An inebriated pilot was the probable cause of the Shaheen Air International flight NL-142 accident, which occurred on November 3, 2015; the flight crash-landed at Lahore airport. The plane skidded off the runway when faulty landing gear caused the tyre to burst. As many as ten passengers were injured. While the pilot’s perspective is awaited, medical reports reveal the pilot was intoxicated and fatigued at the time of landing. Ironically, to land a plane without sleep would mean a level of tiredness that equates to being four times over the legal alcohol limit for flying. Fatigue is a threat to aviation safety because of the impairments in alertness and performance it creates. The impaired judgement, decision-making and flying abilities of the captain due to the effects of alcohol and fatigue, his failure to properly assess the conditions for landing and maintaining vigilant situational awareness of the airplane while manoeuvring onto final approach resulted in his failure to prevent loss. A drunken pilot is a drunken pilot, regardless of the plane.Fatigue creeps up on pilots, slowly diminishing crucial mental capacity for decision-making. Reaction times slow down and situational awareness decreases as pilots tire. A 2013 survey by the British Airline Pilots Association showed that more than half of British pilots admitted to nodding off during flight and that one in three said they awoke to find the other pilot asleep. The effects of fatigue resemble those of alcohol impairment but they are much less measurable. The Civil Aviation Authority (CAA) can, however, still impose standards to prevent pilots from consuming alcohol and reaching exhaustion. In 1992, a 747 cargo jet crashed into an apartment building shortly after take-off from Amsterdam, killing the four people aboard the plane and 39 on the ground. Whether there are packages or people behind the cockpit door, pilot fatigue exists just the same and it threatens the lives of pilots, passengers and bystanders on the ground alike. There is hardly any argument that in the air and on the roads alcohol and fatigue can kill.I know two commercial airline pilots in the family and fatigue is the biggest problem they face in daily operations, especially on early duty when they are getting up at four am to go to work and have 12-hour days. Airlines tend to look at duty limitations as targets so they will push crews to the absolute legal limit to increase productivity. Pilot fatigue has long been a concern and the European Aviation Safety Agency (EASA) has signed into law recently proposing new EU-wide rules setting limits on the duration that pilots could fly and be on duty to ensure passenger safety is not compromised by tired pilots. The issue has always been contentious, with airlines trying to turn a profit and pilot unions making sure that their members are not being pushed beyond their limits. Today, the issue is still being argued as the industry tries to find a common solution in an effort to decrease the risks associated with fatigue.Fatigue is a threat to aviation safety because of the impairments in alertness and performance it creates. Conditions that contribute to fatigue include the time passed since awake, the amount of time spent doing the task, sleep debt and circadian rhythm disruption. As fatigue progresses it is responsible for increased errors. Many of the unique characteristics of the flight deck environment make pilots particularly susceptible to fatigue. Contributing aircraft environmental factors include movement restriction, variable airflow, low barometric pressure and humidity, noise and vibration. In commercial aircraft, hands on flying has been mostly replaced by greater demands on the flight crew to perform vigilant monitoring of multiple flight systems. While the CAA and aviation operators can help mitigate the risks of pilot fatigue through education, changes to flight hour limitations and other fatigue management programmes, the ultimate responsibility of fatigue management lies with pilots themselves.For years, pilot fatigue has been a real issue. Airline pilots, as well as cargo, corporate and charter pilots can all face fatigue while on the job. While pilot fatigue can be common and overlooked, it poses a very troubling threat to aviation safety and should be taken seriously. There is a long history of debates between regulatory agencies, airline pilots and unions, and aircraft operators over pilot fatigue issues. This is why CAA needs strict, scientifically based rules to prevent fatigue from posing a risk to the safety of passengers, crew and people living under the flight-paths. Fatigue has been blamed in numerous aviation accidents over the years and is a continuing problem faced by crews flying aircrafts of all sizes. Why does the CAA not make and enforce laws concerning the conduct of airlines and pilots? Why it is that one type of operation has different flight and duty time restrictions than another? Does the type of operation have any bearing on the level of fatigue that crewmembers experience? Why does the CAA mandate that simple duct tape requires their testing and approval yet companies are allowed to put a flight crew in the noisiest hotels just to save a few thousand rupees? Why is it not allowed for flight crews to alternate taking controlled, planned naps while en route? The rules are changing but not fast enough.The reality is, however, that CAA authorities often need a fatal wake-up call before they introduce adequate measures to screen the physical and mental health of the pilots and Flight Time Limitation (FTL) rules. The airlines need to recognise that the cost of fatigue and the errors that result is much higher than the cost of ensuring adequate rest for their crews. Seventy percent of accidents in aviation are due to pilot error and fatigue is a major cause of those errors. If the airlines took measures to reduce fatigue, they would reduce the chances of errors due to fatigue. Many airlines have seen their total demise due to a single accident like in the case of Valujet Flight 592. It is obvious that preventing fatigue will have a major cost advantage. Aviation psychologists have warned that the effects of severe fatigue are comparable to those provoked by alcohol. However, whilst alcohol is forbidden in transport, fatigue in the cockpit is multiplied when cocktailed with fatigue. The writer is a professor of Psychiatry and consultant Forensic Psychiatrist in the UK. He can be contacted at fawad_shifa@yahoo.com