the process of developing knowledge about medical countermeasures, basic life support in the space.
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Original Article2023-06-30
비행훈련 시 학생조종사 인적요인 영향에 대하여
The Influence of Human Factors in Flight Training
Abstract : Purpose: Most aviation accidents are caused by human factors, and in recent years in Korea, human factors have been identified as the cause of 70% of aviation accidents. Human factors that influence pilots in the aviation field are closely linked to judgment ability and are crucial factors directly impacting flight proficiency. Methods: To explore the human factors that may affect student pilots during flight training, a survey was conducted among flight instructors holding pilot certificates. Results: The results aim not only to identify the human factors that can influence flight performance during training but also to establish a direction for safety by addressing the human factors related to student pilots, with the goal of maintaining safety. Conclusion: Understanding the human factors that affect student pilots, who will be responsible for transporting hundreds of passengers in the future, is essential for cultivating safety knowledge and risk management skills, making it a highly important matter for accident prevention.
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Review Article2023-06-30
포스트 코로나 대비 항공종사자 건강증진 방안: 싱잉볼 명상을 중심으로
A Study on Health Promotion Management Plan for Air Traffic Controllers and Pilots in Post-COVID-19: Focusing on Singing Bowl Meditation
Abstract : COVID-19 has severely impacted the aviation industry, with air travel declining sharply and airlines cutting capacity as a result. Additionally, many countries have closed their borders to block spread of the virus. Air traffic controllers and pilots have also experienced negative effects, in that the experience required to maintain proficiency has decreased over the past three years. This has resulted in financial problems for airlines and air traffic control facilities, leading to increased job uncertainty and a manpower imbalance. As air traffic volumes begin to increase again, air traffic controllers and pilots responsible for passenger safety may experience extreme stress and anxiety in new situations. To address this problem, healthcare methods are needed to help aviation professionals to overcome stress and reduce anxiety. Meditation can stabilize the autonomic nervous system, promote relaxation and comfort in the mind and body, and could aid in smooth metabolism by suppressing the sympathetic nerves that cause our bodies to feel tension and activating the parasympathetic nerves. However, achieving the benefits of meditation can require time and effort, and general meditation can be challenging for individuals experiencing physical pain. Therefore, singing bowl meditation is recommended, as it can easily induce a meditative state. The sounds produced by Tibetan singing bowls can promote meditation by tuning the alpha waves, theta waves, and gamma waves of electoencephalography. Singing bowl meditation is a beneficial method for individuals with limited time or physical disabilities due to work schedules, such as air traffic controllers and pilots, to easily access meditation.
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Review Article2024-03-31
항공교통관제분야 교대근무자를 위한 피로관리 전략
Fatigue Management Strategy for Shift Workers in the Air Traffic Control
Abstract : Recently, shift work, including night shift, has been widely implemented in modern society. These include workplaces that have to work 24 hours a day for production processes, such as petrochemicals, power plants, and steel industries, as well as industries necessary to secure public services such as gas and electricity. In particular, workers in the aviation sector are mostly engaged in shift work due to the nature of their 24 hours of continuous work. Most shift workplaces comply with legal work regulations, but they fail to take into account workers’ fatigue and focus only on compliance with regulatory requirements. Specifically, shift work needs to provide minimum guidelines for workers’ safety and health. Therefore, this study analyzed and reviewed the current status of shift work in the air traffic control field, where shift work is essential, and presented guidelines for the safety and health care of shift workers. First of all, the international shift work guidelines and domestic laws related to shift work were reviewed, and the characteristics of the shift work system in the air traffic control field were reviewed. For the guidelines, we discussed the shift method, shift speed (direction), shift work hours and hours, night work, and other considerations.