Flight Attendants' Health During Pandemic

The whole investigation work aims at analysing flight attendants’ physical and mental health and their job satisfaction level during the COVID-19 pandemic.

Flight attendants during their work are exposed to special health-related challenges. The health status of flight attendants was investigated by McNeely and colleagues and found considerably more sleep difficulties, anxiety, fatigue and depression than in the average population (McNeely et al. 2018). By night work, long flying hours, a very early start of work and long-time shifts, fatigue is favoured. A very late end of duty or a very early beginning of duty in the case of national flights is problematic, along with irregularly structured duty. Following air accidents, flight attendants are affected by post-traumatic stress and anxiety.

With the COVID-19 pandemic, the conditions for flight attendants changed intensely. Curfews, closed restaurants, contact bans, and travel restrictions have been implemented by many countries in order to contain the virus (Gorlich and Stadelmann, 2020). The aviation industry prior to the COVID-19 pandemic never rested. To the airline industry, the COVID-19 pandemic has been so overwhelming that even flight attendants with years of experience have said that their jobs are in danger. The brunt is borne by the largest workgroups of airlines, i.e. flight attendants, due to the pandemic. Unique occupational hazards are always there with flight attendants, from handling bad behaviour onboard to complementary perpetual jet lag. But even more and tougher challenges have been brought by the pandemic for flight attendants (Compton, 2020).

In response to the arrival of the COVID-19 outbreak, borders are shut down by numerous countries. Multiple restrictions and regulations are introduced by the government due to a pandemic that limits individuals’ free movement in an attempt to curb the virus spread (Mazareanu, 2021). As the airlines are plunged into an unprecedented crisis by the COVID-19 pandemic, the mental health of flight attendants or flying cabin crews is also impacted. Greater anxiety is experienced by flight attendants while flying during the COVID-19 pandemic. Due to worries about contracting the coronavirus, there is increased anxiety. Due to the restrictions due to the COVID-19 pandemic, the airline industry is severely affected because of the formal travel bans and voluntary restrictions such as switching corporate trips with virtual meetings. As there is a decrease in passengers, which leads to a drop in revenue for the companies. An instrument, i.e. “Kurzarbeit”, is used by large airline companies to mean short-time work. In this, flight attendants are temporarily compensated by the Federal Employment Agency and thereby release the corporations financially. With the reduction in working hours, there is a loss of pay which impacts the mental health of flight attendants as it causes stress and depression (Gorlich and Stadelmann, 2020).

It was announced by many airline companies that it would fire its flight attendant, which negatively impacted the mental health of flight attendants (Mulfati, 2021). The incidence of psychological and physical problems can be increased due to shift work, irregular working house or/and night work. It is felt uncertain by flight attendants both for their own health, and the security of their jobs as COVID-19 lasts to beat the airline business (Gmoser, 2020). New policies have been adopted by airlines to help reduce the spread of coronavirus. Wearing masks and gloves is made compulsory for flight attendants, and it is their responsibility to provide the passenger with gloves and mask if he/she is feeling unwell or is coughing. It is quite tough for flight attendants to wear masks on their faces for long hours. Against the virus, marks are still the best protection. Yet, it is a tough time for flight attendants to deal with passengers who refuse to comply with mask rules. Limited authority is held by flight attendants for enforcing the rules, and they struggle with varying directions from higher-ups. It is stressful for flight attendants to miss work due to exposure to coronavirus. Only if their test is positive pay protection applies (Johanna, 2021).

The mental health status of flight attendants has significantly deteriorated as a consequence of the COVID-19 pandemic. The flight attendants during COVID-19 are afraid of losing their job. Many flights were cancelled due to the pandemic, which negatively impacts the revenues of airline companies. Job security is in danger for flight attendants because of uncertain times. Unemployment can quickly lead to mental health issues. Support is sought out by some flight attendants during pandemics from co-workers and union counsellors. By airline sanitation efforts, some flight attendants have felt comfortable. It is advised that discussions concerning career outlook must be prioritized by airline companies, and safety measures must be emphasized to prevent infection at work for addressing psychological needs linked with functioning during the COVID-19 pandemic (Ellwood, 2021).

Due to the pandemic, the personal situation of flight attendants has worsened, and they think that enhancement is needed for their personal situation by giving more time to rest, more time for family, better sleep etc. More stress symptoms are shown by female flight attendants than male flight attendants due to fear of the future and lack of prospects. Job loss is considered very serious by flight attendants during pandemics which leads to symptoms of stress, depression and anxiety (Gorlich and Stadelmann, 2020). There is an increase in symptoms of stress and depression in flight attendants due to fear of the future, job insecurity and contact restrictions in general. New steps have been added by flight attendants to their routine during the COVID-19 pandemic. Sets of hand sanitiser are carried by them, and they avoid drinking or eating on the plane. According to the latest figures chased by the Association of Flight Attendants union (AFA-CWA), over the course of the pandemic, over 3,500 flight attendants have tested positive for COVID-19, and an estimated 20 have died. It is said by flight attendants that they are suffering from high levels of depression and stress during COVID-19 (Popken, 2021). Sanitization and health precautions are taken by most flight attendants to new heights due to the global pandemic.

Due to irregular working hours during the pandemic and reduced rest opportunities, shared with difficult childcare situations at home, leads to a negative impact on mental and physical health by affecting sleep, performance, fatigue and family life. Loss of income and job insecurity is increased, which lead to psychological strains such as existential fears or anxiety. A great potential is held by the COVID-19 crisis to negatively affect the ability of flight attendants to safely operate (ECA, 2020). As flight attendants are also responsible for the lives of individuals, it is expected by them to be mentally stable. The research has been conducted to analyse the impact of the COVID-19 pandemic on flight attendants’ physical and mental health. The research will also help in identifying the job satisfaction level of flight attendants during pandemics.

1.2 Aim, objectives and research questions

Aim

The aim of the research is to analyse flight attendants’ physical and mental health and their job satisfaction level during a global COVID-19 pandemic.

Research Objectives

On the following objectives, this research is based-

To critically assess prevailing literature on flight attendants’ physical and mental health and its influence on their job satisfaction levels.
To gather and examine primary data on the well-being and physical health of flight attendants during the COVID-19 pandemic and its influence on their job satisfaction.
To develop recommendations about how COVID-19 impact can be minimized by airlines on the health of cabin crew members.

Research Questions

The following research questions are established based on the aim of the research:

What are the physical and mental health problems faced by flight attendants as an effect of their job?
What is the impact of the COVID-19 pandemic on the physical and mental well-being of flight attendants?
What is the nature of flight attendants’ job satisfaction during the COVID-19 pandemic?

1.3 Rationale for conducting the research

This research will identify the COVID-19 pandemic impact on the physical and mental well-being of flight attendants. Due to the pandemic situations, the physical and mental health of flight attendants is highly impacted. Mental disturbances, physical illness and anxiety are some of the issues flight attendants face due to COVID-19. The job performance of flight attendants might be impacted due to their mental and physical state (Görlich and Stadelmann, 2020). Furthermore, the job performance level is also determined by how satisfied an individual is. Therefore, the researcher thought that it is important to find out about flight attendants’ mental and physical states during a global pandemic. Flights attendants can use the collected data and their analysis for enhancing their mental and physical health. Also, there is a lack of previous studies in the field of flight attendants’ physical and mental health and their job satisfaction level during a global COVID-19 pandemic, due to which the interest has been shown by the research on this research topic. As the Covid-19 pandemic came in 2019 and there is limited research on this topic. This research is important as it will reveal the job satisfaction level of flight attendants during the COVID-19 pandemic. I and others will be made aware with this research that flight attendants are impacted due to the coronavirus pandemic.

1.4 Brief description of the chapters

Chapter 1- Introduction

The topic of the research and the reasons for interest in a specific research topic is presented in the first chapter. Information related to the research topic is included in this chapter, and the research aim, research objectives and research questions are also presented.

Chapter 2- Literature Review

A literature review is the second chapter of the dissertation. In this chapter, a critical review will be conducted by the author of academic books, articles and publications on the research topics. Different secondary sources will be used for gathering data related to the research area.

Chapter 3- Methodology

The methodology will be described in the third chapter. The researcher will present research philosophy and approaches. This chapter will describe the population that contributed to the study and the methods of data collection, as well as sample size and sampling techniques methods. The researcher will also present the aspects related to research ethics, and lastly, the limitations of the research are listed.

Chapter 4- Analysis and Discussion of Findings

The analysis and findings discussion is presented in the fourth chapter. The researcher will describe in detail the data analysis method. To the literature related to the research topic, the analysis results will be referred, and the researcher will indicate differences and similarities.

Chapter 5- Conclusion

In the fifth chapter, conclusions will be described. It will be described in this chapter how to aim, objectives are met, and all research questions are answered by the author. Possible directions will also be pointed out by the author for further research on the research subject.

CHAPTER 2- LITERATURE REVIEW

2.1 Introduction

A detailed investigation of available publications related to flight attendants the impact of COVID-19 on their job satisfaction and health will be contained in the literature review chapter. The author in this chapter will discuss the impact of the COVID-19 pandemic on the physical and mental well-being of flight attendants and their job satisfaction levels during the pandemic.

2.2 Causes of Stress

According to Horswell (2017), a flight attendant’s world is a fascinating one that also provides different benefits. But it is not only about benefits and travelling. Due to the psychological stress created and stress put on the body, the job of flight attendants is very demanding. Amazing aeroplanes have been created by technology which, at extreme speeds and for non-stop hours, can travel thousands of miles around the world. However, for such long trips in a short period of time, the human brain and body are not designed. There are different events or conditions due to which stress is faced by flight attendants. Some of the reasons that cause stress to flight attendants during the COVID-19 pandemic include job insecurity, sleep disruption, irregular hours and working long, encountering uncooperative passengers etc. Various psychological and physical problems are arising with the existence of the commercial aviation sector. Anna (2019) stated that the environment of aviation is rich in potential physical stressors such as poor air quality, oxygen level, turbulence, humidity, light level etc. Flight attendants are frequently suffering from lower back pain, dry skin, skin irritation, cold symptoms etc. A variety of physical demands are carried out by a job on the flight attendants such as carts pulling or pushing, heavy containers removed from the galleys etc. Stress is created among flight attendants due to irregular contact with friends and family. During both nights and days and usually during weekends, flight attendants' work is staggered. The working schedule is different for flight attendants, and due to this, there is a scarcity of leisure time for them which also causes stress.

According to de Assis and de Oliveria Riberio (2017), a Lack of holidays also causes stress among flight attendants. It is not easy to work as a flight attendant and care for a lot of passengers. There is no fixed time for holidays and several nights are spent by them away from home. Due to their job, flight attendants are away from social support. The possible fear of constricting SARS CoV-2, along with pessimists about friends and relatives and insecurity about the future of their employment, cause stress in the minds of flight attendants during pandemics. Ellwood (2021) stated that among flight attendants, there is a fear of flying amid the coronavirus pandemic. It is very tough or even impossible to social distance in air travel. Flight attendants are constantly very scared or worried about contracting the virus, which causes stress among them. Job loss fears during the pandemic are significantly related to the symptoms of stress among flight attendants. Due to the COVID-19 pandemic, passengers are nervous, trips are cancelled, and planes are empty. Also, there is an increase in the work responsibilities of flight attendants, which have also caused stress. A key role is played by flight attendants in maintaining passenger and operational safety during the pandemic.

According to Weiss et al (2020), as the coronavirus developed into a pandemic, a precipitous drop was seen in the travel industry business. Thousands of job losses have been collectively announced by major airlines, tour firms and airports. Last month it was said by the world’s biggest American Airlines that 19,000 jobs would be cut by the company in October when a government wage support scheme comes to an end. Also, a million jobs worldwide are wiped out within the aviation industry due to the COVID-19 pandemic. It was said by United Airlines earlier this year that as many as 36,000 jobs were at risk (BBC, 2020). All of this cause fear of job loss in the minds of flight attendants, which is a major cause of stress during the pandemic.

According to Cramer (2021), dozens of confidential complaints have been received by aviation safety officials in the past year regarding enforcing mask safety rules. The unruly behaviour of passengers is reported by most of flight attendants due to the federal mask mandate. Passengers regularly abuse flight attendants and refuse to wear a mask. Around the world, fear, social and family rifts and economic pain have been caused by the coronavirus pandemic, but the discomfort and tension have often congregated in a tiny cabin space for the flight attendants, which also causes stress. Handling disruptive passengers becomes very challenging for flight attendants.

2.3 Mental Health Problems

According to Rajaveraja (2019), A constant fear of accidents is faced by flight attendants while travelling, and their job nature makes them unstable. Flight attendants are mentally disturbed due to their hectic work schedules, and with this, little leisure is got by them. Sometimes arguments take place due to cultural differences and language barriers between other flight attendants and passengers, which also leads to stress. The emotions of flight attendants are affected as there is a reduction in social support from passengers, workmates and employers. It is often stressful, disruptive and tiring to work as a flight attendant. Due to isolation on duty, dealing with difficult passengers, little energy or time available to adequately fulfilling roles as partners, mothers and community members etc., mental health problems are faced by flight attendants. Palil et al (2021) stated that a significant problem among flight attendants is fatigue. Among flight attendants, an increased prevalence of adverse sleep and mental health outcomes is found, such as depression, anxiety etc. The mental health of flight attendants is adversely impacted due to sleep disorders, including circadian rhythm disruption, which may lead to suicide deaths, suicide attempts and suicidal ideation. The mental well-being of flight attendants is enhanced by providing increased social support and helping flight attendants in reducing conflicts between private and work life.

According to Payne et al (2017), flight attendants, like in other high-stress jobs, can become exposed to alcohol or drug use for coping with their work. The way to constituent dependency and full-blown addiction can be paved by abusing alcohol and drugs to cope with mental health symptoms. Lack of sleep is one of the most common and basic stressors that pay to flight attendants stress. Among flight attendants, a common mental issue is burnout, which is the ultimate cause of a qualified work-life conflict that has repeatedly increased the stress level of an individual. Bore out occurs as a mental health problem among flight attendants and is formed through an amalgamation of role stress, work stress, misbehaving passengers, emotional discrepancies, or/and irregular duty times. Through three different signs, which are growth-related crisis, job boredom and work-related meaning crisis, Bore out is displayed. More sleep problems, fatigue, anxiety and depression, are experienced by flight attendants under mental health problems. Due to air accidents, mental health problems arise in-flight attendants, which can be seen in terms of post-traumatic stress and anxiety. The beginning of flight-related work stress includes physical and cognitive overloads.

According to Gorlich and Stadelmann (2020), with the COVID-19 pandemic, increased mental health problems were found in flight attendants. While flying during the global pandemic, ensuring the safety of passengers is very important for airline companies. Due to this, constant pressure is put by the airline authority and government on flight attendants for ensuring passengers’ safety and following all COVID-19 protocols. Different restrictions are put by the government for minimizing the spread of viruses across the world. The impact of COVID-19 leads to the closure of businesses, schools and banks with the financial crisis and even in the airline industry, a high rate of unemployment is created, which negatively impacts the mental health of flight attendants as it creates depression, stress and anxiety. As flight attendants, due to their nature of jobs have to work long time shifts and long flying hours, due to which sleep problems are faced by them. Before the journey begins and post-traumatic stress is led by occurrences of terrorist attacks and air accidents, flight attendants are frequently affected by anxiety.

According to Laovoravit et al (2021), handling travel during a pandemic is definitely not easy for flight attendants, as, in the airline industry, there are strict new federal mask mandates. The Health and jobs of flight attendants are put at risk by non-compliant passengers every day as some of the passengers refuse to properly wear a mask or adjust their face covering. This creates excessive worry and irritability and leads to depression and stress. Just by the nature of the work, flight attendants on a plane are more at risk from coronavirus. During a flight, flight attendants come within six feet of each traveller multiple times, which is close quarters. When masks are removed by the passenger for drinking and eating, flight attendants are vulnerable to contracting the virus. Overburdened have been caused for flight attendants due to these kinds of problems with the impact of covid-19. Duty schedules are restructured by the flight attendants in the case of national flights to satisfy their employers and their customers. For flight attendants, there is limited federal protection, and there is their own set of policies by each airline. COVID-19-related concerns for flight attendants include quarantine varying policies on interaction tracing and testing, which also leads to mental health problems such as anxiety and depression. Johanna (2021) stated that the entire flight is spent by some passengers by nibbling snacks or sipping from nearly empty cups when flight attendants are near. The toughest part of a flight attendant’s job, which creates mental health problems during the COVID-19 pandemic, is policing masks. It is observed by some of the flight attendants that the advantage of the mask is taken by the passenger’s exception for drinking and eating. Wearing masks is not liked by some of the passengers but keeping everyone protected and safe is vitally important for flight attendants. This is causing mental health problems in flight attendants and making their job more stressful. Some of the other concerns for flight attendants which cause mental health problems during the pandemic includes wanting to be bested, testing positive, waiting for test results and being exposed to COVID-19.

2.4 Physical Health Problems

According to Lieberman (2017), there might have consequential work-related health and safety implications due to the unique environmental and occupational characteristics of flight attendant employment which includes musculoskeletal injury and radiation exposure. From the exposure to the cabin environment, a diverse set of adverse health effects could arise, such as inflammation, irritation, infection and long-term effects such as reproductive disorders and neoplasm. For flight attendants, immediate physical health risks are exposure to contaminants, exposure to minor cuts, burns, stings or bites and exposure to infections. Flight attendants, even during a routine trip, come into interaction with some pretty nasty stuff. As the outcome of functioning unrestricted in the cabin or during an emergency flight from the aircraft by flight attendants, acute injuries are typically sustained. Then, passengers, flight attendants are 12 times more likely to be injured as it is required them to spend more time stirring through aisles and galleys and especially checking passengers after cautioning of impending turbulence. Due to repeated movement and effort or constrained postures, musculoskeletal injuries are faced by flight attendants. Musculoskeletal symptoms are reported by up to 87% of flight attendants. Roeder (2018) identified that other exposures are also faced by flight attendants, such as extended periods in low-oxygen environments, vulnerability to flu, and other infectious respiratory diseases. Among flight attendants, sudden aeroplane movements or turbulence are the frequent causes.

According to Sigurdsson (2019), flight attendants most commonly report lower-back musculoskeletal disorders. With work-related psychological factors, musculoskeletal symptoms might be associated with flight attendants. During work, it is expected for flight attendants to stand for long hours to fulfilling their responsibilities to passengers and the organization. Various physical health problems arise as for supporting the body for long hours, stomach and lower back muscles are used by flight attendants and for regaining balance, flight attendants twist, stretch and bend their bodies. In most countries, flight attendants are cured as radiation workers. A radiation form that comes from outer space is cosmic ionizing radiation. Flight attendants at flight altitudes are unprotected to higher levels of ionizing radiation. Galactic cosmic radiation is included in cosmic radiation bare on aircraft. It is found that cancer in humans is caused by cosmic ionizing radiation. It is recommended by the European Cockpit Association to air carriers that new employees or flight attendants must be informed about the exposure to radiation before recruitment. Sigurdsson (2019) stated that flying fewer hours which reduces exposure time, might help in reducing yearly limits of flight hours in the concern of flight safety. Similarly, by making use of options regarding the operation time (long haul/short haul), aircraft type, flight selection and retirement age, lifelong radiation exposures might be influenced by flight attendants. For providing the possibility of such career choices to flight attendants, airline operators are encouraged.

They are occupationally being exposed to higher levels of cosmic ionizing emission in flight and in a lifelong career, approximately 80 mSv. The whole received radiation dose is reduced with high-energy comic emission absorption and secondary radiation. With trends towards longer sector durations, there might be higher rates of exposure, particularly where long-haul polar routes are used. McNeely et al (2018) stated that damage to chromosomes is the adverse effect of radiation in-flight attendants, which leads to an increase in the risk of some cancers. Among flight attendants, an increased risk of malignant melanoma is noted due to ultraviolet light experience throughout layover. With increased prolonged exposure to radiation, lung cancers and other health issues are found in flight attendants. Blood oxygen levels tend to fall at high altitudes, and a little breathlessness might be felt by some flight attendants. It has been observed with a number of studies across Nordic countries, Europe, and in Sweden, Germany, Iceland, Norway, the United States and Finland that in-flight attendants, there may be an around 40-50% rise in breast cancer incidence. For a condition such as breast cancer, the potential is greater for confounding as there exist non-occupational factors. Milosevic et al (2018) stated that due to harmful radiation, flight attendants are suffering from cancer. Among flight attendants, higher rates of breast, thyroid, uterine, gastrointestinal, cervical and melanoma cancers are found. Cancer of the stomach, liver, oesophagus, pancreas and colon is included in gastrointestinal cancers. The risk of developing melanoma is more than double among flight attendants. Unlike the general population, flight attendants are also exposed to more UV radiation. There might have a negative impact on reproductive outcomes of flight attendants due to occupational factors such as bending, irregular or long working hours, and standing.

According to Sigurdsson (2019), between 30.000 to 45.000 feet, the cruising altitude of the commercial aeroplane is commonly maintained. In-cabin air, the partial pressure of oxygen at cruising altitude is 25-30% lower than at sea level. With special filters, a part of the cabin air, i.e. 40-50%, is scoured and recirculates, while from the outside air, the remainder is derived. Depending on the compartment, the humidity on-board ranges from 6-18%. Between 40-70%, optimal humidity varies. Low levels of microorganisms are contained in the ventilation and air conditioning systems in aeroplanes, due to which there exists transmission of numerous infectious airborne illnesses. Among the flight attendants, higher standard rates are reported of flu, cold and viral gastroenteritis. Mousavi et al (2020) stated that With the introduction of HEPA filters and the prohibition of smoking on board, cabin air quality had enhanced significantly. The risk of disease transmission is effectively limited with high-efficiency particulate air (HEPA). Clusters of infections might be occasionally caused due to person-to-person transmission in the aircraft. Influenza, SARS, meningitis, measles, coryza and tuberculosis are some of the clusters of infections. Furthermore, during a layover, flight attendants might be unprotected from infectious disease hazards. For years, flight attendants were unprotected from second-hand tobacco smoke. Lung cancer, stroke and coronary heart disease are some of the health conditions initiated by second-hand smoke.

According to Thakur et al (2020), some communicable diseases are common lung disorders occurring in flight attendants that can cause respiratory symptoms. Among flight attendants, some common respiratory symptoms include dry throat, runny or stuffy nose, flu or cold, chest illness, bronchitis and wheezing. Air dryness is a general concern about air quality. Symptoms of irritation are caused by in-flight attendants with continued exposure to dry air. More throat, nasal and hand skin symptoms are experienced by flight attendants due to air quality. By toxic substances from ozone, engine bleeds air or bases within the traveller cabin, and flight attendants might be unprotected from cabin air contamination. From cabin air contamination, many cases of severe symptoms have been stated.

2.4 Effect of the COVID-19 Pandemic

According to Suk and Kim (2021), the airline industry is one of the industries that is threatened by the coronavirus pandemic. There has been a dramatic decrease in flight schedules. Airlines are looking for massive layoffs due to the pandemic. COVID-19 has negatively impacted the mental health of flight attendants, and the problem of depression is found in many flight attendants during pandemics in several parts of the world, different restrictions are put by the government, which includes travel bans. Due to a lack of appetite for travel and border restrictions, airlines have cut back on flights. During the pandemic, airlines companies suffered from revenue loss which led to job cuts and negatively impacted the health outcomes of flight attendants. Occupationally, different locations are visited by flight attendants, and they need to interact with numerous unspecialized individuals. On the ground or after flights or during the flights, contact may be encountered by flight attendants. New policies have been implemented within the airline industry, and it is the duty of flight attendants to remind passengers about wearing masks. Martin (2021) found that wearing a mask is refused by some of the passengers, and it is found that a flight attendant is hit by the passenger in the arm as they were asked to wear a mask. Instructions provided by flight attendants are ignored by some of the passengers, and they start fighting with them. With this, it is made challenging for flight attendants to manage and handle such types of passengers, which have caused stress and negatively impacted their health. It is told by flight attendants that passengers are made more aggressive during the pandemic by policing them over mask policies. It is very stressful for flight attendants to miss work due to exposure to coronavirus. It is made compulsory for flight attendants to wear masks and gloves during their job duty.

According to Ellwood (2021), severe symptoms of stress and depression are shown by the flight attendants who were grounded at the beginning of the coronavirus pandemic. Severe symptoms of anxiety are shown by those who were flying during this time. A variety of challenges were faced by flight attendants during regular times due to their unique job nature and off-beat work schedules. A new set of challenges was faced by flight attendants when the COVID-19 pandemic beached flights around the world. Due to the pandemic, flight attendants feared losing their jobs, and to higher depression, anxiety and stress symptoms, this fear is linked. Flight attendants, while flying during the pandemic, worry about contracting the virus, which leads to increased anxiety among them. With sophisticated air circulation systems and HEPA filters, the aeroplanes are kept cleaner and safe. Flight attendants are protected from viruses by implementing airline mask rules, electrostatic fog sanitizing and changes and procedures for reducing touchpoints, but during the pandemic, planes are not totally risk-free. Grout and Leggat (2021) stated that during the pandemic, health and safety were one of the top priorities for businesses and families. Also, flight attendants are worried by thinking that their jobs are more at risk due to the pandemic, and on the other hand, during the pandemic, they are also worried about their decision to continue working. This situation with the impact of C0VID-19 has caused huge stress and affected their health negatively.

According to Johanna (2021), for protecting flight attendants during the pandemic, most effective policies are implemented by airline companies, such as temperature checks, contact tracing, blocking middle seats, and putting fines for refusing to wear masks. With the sanitation efforts of airlines, some flight attendants have started feeling comfortable during their job. As a result of refusing to wear masks on board, hundreds of individuals are banned by airline companies from flying on the airline. Bergengruen (2020) stated that concerns were started to be expressed by the flight attendants due to the virus's spread. They ask for permission to self-quarantine and disinfection supplies. A continuing shortage of basic protection is described by most flight attendants, along with a lack of guidance for performing their job during pandemics. Many flight attendants were feeling forced to fly to keep their jobs due to the rapid spread of the outbreak and overlapping travel bans for months. As in some countries, travel restrictions were removed, and flights started to fly; it is said by flight attendants that they are not provided with higher-grade cleaning products or medical-grade gloves, which leads to job dissatisfaction among flight attendants. From wearing face masks or protective gloves, earlier flight attendants were barred. In late March, most airlines began allowing wearing masks to flight attendants. Widespread confusion was cited by the flight attendants about what will be done by different airlines without penalising flight attendants or docking pay. For limiting exposure, food and drink services are eliminated by many airlines on most flights so that adequate protection can be provided to flight attendants. Before the COVID-19 pandemic, the job satisfaction level amongst flight attendants was found to be a constant fear of air accidents existed.

According to Gibbs et al (2017), for performing safety functions on aircraft as well as customer service, flight attendants are trained and employed. Hence, much-needed characteristics include being calm, pleasant, quick-thinking, flexible and collected. Flight attendants are constantly uncovered to a range of job-related revelations such as high levels of occupational noise, poor cabin air quality, elevated ozone levels, cosmic ionizing radiation, pesticides from cabin disinfection, sexual and verbal harassment etc. A whole range of potentially very stressful elements is involved in the regular job of flight attendants. Contact restrictions fear of the future due to job insecurity during the pandemic leads to an increase in symptoms of stress, anxiety and depression. Flight attendants during this pandemic are required to be mentally and physically healthy for performing their duties. But there is a decrease in the job satisfaction level of flight attendants. It is found that some of the flight attendants felt that before the pandemic, due to high safety standards of aircraft maintenance, they felt safe working on the plane. But during the pandemic, flight attendants are worried about their safety due to a fear of the virus spreading.

According to Marais and Sorrell (2020), strict quarantine and physical distancing measures have been issued by most countries. There is an increase in the workload of flight attendants during the COVID-19 pandemic due to changes in flight operations, emergency operations and intensive cargo operations. All flight attendants are exposed to particularly high psychological stressors due to the COVID-19 crisis. There is an increase in the risk of infection for flight attendants due to contact with individuals at airports and cabins. Thus, the job satisfaction level and productivity of flight attendants are negatively impacted due to the pandemic. New norms are followed by flight attendants, and after being under constant risk of being affected, services are provided by them. There is a rise in feelings of despair among flight attendants and a reduction in their morale.

2.5 Recommendations on how airlines can minimise the impact of COVID-19 on the health of cabin crew members

Passengers are starting to adapt as airlines add new safety regulations and cut services for stemming the spread of COVID-19. It is very important for airline companies to help flight attendants in overcoming and coping with potential problems, which will provide them job satisfaction. It is recognized by the founding members of EPPSI that there is a great potential held by the present pandemic to negatively impact the ability of flight attendants to safely operate. Gilger (2021) identified that daily battles had been faced by flight attendants with passengers over masks onboard flights. On every single flight, flight attendants are dealing with mask compliance issues which are causing huge stress to them during their work. New cleaning methods must be used by airlines for ensuring the safety of flight attendants. “Dos and don’ts” should be added in detail by the airlines on preventing COVID-19 transmissions, which help flight attendants. More emphasis is placed by the airlines on the cleanliness of the aircraft. As through the air, COVID-19 is mainly transmitted rather than touched surface, and high-quality airline filtration must be touted by airlines for getting people back on board. Phadnis (2021) stated that wearing full personal protective equipment must be mandatory for flight attendants when flying domestic or internationally. Insurance must be provided by the airlines to their flight attendants, which cover hospitalisation expenses. In case any flight attendant is tested positive for COVID-19, no leave should be deducted from salaries or entitlements for providing further support during the time of the pandemic, and this will also keep them satisfied with their job.

According to Puckett (2020), the new responsibilities of flight attendants are to uphold social disaffection in the cabin and to ensure travellers have the proper shielding gear and disinfecting tools. A fresh “hygiene professional” team of flight attendants must be implemented by the airlines by whom these new measures will be overseen as there is an increase in workload for flight attendants. This will help in providing job satisfaction to flight attendants as it will be felt by them that the organisation is making efforts. The grab-and-go style must be used by airlines for serving meals that will reduce the risk of virus transmission and provide satisfaction to flight attendants. Makeup requirements for female flight attendants must be ended temporarily by the airlines during the pandemic as flight attendants on some carriers donned head-to-toe protective gear. Johanna (2021) stated that masks should be worn by passengers for the sake of others and their well-being. Passengers refusing to mask up should be removed by the airlines. For mask infractions, airlines should ban travellers as this has caused huge stress to flight attendants, which are impacting their mental health. Airlines must effectively follow contact tracing, quarantine and testing standards for addressing the concerns of flight attendants and keeping them satisfied with their job. Under specific circumstances, testing should be made mandatory for flight attendants and other staff members at an airline. The airlines during the pandemic must instruct flight attendants to continue work and monitor for symptoms.

According to Akhtar (2021), greater consistency must be provided by the airlines in safety protocols, and most effective policies must be practised, such as temperature checks, blocking middle seats etc. Flight attendants will worry less about getting infected on board with additional spraying of cabins and maintaining physical distancing. It will make flight attendants feel safer to know that flight has been disinfected. On aeroplanes and inside airports, it should be made compulsory for passengers and staff to wear masks. For flight attendants exposed to COVID-19, 14-day quarantine periods must be granted by the airline, which should be paid for flight attendants, which will help in protecting the rest of the flight attendants and providing job satisfaction to them. Flexible sick leave and supportive practises and policies should be implemented by the airlines. Accurate information must be provided to flight attendants about COVID-19 and the risk of exposure. Sarma (2021) identified that disposable disinfectant wipes must be provided to them, and all applicable federal regulations must be followed. Effective initiatives must be taken by airlines for ensuring the safety and health of flight attendants, such as the use of innovative technologies for cleaning cabins.

CHAPTER 3- METHODOLOGY

3.1 Introduction

The methodology used for analysing flight attendants’ physical and mental health and their job satisfaction level during a global COVID-19 pandemic will be described in this section. The research philosophy and approach will be explained in this chapter. Further, this chapter will include research methods, sampling techniques and sample size. Both primary and secondary information use will be done effectively, and a mono method is the research strategy that the researcher will implement. There are different methods for analysing the collected data, which will be described in this chapter. For understanding the position of the research in the concerned literature area, the limitations of the research are also stated. Ethical considerations will also be summarised, which are taken by the researcher.

3.2 Research Philosophy

A system of assumptions and beliefs about knowledge developed is research philosophy. The way of analysing, collecting and using the data is established by the research philosophy. For determining the suitable philosophical approach for this study, the practical implication of all philosophy has been analysed by the researcher. The four major types of philosophies named pragmatism, realism, interpretivism and positivism can be used by the researcher (Zukauskas et al. 2018). For facilitating effective conduct of the research, different types of philosophy are there, which the researcher can adapt. The researcher has pursued a positivism research philosophy for this research. A detailed and rational analysis of the subject matter is involved in the positivism philosophy, and through this philosophy, the research is conducted in an efficient manner. As detailed, in-depth analysis is undertaken by the positivism philosophy of the subject matter, this philosophy is suitable for this research. The collected data can be generalised through positivism philosophy. On quantitative data, the positivism philosophy is based.

Hypothesis formulation and testing are required in positivism philosophy through analysis and collection of data, therefore for pursuing it, quantifiable data is required. It is considered by interpretivism philosophy that only through shared meaning, language, instruments and consciousness connection with reality is possible. On qualitative data, this philosophy is based, and as the data is heavily impacted by personal opinions and values, it cannot be generalised. For a mono method, the pragmatism philosophy advocates and practical and legal data is required for investigating the problem (Simpson, 2017). All the logical and real-life aspects of the subject matter are taken into consideration by a realism philosophy. This study will be created on the online methods of facts collected due to the constraints of the COVID-19 pandemic.

3.3 Research Approaches

An essential part is formed by the research approach in the research. The deductive approach and inductive approach are the two types of research approaches. A new theory development comes under the inductive approach, and the existing theory related to the subject is tested under the deductive approach. The researcher can reach relevant conclusions with the help of a deductive approach through a set of available data. Inferences and conclusions are analysed with the help of an inductive approach, and detailed background is made regarding the research subject matter (Danaee Fard, 2020). For obtaining a testable conclusion, the researcher can use the existing premises with the help of the abduction approach.

For finding out the problems faced by flight attendants during the COVID-91 pandemic, the inductive approach has been used in this research. For the research topic, i.e. analysing flight attendants’ physical and mental health and their job satisfaction level during a global COVID-19 pandemic, this approach is suitable as there is limited research on this topic. Flexibility is provided by the inductive approach as following the predetermined data is not required by the researcher.

The researcher has not implemented the deductive approach, along with making the observation test, and the existing rules need to be presented. Also, further changes could be implemented with the application of the deductive approach, which would affect the conclusions that are formed (Azungah, 2018). Only existing concepts and theories are analysed under the deductive approach, and new theory creation is not supported by this method, and this is the reason for choosing the inductive approach rather than the deductive approach.

3.4 Research Design

For this research, an online questionnaire has been used as data collection. Direct contact has been avoided in the current COVID-19 pandemic situation. Therefore, for collecting primary data from the sample, an online questionnaire has been selected as the best possible option. The mono method of data collection has been used in this research study which includes quantitative research methodology. This method is associated with the one research approach used for a given study.

Quantitative research

For testing a hypothesis, quantitative research deals with the statistical data and numbers by collecting and analysing the ideas proposed by numerous studies. Different graphs and numbers are used in the qualitative research strategy to express the entire research. Flexibility is offered to the researcher by this method, and also meaningful insights are reflected that are aligned with the research aim (Queiros et al. 2017). For presenting the data in numerical terms, the investigator has applied the quantitative research technique. An online survey has been conducted to obtain data of quantitative nature, and more accurate data is collected directly from the respondents. Establishing a physical setting is avoided due to the COVID-19 pandemic constraints, and therefore the online survey method has been pursued by the researcher. Charts and graphs have been used for analysing data obtained.

The literature review section has also been included in the research, which is based on theoretical data or non-numeric data through which in-depth insight is obtained about the research area. The investigator has used the literature review for the research, which helps in saving investigators’ time and money. For ensuring the in-depth examination of the study problem with the aid of rich information from the previous literature that is extremely specific to the investigation problem, the literature review has been also included in this research (Hamilton and Finley, 2019). Several books, newspapers and journals have been used by the researcher for collecting data for literature review.

3.5 Data Collection Methods

The process of assessing and gathering data on variables of concern in a recognized fashion that allows one to respond to specific research questions, check hypotheses and assess results is data collection. The researcher has adopted a mono methodology for this research. The help of both secondary and primary data has been taken for the effective completion of the research. Deep insights are attained by the researcher about the research topic. For collecting data of primary nature, an online survey through a questionnaire is conducted. Information about the impact of the COVID-19 pandemic on flight attendants’ mental and physical health has been gained with the application of quantitative data. Research aims and objectives will be gained with the help of the data collected by the investigator.

From different journals, newspapers, books, articles, magazines etc., published on Google Scholar and different websites, the secondary information has been obtained by the researcher. For using relevant data about the impact of COVID-19 on flight attendants’ physical and mental health and their job satisfaction level, the investigator has effectively read, analysed, accessed and compared the whole data that is gathered from secondary sources. Only secure and recent sources have been used to collect information, and as the information is used in the literature review, it has been sourced effectively by the researcher (Kalu et al 2019).

By using the questionnaire method, the primary data for the research is obtained for acknowledging the impact of the COVID-19 pandemic on flight attendants’ mental and physical health. In comprehending the opinions of flight attendants working in different airlines and analysing the pandemic impact efficiently, the primary research is beneficial. Through the survey, the primary data collected helped in asking respondents’ opinions on the job satisfaction level, mental health issues and physical health issues faced by flight attendants during the pandemic (Rahi et al. 2019).

Survey Questionnaire method

For recognising designs in the characteristics and activities of a definite population by a set of organised questionnaires, the survey questionnaire method is very effective. Through the online mode, questionnaires will be prepared and circulated for conducting surveys, and with the help of BOS, the responses have been obtained. For preparing the questionnaire, BOS will be used.

3.6 Population

Choosing a suitable sample size is very important for the researcher. Flight attendants working in different airlines are the target population for the primary research. To the flight attendants, the online survey was addressed. In this, the researcher was able to analyse the impact of COVID-19 on flight attendants’ mental and physical health. The investigator tries to reach flight attendants working in different airlines. For evaluating the impact of a pandemic on job satisfaction level and mental and physical health of flight attendants, both senior and, junior flight attendants were included in the study. Conducting the survey among flight attendants determined the mental and physical health problems faced by them and the impact of covid-19 on their health. In this way, an online questionnaire helped in meeting the objectives of this research.

3.7 Sampling Techniques

100 respondents will be selected from the entire flight attendants of the UK as a sample of this research. Non-random sampling is a sample in which unit selection is based on factors other than random chance, e.g. prior experience, convenience or the researcher's judgement. Some of the non-random sampling methods include purposive sample, convenience sampling, quota sample, voluntary response sampling and snowball sample. Effective collection and analysis of data are facilitated with non-random sampling. For effectively conducting the entire research work, both the sample type and sample size has been effectively chosen. Both convenience sampling and purposive sampling has been used in this study as sampling technique by which the selection has been done as per the study requirements (Bhardwaj, 2019).

A type of nonprobability sampling in which individuals are sampled simply because they are a “convenient” source of data for investigators is convenience sampling. Random selection of participants is not included in this sampling technique. In a short duration of time, the data collection can be facilitated with this technique. This method is used by the researcher as the data is immediately available. For getting the information needed, it is not important to approach specific demographics (Bhardwaj, 2019). A wealth of qualitative information is provided by this sampling method. The sample selection is not random, which the disadvantage of convenient sampling is.

A form of non-probability sampling in which investigators depend on their own judgment when selecting participants of the population to take part in their surveys is purposive sampling (Campbell et al. 2020). As there is a limited number of primary data sources, purposive sampling is an appropriate method. One of the advantages of this sampling technique is the low margin of error. Using the purposive sampling approach, a lower margin of error is achieved by the research as information collected by them comes straight from the source (Regoli, 2019).

3.8 Sample Size

Through an online questionnaire, the information from respondents will be gathered regarding the impact of COVID-19 on flight attendants’ mental and physical health. The researcher aimed to collect information from 100 respondents. For analysing the data and its trends, the SPSS software has been used by the researcher. For getting information about the research subject, the questionnaire has been posted on different social media platforms. Also, on the cabin crew groups, the online questionnaire was published, such as Flight Attendant Club, Emirates Airline-Cabin Crew, Ryanair Cabin Crew and BA Cabin Crew. Also, it has been revealed by the researcher that in which airline companies the flight attendants work and permission is sought from the line managers of flight attendants. For encouraging a higher response rate, the researcher will send reminders.

3.9 Data Analysis

In every research work, analysis of data is very important as data analysis efficiency, study results, and conclusions are dependent. The meta-analysis of the literature review is steered for the data analysis process in the current research by focusing on set research objectives. For accessing the value of the sign used from the prevailing literature parts to exact appraisal of the interrelation of the variables alongside growing the generalisation of the results, the meta-analysis is adopted here. Interrelation among the different research outcomes is found by the researcher that is successful in drawing a valid conclusion (Gurevitch et al. 2018). In this way, for formulating concepts and theories from available sources, the meta-analysis of the review of the writing is a beneficial method. For describing the basic actions that are elaborate in the survey information, the descriptive analysis method is used. There is a summarised description analysed for each variable from the available data.

3.10 Research Ethics

Throughout the research, ethical consideration has been strictly maintained. All the ethical standards are well considered by the researcher, and all the rules and regulations are followed for data collection. Complete confidentiality has been maintained by the researcher of responses of participants. Various ways have been followed by the researcher for confirming adherence to ethical considerations. Respondent’s identity is protected by whom responses were obtained against the questionnaire questions. This research purpose was informed by the investigator the respondents before collecting their responses. The identity and privacy of all the respondents are kept secure and private, and it is ensured that only authorised personnel can access it. Also, it is not compulsory for the respondents to answer all the questions, and questions can be skipped by them (Knottnerus and Tugwell, 2018). Prior consent has been taken from the respondents by the researcher for maintaining the ethical codes of primary research.

It was instructed to all participants in the survey that at any time, they can withdraw as survey participation is completely voluntary. The investigator, while leading the research, is obliged to retain the rights of the members and doesn’t discover any data without taking genuine assent from the members. In the current research, only reliable and authentic secondary data sources have been used by the research and required in-texting and referencing has been given for maintaining the rights of authors. In the study, plagiarism has been also avoided by the researcher, and effective efforts have been put into ethically completing the research (Kara and Pickering, 2017).

3.11 Research validity and reliability

It is important to evaluate the chosen research methodology for its effectiveness in attending to the current research purpose. The two key measures that help in assessing the research methodology used by the investigator are the validity and reliability of the research methods (Mohajan, 2017). This research method is embraced by examining numerous portions of literature that goes to the same study setting so that a recognised study methodology validates its use in the existing research.

Validity- By the extent to which the selected set of study approaches can govern the study constraints as planned by the investigator, the validity of the research is measured. By comparing the expected results and actual outcomes, it can be evaluated. The existing pieces of literature were analysed in the research in which the four major criteria of validation are scope, audience, purpose and format. All these criteria are sufficient in the literature review done in this research that validates the embracing of literature review as a method in this study.

Reliability- Research method reliability is well-defined by the efficiency of the study tool used by the investigator to create reliable results. For finding relevant pieces of literature, the search study used in this research uses effective structure and technique that can be useful in other investigations for producing results as efficiently as in the existing investigation.

3.12 Research Limitations

The literature review is a very comprehensive, long and time-consuming process that needs consideration of the viewpoints of different investigators in carrying out their own studies. The risk of data misinterpretation is contained in this as in a different context, the researchers have researched. Therefore, various biases, confusions and errors can be created due to the complete dependency or over-dependency of current research on the previous research data. As this research also involves human participation through an online survey, the research can be impacted due to individuals’ preferences and perceptions. Also, based on the respondents’ opinions and viewpoints, the results are drawn in the research.

3.13 Summary

The research methodology that the researcher has adopted for visualising the entire research system has been summarised in this chapter. In the research, the research philosophy used is positivism, and by using the inductive approach, the study further has been completed. In the current study, quantitative as well as qualitative research strategy has been used. For understanding the reason behind choosing the method, the justification for using each strategy and method is also provided. This chapter has been stated to have chosen methodology limitations and ethical considerations by the investigator.

Chapter 4: Result

The research aims to analyse flight attendants’ physical and mental health and the level of job satisfaction flight attendants have during the pandemic. Sample size has an important role in the data collection and conducting of research, so when the research is based on a specific community, then it is important to communicate with both male and woman members of the community or group. A total number of 134 flight attendants responded to the questions, and the questions were sent to the crew members of different airlines. As per the response received from the crew members (Figure1), it is observed that a more percentage of females who attended have responded with the participation of 61.2%. Whereas a less percentage of male members have responded to the questionnaire and male member's contribution is 38.81%.

Figure 1: Responses

The other concerning factor is age, as job satisfaction can differ between different age groups, and the impact of Covid-19 has also shown its different impact on different age groups. For this, the researcher has made three age groups, and the age groups are 18-25 years, 26-34 years, and 35-43 years (Figure2).

Figure 2: Variation of collected responses based on age

The major focus is put on the attendants from the age group of 18-25 years, and the majority of the response of 59.7 %, is from this age group. Whereas response from the age group of 26-34 years is 35.1% and 35-43 years is 5.2%. Now the working experience of the attendant is also important, so four categories were made based on the years of work and the categories are less than a year, 1-3 years, 4-6 years, and more than six years. The category of 1-3 years gave maximum responses that give a contribution of 45.5% next to this 32.1% attendants are working from less than a year. The next category is 4-6 years with 13.4% responses, and the remaining response of 9% is from the attendants who have been working for more than six years (Figure3).

Figure 3: Variation of the collected responses based on the working experiences

On the other hand, due to Covid-19 hand, the change in the work culture has led to the occurrence of different health issues. As per the Figure4, a conclusion can be drawn that fatigue is the most common health issue found among flight attendants, and 48.5% of attendants agreed on the problem of fatigue. Whereas sleepiness is the next health issue, on which 21.6% of attendants agreed. On the other hand, 13.4% of attendants agreed that anxiety is the health issue that these attendants were going through. From the data obtained, it is concluded that the maximum attendants fight with the problem of fatigue.

Figure 4: Health issues occur due to changes in working culture

In order to obtain the common reasons which are giving high rise in the health problem, the researcher enquired attendants with the help of the question ‘what increases the incidence of health problems in flight attendants’ (Figure5). This, irregular working hours came up as the most common issue, which is increasing the health problem, and a majority of 59.7% of attendants agreed that irregular working hours are creating health problems for them. Whereas 14.2% of attendants mentioned high blood pressure as the reason behind the health problem. 10.4% of attendants also agreed on the fact that night work is affecting their health, and this has given rise to the health problem.

Figure 5: Reason behind the health condition variation

As per Figure6, the majority of 41.8% of attendants agreed with this, whereas 38.8% of attendants strongly agreed that the pandemic is putting an impact on the mental health of the flight attendants. However, the number of attendants who disagreed or strongly disagreed that the covid-19 has any type of impact on mental health is very less. The obtained data help in concluding that the Covid-19 pandemic has an impact on the mental health of flight attendants.

Figure 6: Impact of COVID-19 on flight attendants' mental health

Again, as per the Figure7, the majority of the attendants agreed on this that the pandemic is affecting the physical health condition of the flight attendants. At the same time, 31.3% of attendants said that there might be no impact or there may be no impact on the physical health of the flight attendants. 22.4% of attendants strongly agreed; on the other hand, very few attendants disagreed with the fact. This shows that many of the flight attendants have faced physical issues due to the pandemic.

Figure 7: Impact of the COVID-19 pandemic on physical health

Figure8 is used for checking the validity; attendants have been asked, ‘how do you think the fear of job loss during Covid-19 could impact your mental health’. Researchers have given names of some of the mental health issues like depression, stress, anxiety, and a maximum of 54.5 % of attendants agreed that the fear of job loss has an impact on health conditions that can result in depression, stress, and anxiety. At the same time, 21.6% of attendants agreed that anxiety is a common mental health problem due to the fear of job loss during a pandemic. Job loss has multiple impacts, and the biggest impact is on financial conditions.

Figure 8: Analysis of Job fear on mental health during a pandemic

As per Figure9, 39.6% of attendants said to some extent, they are afraid of losing their job due to the pandemic, and this gives the idea that the pandemic has created a fear in the attendants of losing their job.

FIGURE9: Rate of the afraid related to job losses during a pandemic

Figure 9: Rate of the afraid related to job losses during a pandemic

Further, going with the question (Figure10), how would you rate job satisfaction during the covid-19 pandemic, 47.0% of attendants were unable to mark their job satisfaction as poor or high. At the same time, 24.6% of attendants said that their job satisfaction was poor during the pandemic, and only 6.0 of attendants agreed that they had high job satisfaction during the pandemic.

Figure 10: Rate of Job satisfaction during the COVID-19 pandemic

It was observed that 77.6% of attendants said that there is stress in the flight attendants due to the spread of covid-19 (Figure11). Furthermore, Figure12 helps to validate the fact question of job insecurity due to covid-19 and most of the 45.5% of attendants strongly agreed that there is job insecurity due to the spread of covid-19. Whereas only 0.7 % of attendants strongly disagreed and so it can be said that job insecurity has risen due to the spread of covid-19.

Figure 11: Impact of COVID-19 spread on flight attendance stress

Figure 12: Analysis of The Job insecurity during spreading of COVID-19

According to Figure13, approx. 57.5% of attendants agreed with the point that the spread of covid-19 is the prime source of mental and physical health issues. However, a very small number of attendants disagreed with the point. But as per Figure14, 35.1% of attendants agreed that with the decline in the covid-19, there is a decline in mental and health issues on the other 32.1% of attendants are unable to mark, and 17.2% of attendants have disagreed with the point. The mixed answer on the point indicates that there is a mixed impact of the decline of the covid-19 on mental and physical health issues.

Figure 13: Analysis of the COVID-19 pandemic on mental and physical health issues

Figure 14: Analysis of the impact of COVID-19 decline case on mental and health issues

As ninety-five attendants said that these all changes have been applied by the aviation industry for maintaining workplace safety (Figure15). Where 15.7% of attendants validated that wearing a mask is the biggest change that they have seen due to pandemics, and the second change is that now attendants have to keep their eyes on the passengers about safety protocols.

Figure 15: Analysis of the changes bought due to COVID-19

As per Figure16, among these, 38.8% of attendants went with the option all of the above, which means attendants agreed that all the above-mentioned health issues are faced by the flight attendants during work regardless of covid-19.

Figure 16: Analysis of the health-related issues faced by the flight attendants

Again, information understanding from fig 17 showed that the majority of 39.6% of attendants agreed all the above factors caused stress among the flight attendants, whereas 22.4% of attendants went with a salary cut as a reason for the stress among the attendants. Twenty-five attendants accepted that there was fear of getting affected by the coronavirus, and 16.4% of attendants reported that they got stressed due to the fear of job loss. In Figure17, the obtained data suggest that the majority of the attendants were under stress due to various factors during the pandemic phase.

Figure 17: Analysis of the major cause of stress during the COVID-19 pandemic

The next question raised by the researchers was for knowing the reasons behind mental health problems faced by flight attendants while working during the pandemic. As per the analysis, 48.5% of attendants agreed that all of the above factors are the prime reason for mental health problems which are with flight attendants. Whereas 29.1% of attendants mentioned a high rate of unemployment in the airline industry as a reason for mental health problems, 11.2% went with the changing norms, and 9.7% with the fear of getting affected by covid-19.

Figure 18: Analysis of the reasons behind the flight attendants' mental health

For reducing health issues, flight attendants need to take some measures, and in the way of answering, a majority of 69.4% of attendants agreed that there is multiple factor-like wearing facemasks, sanitizing, eating healthy, avoiding personal touch can be measured for overcoming the issues during the pandemic. On the other hand, as per Figure19, 11.9% of attendants said that wearing a facemask can help them in overcoming health issues during the covid-19 pandemic. However, 9% of attendants gave their support to eating healthy and 6.7% to sanitizing for overcoming health issues. Airline industries also have some sort of responsibilities and take care of health and safety during the covid-19 pandemic (Figure20). In this, 30.6% of attendants agreed that companies are taking steps like preventative disinfection and routine cleaning of aircraft. Whereas 18.7% of attendants went with the step of infection control measures such as PPE, 36.6% of attendants agreed that companies are taking all these common steps for helping flight attendants and taking care of their health and safety during the covid-19 pandemic.

Figure 19: Analysis of the measures taken by the flight attendants to overcome health issues.

Figure 20: Analysis of the process helps the flight attendants to manage health and safety

Cross Tabs analysis

The cross-tab analysis has been helped to analyze the collected information efficiently which is presented below.

What is your gender? * How long have you been working as a flight attendant?

Figure 21: Analysis of years attendants have worked in the industry

Participants from different age groups have taken part, and the question focused on enquiring about the experience of the attendants; relevant data is presented in Figure21. Out of all the participants, 39% were male, and 61% were female. Around 34% of the male participants have joined this industry for less than a year, and around 48% have experience of around 1-3 years as a flight attendant. Among female participants, 30% have been working as a flight attendant for less than a year, and around 44% have been in this industry for around 1 to 3 years.

What is your gender? * What are the health issues faced by flight attendants

Figure 22: Analysis of health issues faced by the flight attendants.

Figure 22 highlighted that around 38.17% were male, and 61.83% of them were female. 48% of the male flight attendants agreed to have fatigue while 24% suffered from sleepiness while few reported health issues such as anxiety, reproductive disorders, etc. Out of the female participants, 50% suffered from fatigue, and around 21% were the victim of sleepiness. Most of the flight attendants agreed that they have fatigue, and the data can be seen from Figure22, so it can be said that the flight attendants have health-related issues.

What is your gender? * Based on your experience and observations, what increases the incidence of health problems in flight attendants?

Crosstab

Figure 23: Analysis of the reason for the bad health condition.

In the survey, 38.80% of males and 61.20% of females took part when participants were asked about their point of view on the factors that are responsible for the health factors in flight attendants. Around 65% of male participants pointed their fingers toward the irregular working hours, and some of them thought the health issues were due to other factors such as night work, High BP, etc. Around 56% of the female attendants gave their vote to the irregular hours of work, and around 20% said the issues are due to high Blood Pressure (Figure23).

What is your gender? * Do you agree that the COVID-19 pandemic is impacting the mental health of flight attendants?

Figure 24: Analysis of impact on the mental health of the flight attendants.

The respondents' list had 38.80% of males and 61.20% of females, and participants were asked whether they think Covid- 19 pandemic has a mental effect on health, 42% of male attendants strongly agreed, 40% agreed, 9% had a neutral answer, and the others disagreed. Around 36% of the female flight attendants strongly agreed, 43% were in favour, 15% were neutral, and the others were against that the pandemic has impacted their mental health issues on them (Figure24). The analysis showed a result on which behalf it can be said the flight attendants have got mental health problems due to the covid-19 pandemic.

What is your gender? * Do you agree that the COVID-19 pandemic is impacting flight attendants’ physical health?

Figure 25: Analysis of the covid-19 on the physical health of attendants.

When respondents were asked if they had faced any physical health issues due to the pandemic, around 38.80% of male attendants participated, 23% of them strongly agreed, 42% agreed, and around 29% didn’t have any say on it, and others disagreed. Out of 61% of the total female participants, around 22% were in strong favor, 34% agreed, 33% had a neutral response and the others opposed the fact of any impact on their physical health due to the Covid-19 pandemic (Figure25). Not only mental health but the physical health of the attendants got impacted by the covid-19 pandemic.

What is your gender? * How do you think the fear of job loss during Covid-19 could impact your mental health?

Figure 26: Impact of job loss fear on mental health.

As per the above analysis, 38.80% of males and 61.20% of females presented their views on the fear of job loss due to the pandemic situation as it has been seen a lot of people lost jobs and aviation is one among them (fig. 26). Around 9% said they suffered from anxiety, 23% suffered from stress, 19% suffered anxiety, and the others suffered from all three mental issues. of female flight attendants, 3.65% were depressed, 14.63% were under stress, 23.17% suffered from anxiety issues, and 58.53% had all three issues related to mental health due to the fear of losing a job due to the pandemic (Figure26).

What is your gender? * Are you afraid of losing your job due to the COVID-19 pandemic?

Figure 27: Evaluation of fear of losing a job due to pandemic.

When the participants were asked if they faced the scare of losing a job due to Covid-19, in which 38.80% were male, 61.20% were female. 46.15% of males agreed, 9.61% disagreed, and 44.23% were scared of losing their up to some extent. 46.34% of female flight attendants agreed, 17.07% disagreed, and 36.58% had a fear of losing their jobs due to pandemics up to some extent (Figure27).

What is your gender? * As a flight attendant, how would you rate your job satisfaction during the COVID-19 pandemic?

Figure 28: Evaluation of job satisfaction during the pandemic.

Fig 28 highlights that 9.61% of males strongly agreed, 19.23% of males agreed, 46.15% had a neutral answer, and the others were satisfied with their jobs. 3.65% of female respondents were strongly satisfied, 15.85% of them agreed, 47.56% were neutral, and the other of them said they were not satisfied with their jobs (Figure28).

What is your gender? * Did the spread of COVID-19 cause stress to flight attendants?

Figure 29: Evaluation of Stress in attendants due to pandemic.

The analysis of fig 29 showed that from 75% of males agreed, only 3.84% disagreed, and around 21.15% of them said they faced stress due to pandemics up to some extent. Around 79.26% of females said yes, 2.43% of them said no, and around 18.19% said they were under stress due to the spread of Covid-19 for up to some extent (Figure29). The results show that the majority of attendants have been under stress as attendants have been in touch with people from different locations.

What is your gender? * Do you agree that job insecurity became one of the issues during the spread of Covid-19 for flight attendants?

Figure 30: Evaluation of the job insecurity issues in attendants during a pandemic

Attendants were asked whether job insecurity was one of the issues the spread of covid-19 became for flight attendants to which 47.05% of males strongly agreed, 41.17% agreed, 9.80% were neutral, and only 1.9% of them disagreed as shown in fig 30. Out of all the females, 45.12% were in strong favor of this issue, 47.56% agreed, and 7.31% had a neutral opinion on the question (Figure30).

What is your gender? * Do you agree that the Covid-19 pandemic was a source of both mental and physical health issues at the work of flight attendants?

Figure 31:Analysis of views of attendants regarding the impact of the pandemic on the health of attendants.

When the respondents, 39% males and 61% females, were asked whether the Covid-19 pandemic was a cause of both mental and physical health issues for the flight attendants. 32.69% of males strongly favoured, 50% of them agreed, 17.30% were neutral, and no male disagreed. Around 24.69% of females strongly agreed, 62.96% of them agreed, 7.4% were neutral, and only 4.9% disagreed with the fact of any involvement of Covid-19 In causing mental and physical health issues among them (Figure31).

What is your gender? * Do you agree that with the decline of COVID-19 cases, health and mental issues have also declined?

Figure 32: Analyzing the decline of impact of covid-19 on health with the decrease of cases.

What is your gender? * What are the changes brought due to the COVID-19 pandemic for flight attendants?

Figure 33: Analyzing the change that came due to the pandemic.

The participant's answer analysis showed 25% of males said mask-wearing was a change they faced, 7.69% answered covid testing, 9.61% said that they needed to keep an eye on the passengers following the safety protocols, and around 57.69% mentioned all the above changes were seen. 9.75% of female participants answered mask-wearing, 4.87% answered covid testing was a change, 6.09% of them said keeping an eye on passengers about safety protocols and most of them, around 79.26%, mentioned all the three changes to be followed (Figure33).

What is your gender? * What type of health-related issues are faced by flight attendants during their work regardless of Covid-19?

Figure 34: Analyzing other health-related issues.

The figure presents that out of total males, 28.26% faced a sleep-related problem, 23.91% suffered from fatigue and depression, 13.04% had fear and uncertainty, and 34.78% had all health issues. Around 17.33% of the female attendants suffered from sleep-related problems, 24% of them faced fatigue and depression, 10.66% had a problem of fear and uncertainty, and 48% from all of them suffered from all the given health issues (Figure34).

What is your gender? * In your opinion, what are the major causes of stress among the flight attendants during the COVID-19 pandemic?

Figure 35: Evaluation of the major causes of stress among the flight attendants during the pandemic.

Among, 38.80% of males and 61.20% of females participated, out of which around 17.30% of males accepted they were suffering from fear of being affected by the virus, while 19.23% had a fear of losing their job, 30.76% of them said they suffered from stress due to salary cuts, only 5.76% of them had stress because of work overload and 26.92% suffered from stress because of all the mentioned factors. Around 19.51% of females were stressed because of the fear of being affected by the covid-19 virus, 14.63% from job loss, 17.07% from salary cuts, 1.21% from work overload and 47.52% from all the suggested health issues (Figure35).

What is your gender? * What are the reasons behind mental health problems faced by flight attendants during Coronavirus?

Figure 36: Evaluation of reasons for mental health problems in attendants during the pandemic.

A question about the main reasons for problems faced in mental health showed that 45.09% of the male respondents said it was due to the higher rate of unemployment in the airline industry (fig 36). Also 13.72% said it was due to new rules and protocols due to covid-19, 9.80% of them accepted the fact that it was from the fear of getting affected by covid-19 and 31.37% of them thought the reason behind the problems in mental issues are from all the above factors. 19.75% of females faced issues due to the high rate of unemployment in their sector, 19.75% due to the fear of getting contacted to the virus, and around 60.49% of them got issues due to all the factors mentioned (Figure36).

What is your gender? * What are the measures that can be taken by flight attendants to overcome health issues during the COVID-19 pandemic?

Figure 37: Analysis of the measures to overcome the health issues in attendants during the pandemic.

About 19.60% of males answered wearing the facemasks, 11.76% said proper sanitization, 5.88% answered eating healthy, only 1.9% thought avoiding the touches, and around 60.78% answered by doing all the activities mentioned could help reduce the issues during Covid-19. About 7.31% of female attendants replied wearing facemasks, 3.65% from sanitizing, 10.97% from eating healthy, 2.43% avoiding personal touches and about 75.60% answered following all the given activities could help overcome the pandemic (Figure37).

What is your gender? * How are aviation companies helping flight attendants and taking care of their health and safety during the Covid-19 pandemic?

Figure 38: Analysis of the measures taken by the aviation industry for health and safety.

The participants, 59.70% of the age group 18-25 years, 35.07% between 26-34 years and 5.23% between 35-43 years, were asked whether the Covid-19 pandemic has an impact on their mental health. 80% from the first age group, 85.10% from the second group and 57.14% of the participants aged between 35-and 43 years agreed. 16.25% of the age group 18-25 years, 8.51% from the 26-34 age group, and 14.28% from the 35-43 years age group had a neutral response. 3.75% of the people having aged between 18-25 years, 6.38% from the age group 26-34 years, and 28.57% of the participants aged between 35-43 years disagreed that covid-19 causes an impact on the mental health of flight attendants (Figure38).

What is your age? * How long have you been working as a flight attendant?

Figure 39: Evaluating age and working experience of the attendants.

In the slot of participants having their age between 18-25 years, which was around 59.70% of the total, 47.5% of them had worked for less than a year, 43.75% had worked for 1 to 3 years, 8.75% for 4-6 years and no one for more than 6 years. In the group having their ages between 26-34 years was about 35.07%, 10.63% of them had worked for less than a year, 53.19% for 1-3 years, 21.27% for 4-6 years, and 14.89% for more than 6 years. In a group aged between 35-43 years, about 5.23% of the total, no one had worked for less than a year, 14.28% for 1-3 years, 14.28% for 4-6 years, and 71.42% of them has worked for more than 6 years (Figure39).

What is your age? * What are the health issues faced by flight attendants?

Figure 40: Analyzing health issues faced by flight attendants.

The respondents were asked about their ages and the health issues faced by them; 60.30% were people aged between 18-25 years, 34.35% were aged 26-35 years, and 5.35% were participants aged between 35-43 years. In the first group, 49.36% suffered from fatigue, 25.31% from sleepiness, 12.65% from anxiety, and the other suffered from issues like reproductive disorders, musculoskeletal injuries, etc. In the group aged between 26-34 years, 51.11% had fatigue, 17.77% suffered from sleepiness, and the others suffered from different issues. In the last group of participants aged between 35-43 years, 42.85% had fatigue, 14.28% had sleepiness, and the others had a problem from the other issues mentioned (Figure40).

What is your age? * Based on your experience and observations, what increases the incidence of health problems in flight attendants?

Figure 41: Evaluation of the incidence of health problems in attendants.

When the participants, 59.70% aged between 18-25 years, 35.07% between 26-34 years, and 5.23% between 35-43 years, were asked the factors like irregular working hours, shift work, night work, high BP, lungs and heart disease and all of the above issues that cause health issues in the flight attendants. 71.25% of the group aged between 18-25 years, 44.68% of the participants aged between 26-34 years and 28.57% of people aged 35-43 years answered it was due to irregular working hours. 6.25% of the first group, 17.02% from the age group 26-34 years and 14.28% of the age group 36-43 years observed it was due to High Blood Pressure. 6.25% from the first age group, 12.76% from the age group 26-34 years and 28.57% from the group aged between 35-43 years analysed it was all the factors given (Figure41). The results obtained by the study show that the attendants have got health issues due to irregular working hours.

What is your age? * Do you agree that the COVID-19 pandemic is impacting the mental health of flight attendants?

Figure 42: Analyzing the impact of the pandemic on the health condition of attendants.

The participants, 80% from the first age group, 85.10% from the second group and 57.14% from the participants aged between 35-43 years agreed. 16.25% of the age group 18-25 years, 8.51% from the 26-34 age group, and 14.28% from the 35-43 years age group had a neutral response. 3.75% of the people having aged between 18-25 years, 6.38% from the age group 26-34 years, and 28.57% of the participants aged between 35-43 years disagreed that covid-19 causes an impact on the mental health of flight attendants (Figure42). The data reflected that the majority of attendants faced mental health issues during the pandemic.

What is your age? * Do you agree that the COVID-19 pandemic is impacting flight attendants’ physical health?

Figure 43: Analysis of the impact of the covid-19 pandemic on attendant's physical health.

The age of respondents were asked whether the covid-19 has an impact on their physical health. The analysis showed 75% of the first group, 61.70% of the second group and around 57.14% of the third group agreed with the impact of a pandemic on their physical health. 36.25% of participants from the first group, 25.53% from the second and 14.28% from the third group had a neutral response. 5% of the respondents from the first group, 12.76% from the second and 28.57% from the third group disagreed with any impact on their physical health from the Covid-19 pandemic (Figure43).

What is your age? * How do you think the fear of job loss during Covid-19 could impact your mental health?

Figure 44: Evaluation of the impact of job loss fear on mental health.

The participants were asked if the fear of job loss had impacted their mental health during the covid-19 pandemic. The majority of participants, i.e., 55% of them between the age group 18-25 years, mentioned all the three issues faced by them due to the fear of loss of job during the pandemic, while some of them were just suffering from a single issue among the three (Fig 44). In the age group 35-43 years, 28.57% were having all the issues, while 42.85% had anxiety, and 14.28% of participants in the group had stress and depression due to the scare of job loss (Figure44).

What is your age? * Are you afraid of losing your job due to the COVID-19 pandemic?

Figure 45: Evaluating the fear of job loss due to the covid-19 pandemic.

The results of fig 45, showed that around 47.5% of the participants aged between 18-25 years agreed, 14.89% said no, and 43.75% answered they were scared up to some extent. In the age group 26-34 years, 46.80% said yes, 21.27% said no, and 31.91% had a fear up to some extent. Among the respondents aged between 35-43 years, 28.57% said yes, 28.57% were against, and around 42.85% accepted that they were scared up to some extent of losing a job due to pandemics (Figure45). Attendants have been in fear of losing their job due to the pandemic.

What is your age? * As a flight attendant, how would you rate your job satisfaction during the COVID-19 pandemic?

Figure 46: Analyzing the job satisfaction in attendants.

The participants were asked to rate their satisfaction with the job during the pandemic. From the age group 18-25 years, around 28.75% were satisfied, 46.25% had a neutral response, and 25% were unsatisfied. Of the respondents from the group aged between 26-34 years, 14.89% were satisfied with their jobs, 46.80% were neutral, and 38.29% were not satisfied with their jobs. Among the age group 35-43 years, 14.28% of the participants were satisfied, 57.14% were neutral, and 28.57% of participants did not have any sort of job satisfaction (Figure46).

What is your age? * Did the spread of COVID-19 cause stress to flight attendants?

Figure 47: Analysing the stress level in the attendants due to the pandemic.

When the participants were asked if the spread of Covid-19 has caused stress to the flight attendants, out of the respondents aged between 18-25 years, 77.5% said yes, 2.5% disagreed, and 20% of them had stressed up to some extent. Of the participants from the age group 26-34 years, 80.85% of them agreed, 14.28% said no, and 17.02% had stressed out due to covid up to some extent. About 57.14% of the flight attendants aged between 35-43 years agreed, 14.28% disagreed and around 28.57% of them accepted the fact of being stressed out due to the spread of Covid-19 (Figure47).

What is your age? * Do you agree that job insecurity became one of the issues during the spread of Covid-19 for flight attendants?

Figure 48: Checking the job insecurity sense in attendants.

The respondents were asked whether the job insecurity of flight attendants became one of the issues due to the spread of the pandemic. Out of the participants aged between 18-25 years, 89.87% agreed, 10.12% had a neutral response, and no one fully disagreed. In the age group, 26-34 years, 91.48% agreed, 6.38% disagreed, and only 2.12% disagreed. Out of the participants aged between 35-43 years, all of them agreed that covid-19 made job insecurity the main issue (Figure48). Further, on being asked whether the covid-19 was a cause of mental and health issues for flight attendants at work, among the participants aged between 18-25 years, 77.52% agreed, 10.12% did not have any say on it, and 2,53% disagreed. Among the age group 26-34 years, 85.10% of participants agreed, 12.76% had a neutral response, and about 14.28% disagreed (Figure49). The majority of the attendants have felt mental and health issues due to work during a pandemic.

What is your age? * Do you agree that the Covid-19 pandemic was a source of both mental and physical health issues at the work of flight attendants?

Figure 49: Analysing the views of attendants regarding the pandemic.

What is your age? * Do you agree that with the decline of COVID-19 cases, health and mental issues have also declined?

Figure 50: Analysing the views of attendants on the decrease of the covid-19 cases.

When the participants were asked that due to the decline in the covid-19 cases, health and mental issues has also declined, among the participants from the age group 18-25 years, 51.25% agreed, 28.75% had a neutral response, and about 20% of them disagreed. From the age group 26-34 years, 48.93% said yes, 34.04% were neutral, and 17.02% were against. In the age group 35-43 years, 28.57% of them agreed, 57.14% did not have any say on it, and 14.28% disagreed (Figure50). Also, when the respondents were asked about the changes that were brought about due to the covid-19 pandemic for them, the majority, about 71.25% of the people from the group aged between 18-25 years, mentioned all the measures that were needed to be followed by them, while some mentioned the other three alone. In the age group 26-34 years, 72.34% option for all of the above options and in the group of participants aged between 35-43 years, 57.14% opted for all of the above, and the rest of them answered mask-wearing (Figure51).

What is your age? * What are the changes brought due to the COVID-19 pandemic for flight attendants?

Figure 51: Analysing the changes brought due to pandemic.

What is your age? * What type of health-related issues are faced by flight attendants during their work regardless of Covid-19?

Figure 52: Analysis of the health issues due to work in the pandemic.

The respondents were asked about various health issues they face regardless of covid-19, for which in the age group 18-25 years, the majority, 41.09%, of them faced all three issues, while 26.02% suffered from sleep-related problems and the rest suffered from the other two issues. Of the participants aged between 26-34 years, 48.78% faced a major concern from all three issues, around 29.26% faced fatigue and depression, and the others suffered from sleep-related problems and fear and uncertainty. Among the age group 35-43 years, 28.57% suffered from all the issues, 28.57% from fatigue and depression and around 42.85% from fear and uncertainty, while the rest had an issue with problems related to sleep (Figure52). For what are the main causes of stress during the pandemic to them, around 42.5% from the age group 18-25 years observed all of the above factors to be the main cause, while 20% of them thought it was job loss and the others answered different factors. Of the participants from the age group 26-34 years, 38.29% considered all the issues, 25.53% considered fear of being affected by the coronavirus, and some of them chose the other options. In the age group 35-43 years, only 14.28% chose all the factors, 28.57% chose fear of getting corona and 42.85% considered salary cuts as the biggest factor (Figure53).

What is your age? * In your opinion, what are the major causes of stress among the flight attendants during the COVID-19 pandemic?

Figure 53: Analyzing the major cause of stress in attendants during the pandemic.

What is your age? * What are the reasons behind mental health problems faced by flight attendants during Coronavirus?

Figure 54: Analyzing the reasons of mental health issues during the covid-19 pandemic in attendants.

When the participants were asked about the reason for problems in their mental health faced by them during a pandemic, about 49.36% of the age group 18-25 years considered all the factors whereas the others chose the other options. In the age group 26-34 years, the majority, around 52.17%, chose all the factors, and in the age group 35-43 years, 71.42% chose the high rate of unemployment in the airline industry as the main cause of mental health (Figure54). The respondents were also asked about the steps taken by them to overcome health issues during the pandemic to which about 73.41% of the participants from the age group 18-25 years considered all the steps to be necessary while considering other options alone. In the age group 26-34 years also, the majority, around 63.82%, chose all the steps to be taken. The respondents from the age group 35-43 years, most of them about 71.42%, chose all the steps that were necessary for overcoming the health issues during the pandemic (Figure55).

What is your age? * What are the measures that can be taken by flight attendants to overcome health issues during the COVID-19 pandemic?

Figure 55: Analyzing the measures used by the aviation industry to overcome the pandemic.

What is your age? * How are aviation companies helping flight attendants and taking care of their health and safety during the Covid-19 pandemic?

Figure 56: Analyzing the techniques used by the aviation industry to improve the health condition of attendants.

The respondents were also asked how the aviation companies were helping them in taking care of their health and safety during a covid-19 pandemic. The 37.66% of respondents in the age group 18-25 years chose all the measures necessary, while 27.27% chose the regular disinfection of the aeroplane, and some of them chose the other options. Of the participants from the age group 26-34 years, 40.42% considered all the measures important from the aviation company, while some of them chose the other options alone. In the group aged between 35-43 years, most of them, around 83.83%, chose aircraft disinfection main step while the others chose all of the above (Figure56). Among all, PEE has been the main measure for making attendants safe from the covid-19.

Chapter 5: Discussion

The literature review stated that despite the various opportunities in the job of flight attendants, there are different types of challenges that become the reason for the physical and mental problems of flight attendants. In general, flight attendants need to travel long distances at high speed and the non-stop hours of travel put different types of stress on the attendant’s physical and psychological conditions (Horwell, 2017). In addition to this, various other literature has also supported this statement that in the aviation industry, the attendants have to go through challenges like poor air quality, oxygen level, turbulence, humidity. Light level etc. Further based on the analysis of survey responses in Figure5 effectively highlighted 59.7% irregular working hours, 10.4% night working, 14.2% blood pressure issues, and 4.5% heart with lung disease as the incidence of causing the increase of flight attendants health problems. Other reasons are the lack of holiday, which causes stress among the flight attendants (de Assis and de Oliveria Riberio, 2017). At the same time, other literature reviews stated that the reason for stress among flight attendants include sleep disruption, job security, irregular working hours, encountering uncooperative passengers, etc. (Horswell, 2017). Similarly, the survey results also showed participants’ response count significantly highlighted fatigue (48.5%), sleepiness (21.6%), anxiety (13.4%), and musculoskeletal injury (10) as the majority health issues faced by flight attendants (Figure4). The survey responses also presented sleepiness, depression, fatigue, fear, and uncertainty for the type of issues faced by attendants also helped in gathering information systematically streamlined to literature content. On the other hand, various literature stated that recently, the major cause for the stress and challenges that flight attendants have faced was the Covid-19 pandemic (Horswell, 2017; de Assis and de Oliveria Riberio, 2017; Ellwood, 2021). The pandemic has also created the fear of getting affected and job loss due to the high unemployment rate due to the pandemic. In addition, the responses to the survey question of are participants as flight attendants feared job loss in covid helped in supporting the learning gained from secondary sources. From all participants, 46.3% responses to ‘Yes’ and 39.6% for ‘to some extent helped in confirming the job loss fear among participants due to the adverse impact of the pandemic (Figure9). An increase in job responsibilities and fear at work has created a lot of stress in flight attendants. However, the pandemic is the reason for the loss of jobs in the airlines, as the travel industry has seen a high drop during the pandemic time (Weiss et al. 2020). In support of this, another piece of literature stated that United Airlines had put 36,000 jobs at risk, and this created a high level of fear of job loss in the mind of the flight attendants. This fear gets converted into stress. Airlines have introduced many new norms regarding the covid-19 pandemic to make the passengers and attendants safe (BBC, 2020). Further, by reviewing different pieces of literature, most of the authors have stated that due to the coronavirus pandemic, flight attendants have faced various issues, whether related to job insecurity or stress related to work (Weiss et al. 2020; Cramer, 2021; Anna, 2019). The evaluation of the stress in flight attendants during the pandemic based on survey responses in the majority to ‘Yes’ with 77.6% presented the significant stress cause among participants in the job role. The combined learning from the primary survey and secondary literature review showed the adverse impact of the crisis on flight attendants resulting in job satisfaction being neutral (47%) and poor (24.6%) during the pandemic. The understanding also showed the rise of complex situations among flight attendants placing a significant effect on the psychological and mental health of individuals along with physical problems. Moreover, the results of the major cause of stress among flight attendants during crisis helped in getting a sight to work overload and salary cut aspects along with fear of infection as reasons for cause of stress (Figure17). The literature review and survey responses confirmed that there are various causes of stress in the flight attendant's job, such as lack of irregular contact with family and friends due to unlimited flying hours and irregular working hours. Furthermore, the studies have also confirmed that the covid pandemic was also one of the major causes of stress for flight attendants.

The literature review stated that stress is one of the biggest reasons for physical health problems in flight attendants (Rajaveraja, 2019). In which the survey responses also significantly highlighted the similar understanding of flight attendants having a stressful job and high stress creating activities which increased during the covid situation. The responses to the survey questionnaire also significantly highlighted the similar understanding of flight attendants having a stressful job and high stress creating activities which increased during the covid situation. In addition, this literature review helped to understand various health and physical problems that are faced by flight attendants. Fatigue is one of the prominent problems with flight attendants, and adverse sleep and mental health outcomes are the reason for depression and anxiety etc. (Palil et al., 2021). Other literature also stated various other problems, such as lack of sleep is one of the most basic and common stressors in the case of flight attendants (Payne et al. 2017). However, contrary to this, another piece of literature has stated that constant pressure by airline authorities on the flight attendants amidst the covid pandemic for ensuring the passenger’s safety was one of the major stressors. The high spread of the covid-19 pandemic pressurized government officials and airline officials to implement various guidelines, which suddenly increased the job responsibility of the attendants (Gorlich and Stadelmann, 2020). The literature review has helped us understand that flight attendants face various mental health problems. The agreement of 57.5% flight attendants as the respondent in the survey helped in getting an insight into pandemics being the source of physical and mental issues among workers. The survey answers to other survey questions with literature understanding also helped in confirming the gained information. The analysis of the pandemic impact on the mental health of flight attendants in Figure6 showed 38.8% and 41.8% responses, respectively, for strongly agree and agree helped in improving the understanding. For example, fatigue, stress, lack of sleep, anxiety, depression, and mental exhaustion that various authors discuss in their work (Rajaveraja, 2019; Palil et al. 2021; Gorlich and Stadelmann, 2020; Laovoravit et al. 2021). Compared to which various other authors have stated that flight attendants face various physical health problems. Examples, flu or cold, chest illness, bronchitis and wheezing musculoskeletal injury and radiation exposure, flu, other infectious respiratory diseases, lower-back musculoskeletal disorders, etc. (Lieberman, 2017; Roeder, 2018; Thakur et al. 2020). The survey participants also agreed on some of the issues supporting enhancing the problems associated with flights attendants. Further which covid pandemic has increased the mental and health problems among flight attendants. In support of this, other literature has also helped to understand that handling passengers during a pandemic is not easy as the airline industry has implemented complex and strict regulations. Some of the norms like social distancing, regular sanitization, and wearing masks are measurable steps to reduce the impact of the covid-19 and reduce the safety threat. The responses presented in Figure19 also significantly supported the involvement of norms in the flight attendants' schedule during the pandemic (Laovoravit et al. 2021). Flight attendants have been under the threat of health safety due to the environment, which has emerged due to the pandemic. As the flights are operated at high altitudes, there are several radiations that affect the health condition of the attendants (Lieberman, 2017). The literature review discussed various physical health issues of a flight attendant, such as lower-back musculoskeletal disorders are the most common physical problem with flight attendants. The survey analysis presented in Figure7 also helped in analyzing the 37.3% participants being agreed, 22.4% strongly agreed, and 31.3% were neutral about the significant impact of covid on flights attendants’ physical health. The understanding of secondary information also showed that flight attendants are liable for fulfilling the passengers' responsibilities, making attendants need to stand for hours in flight and resulting in physio-mental issues in them. In addition to this, other literature has suggested that radiations are responsible for the damage of chromosomes which is the reason for the occurrence of cancer in flight attendants. Ultraviolet light exposure during the layover increases the risk of malignant melanoma in flight attendants. As the flight is operated at a high altitude, this gives rise to a decrement in the blood oxygen level and breathlessness as continuous work develops a high need for a high oxygen level in the body (McNeely et al. 2018). In support of this, another literature review demonstrated that flight attendants face serious health problems like cancer as they are continuously exposed to radiation. This is the reason flight attendants are more vulnerable to breast cancer, thyroid, uterine, melanoma cancer, etc. (Milosevic et al. 2018). The survey responses regarding physical and mental health issues among flight attendants supported learning of problems due to inappropriate job profiles. However, the comparison of survey knowledge with the literature review information showed the lack of health issues questions in the questionnaire, which could have supported presenting the participant's vulnerability towards physical health issues clearly. These studies have confirmed that there are several issues, both mental and physical, that are faced by flight attendants.

The literature review has stated that the majority of industries got affected by the covid-19 pandemic, among which the Airline industry was one of them. This came as a challenge to the flight attendants to motivate passengers to wear a mask all the time during travel or to obey the covid-19 guidelines (Suk and Kim, 2021). Various literature has helped to understand that the major challenge that was faced by flight attendants was to make sure that passengers wear a mask all the time during their travel (Suk and Kim. 2021; Martin, 2021). The literature review has stated severe symptoms of depression and stress shown by the flight attendants who were grounded at the start of the pandemic. The survey responses understanding also delivered similar knowledge of flight attendants facing mental issues with physical problems in working, which significantly enhanced during covid spread. At the same time, other literature has helped to understand that during the pandemic, health safety came as one of the topmost priorities for businesses and families as well (Grout and Leggat, 2021). During the pandemic time, airline companies implemented several guidelines and policies for protecting their flight attendants and implemented procedures like temperature checks, blocking middle seats, regular sanitising, contact tracing (Johana, 2021). Another piece of literature has stated that airline companies started giving permission for self-quarantine so that flight attendants and their families could be safe from the pandemic (Bergengruen, 2020). However, other literature has stated that airlines strictly implemented quarantine and physical distancing. This again gave rise to the work responsibilities of the flight attendants Marais and Sorrell (2020). These studies have confirmed that the covid-19 pandemic had several impacts on the job of flight attendants. That has caused various mental and physical stress as well on the flight attendants.

The literature review helped to understand that to minimise the impact of covid-19 on the health of the flight attendants, airlines introduced many new norms like wearing masks and following social distancing (Gilger, 2021). For effective measures for protecting flight attendants from getting affected by a coronavirus. Another piece of literature stated that airlines must provide full-body personal protection kits to the flight attendants, and if any attendants get affected by the coronavirus, then attendants should not be asked to compromise their salary (Phadnis, 2021). Compared to which other literature have discussed that attendants should disinfect their cabins on a regular basis and ask passengers to carry proper protection gear. Some of the airlines hired hygiene professionals to maintain proper hygiene, and many of the airlines started providing training on maintaining hygiene (Puckett, 2020). Other literature has made suggestions like the implementation of safety protocols and more strict policies for maintaining the safety of flight attendants. Along with an understanding of all researcher’s data, the survey responses presented in Figure20 helped in gaining an idea of temperature screening, infection control measure usage, quarantine management, and routine cleaning as the steps taken by aviation companies for managing health and safety. The overall learning from secondary and primary sources also highlighted that the airline also started practising temperature checks, blocking seats for maintaining social distancing, making the covid-19 test report compulsory, continuous passenger monitoring, and tracking with other tasks during a pandemic for effective situation handling. Another piece of literature has suggested that airlines should focus on providing disposable disinfectant wipes to the attendants (Sarma, 2021). These studies have helped to identify various methods that are being implemented or can be implemented by the airline. This can help them in reducing the impact of a covid-19 pandemic on flight attendants.

Chapter 6: Conclusion

One of the jobs full of opportunities is flight attendant, which provides various benefits such as travelling worldwide. However, along with the benefits, it has been found that the job of a flight attendant is a difficult one that puts mental or psychological stress on the body and physical stress. Flight attendants have to make long trips in a short period of time to different locations and at odd working hours, which impacts their mental health in the form of stress, lack of sleep, depression, anxiety etc. However, when the covid pandemic spread, every travel sector or industry was impacted by it; air travel was impacted the most. All flights were either blocked or allowed only with a limited number of passengers as most of the countries had imposed lockdown. Due to the covid-19 pandemic, there were various policies and regulations put by the government for air travel, such as enforcing the mask mandate. That has impacted the mental health of flight attendants due to various issues. For example, with the risk of the covid virus spreading, the flight attendants had to make sure that all the passengers had kept their masks on, but there were cases in which passengers refused to wear the mask. This research study aimed to analyse the flight attendants’ physical and mental health and job satisfaction during a global COVID-19 pandemic. This research study has adopted both primary and secondary methods for collecting the data. A survey using the questionnaire was conducted to collect the primary data related to the research study, which was analysed using the SPSS data analysing tool. On the other hand, for collecting the secondary data already published data such as books and literature, related data was extracted from the literature using the literature review method. In some cases, the flight attendants worked continuously for long hours as there were very few attendants available for work due to fear of the pandemic. Long working hours and irregular work schedules were the reason for the stress, which led to the creation of different types of physical and mental health problems. Based on the study, it has been found that flight attendants face depression, anxiety, and many mental problems. On the other hand, long working hours cause many physical health-related problems and radiation results in cancer. For reducing the impact of the pandemic, making use of masks compulsory is important, and for this, companies are providing PPE to flight attendants.

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