Let me introduce you to John, our imaginary business traveller. He’s a 54-year-old executive who usually completes around 10 business trips per year. He looks well, although he’s slightly overweight and is prescribed regular medications for high blood pressure and diabetes. John enjoys a drink or two and is an occasional cigarette smoker, typically when away on business. When travelling, he doesn’t always remember to take his medication – in fact, sometimes he’s so concerned about the different time zones, that he decides the safest approach is to pause his medication until he returns home.
John arrives in New York after a long-haul flight. He has dinner, completes a 20-hour day, falls into bed and goes to sleep immediately. He wakes with a terrible headache and blurred vision, preventing him from working. Concerned by his symptoms, he alerts the hotel staff who call a doctor. John is diagnosed with a ‘hypertensive crisis’ and admitted to a local hospital as a medical emergency. In hospital, he’s shocked to hear the doctors describe his diabetes as being ‘out of control’. John stays in hospital for three days for further treatment. Consequently, he’s unable to carry out his business activities and returns home with a nurse on a commercial flight the following week.
This may seem like a far-fetched story but it’s a surprisingly frequent scenario.
Health implications of the global workplace
When we think about the various components of travel that John and many others like him contend with on a regular basis, we need to give these the same risk considerations as we would all other workplace risks, potentially even more so. To help prevent ill health and the loss of productivity, and to protect business travellers like John, it’s vital that appropriate risk assessments are undertaken that account for not just ‘typical workplace’ risks but the additional risks that regular travel can, and does, present.
Considering John’s story, could events have been prevented? If so, how? When? And who is responsible? Who should be taking ultimate responsibility for John’s welfare? Should it be John himself? Should it be his employer? Should it be the insurance company providing his company’s travel health insurance? In reality, it requires a broader combined effort.
Regular pre-travel health assessments, similar to the health and wellness checks that are offered by many health insurance providers and healthcare providers, can significantly reduce injury and illness associated with business travel when given at the right time and place. Such assessments reinforce what is typically found during regular health checks and alert the traveller to aspects of managing long term medical conditions (such as high blood pressure and diabetes) while travelling, and also identify any additional risks associated with the activity of travel.
This approach is particularly pertinent when travelling in the first world, where the activity of travel has become routine and therefore physiological stresses on the body associated with travel are not usually considered.
Referring to our traveller, John, factual pre-trip risk assessments and professional travel health advice would have helped him greatly – advice on healthy sleep routines while travelling; stress management strategies; staying within recommended alcohol guidelines; alternatives to cigarette smoking; carrying sufficient quantities of the right medications; suggested timings of taking medications when travelling through different time zones; and ensuring that his business travel health insurance is up to date with his latest medical conditions and medications.
Engagement with a travel health professional (doctor, nurse, paramedic, occupational health advisor, pharmacist) as part of the preparation for a business trip would also help to mitigate more general risks prior to travel and during the trip.
For many organisations, business travel programmes are still driven by a need to contain costs and there’s often little thought around the effect on the travellers
This could include the timely provision of vaccinations; timely provision and substitution of medications (as not all medications are licenced in all countries so alternatives may have to be sourced); and education on cultural norms and what to expect of health conditions at the destination. It could also include environmental conditions to be aware of; and factors affecting long-term health conditions and acute health problems, such as food safety and infectious diseases.
Should John, or any other traveller, still become unwell, they would have a far greater understanding of the hazards and risks, which in turn would help to have a more positive impact on their outcome.
Far-reaching benefits of health assessments for globally mobile employees
Pre-travel health assessments, as part of a broader occupational health provision, benefit both the traveller and their employer. The outcome of a travel health risk assessment is shared with the traveller and acts as a prescription for an agreed period of travel. This not only helps the traveller to plan effectively and realistically, but also provides the employer with clear information on their duty of care, and any adjustments to the ‘workplace’ that must therefore be considered.
Occupational travel health provision can also improve short- and long-term healthcare intervention, as well as improving personal, physical and psychological health resilience. It provides an opportunity to set personal travel health goals and engage with existing employee benefits programmes in a more effective way.
Aside from the fact that the benefits of implementing procedures and programmes to mitigate health and wellbeing issues among business travellers far outweigh the costs, employers have a legal and a moral duty of care to ensure both the physical and emotional safety and wellbeing of their employees. For many organisations, business travel programmes are still driven by a need to contain costs and there’s often little thought around the effect on the travellers. Thinking differently and introducing even small changes like allowing time in schedules for travellers to have sufficient downtime and acclimatisation; encouraging the use of hotels with gyms or opportunities for exercise; and looking for options with healthier food choices; can help significantly.