Business travel is projected to grow an average 6.9% through 2016. Small- to midsized businesses are a growing part of the global business market. Through 2014, nearly 98% of all US identified exporters were small or midsized companies, a trend that has held steady since 2006. Building and maintaining that export business has created an increasing need to travel business staff overseas. Many large corporations have corporate medical offices or contract for services that provide travel assistance and preparation for business travelers. However, small and medium enterprises as well as self-employed travelers may not possess the resources to make comprehensive decisions regarding travel abroad.
Preparing for Travel
Employers and workers traveling internationally for job duties should take steps pretravel, during travel, and post-travel to prevent injury or illness. Risks associated with the type of work or the travel destination, as well as ways to protect and achieve optimal personal health and safety, should be identified during each of these three phases of travel.
Using checklists, planning tools, and various information sources, employers and workers can help maximize the likelihood that work-related travel is completed safely. This section cannot give specific information on the workplace hazards in every industry or travel location. Instead, the information in this chapter guides employers and workers in recognizing and mitigating common hazards, and it generally applies to all who travel for work.
The pretravel period is the best time to identify risks and make plans to prevent occupational injury and illness. Planning needs vary depending on the type of work; for example, business meetings in a metropolitan office setting differ from site visits at a mine or work on a construction site in a remote location. The first step in pretravel planning is for employers and workers to confirm the need for international travel. Make a list of assessment topics tailored to a given travel assignment to guide this determination. These topics may include the following:
- Type of Work
- Assess the trip’s objectives and whether they could be met by using videoconferences, phone meetings, or other methods.
- Assess duration of travel. Risks may increase as more time is spent on a trip. Requirements (such as work visas) or recommendations (such as immunizations) also vary based on the expected length of stay.
- Determine whether site visits to factories, industrial facilities, or other worksites will be needed. If so, evaluate the potential hazards at those sites and how those hazards can be minimized.
- Travel Destination
- Assess the potential hazards of the travel destination, including hazards related to security concerns, natural disasters, infectious diseases, and climate extremes.
- Assess the timing of the trip. Can the trip be postponed to a time when there may be less risk (such as after contentious elections, rainy seasons, or infectious disease outbreaks)?
- Personal Health
- Assess whether the most appropriate personnel are selected for the trip. Think about technical and job expertise as well as current workload, responsibilities, and potential health concerns.
- Ensure that travelers have opportunities to maintain optimal health during the trip and access to care and resources they may need while traveling.
If travel is judged as necessary, the next step is to give workers the information they need to stay healthy and safe. Employers and workers together can assess risks related to the type of work and make a plan that adequately addresses risks. Useful steps include the following:
- Identify points of contact.
- At the home worksite, in case problems arise.
- At the international worksite, to assist with questions and problems; discuss the upcoming trip to ensure that workers bring adequate work clothes, equipment, and personal protective equipment (PPE).
- US embassy and consulate personnel.
- Assess job tasks.
- Determine whether tasks will differ from the usual work at home.
- Determine where the job tasks will be performed (indoor/outdoor, rural/urban, office or other setting).
- Determine what PPE is needed, if the traveler needs to bring PPE, and if any additional training to use this PPE is required before departure.
- Evaluate whether differences in language, customs, or culture are likely to affect job tasks.
- Review existing local health and safety rules and regulations.
- Determine if specific rules exist for possible work-related hazards such as exposure to chemicals.
In addition to assessing specific risks related to the type of work, employers and workers should remember to plan for common risks associated with the travel destination (such as risks associated with driving, personal safety, or infectious diseases) or opportunities to maintain optimal personal health. Workers may want to discuss their travel plans with their personal physician before departure. This is especially true for those with chronic health conditions. A health care provider can evaluate workers and guide them on issues such as food and water safety, vaccinations, prevention of exposure to infectious diseases and environmental hazards, and the potential impact of travel demands on personal health. Other sections of the Yellow Book give extensive guidance on these issues.
Once an employee arrives in a country, reassess whether conditions have changed since plans were put into place during the pretravel phase. Pretravel plans should be reassessed periodically throughout travel and whenever conditions change substantially. Common issues arising before and during travel include the following:
- Type of Work
- Changes in working conditions that may have different potential hazards
- Changes in requirements for personal protection
- Changes or additions to work locations
- Travel Destination
- Disease outbreaks
- Severe weather and natural disasters that may affect travel
- Changes in availability or nature of local transportation
- Changes in local security situations due to protests, strikes, or armed conflicts
- Changes in accommodations or in food/water availability
- Personal Health
- Changes in personal health status, including worsening of existing conditions or onset of new illness
Each of the 3 factors to consider in work-related travel—type of work, travel destination, and personal health—need to be reassessed. Issues related to the travel destination and personal health may apply to either leisure or work-related travel, but some specifics related to the job need to be considered that may present challenges not encountered by typical leisure travelers.
Travel-related safety and health concerns do not necessarily end after returning home. The following issues should be considered in the post-travel setting: transitioning back to work and life at home, reporting of incidents and exposures, getting necessary medical care, and capturing lessons learned to ensure future travel is safe for other workers. In addition, certain elements of the pretravel and travel periods, such as completing vaccination series or resuming care of a personal health condition, may also need to be addressed after travel.
Transitioning Back to Work and Life at Home
Depending on the length and nature of travel, returning workers may need a transition period before resuming pretravel work activities. It is important that employers and workers discuss a plan for returning to regular duty that addresses the following employee needs:
- Time for rest, adjusting to the new time zone, and resuming a normal sleep cycle
- Time for adjusting to work or pace of activity that is different from travel
- Refresher training (or new training) on returning work tasks and any changes in safety procedures or PPE
- Time to reconnect with family or significant others or to catch up on home responsibilities
- Time to wrap up unfinished business with employers and workers at the international location
Returning workers can contact their employer’s employee assistance program, if available, or they can consult with their health care provider, especially if the transition to home becomes difficult or adjustment challenges are prolonged.
Reporting Incidents and Exposures
Returning workers need to notify their employer of any work-related incidents that may have occurred during travel and take appropriate actions. Commonly occurring incidents that require reporting include the following:
- Work-related injuries or illnesses
- Health and safety-related exposures related to the work performed or the location visited, including physical hazards, chemical hazards, or infectious disease risks
- Incidents and close call mishaps related to the travel that could affect other workers at the site or future travelers
- Traffic crashes
- Property damage or loss
- Security incidents, thefts, personal violence or other crimes
- Legal issues that may have occurred during travel
Returning workers should immediately seek treatment for any lingering, worrisome, or new medical complaints, symptoms, or concerns that have arisen during travel or after. In addition to information related to travel history and destination that would normally be reported to health providers, workers should give information about specific job duties and hazards encountered in their work during international travel. Health providers should consider potential associations between new symptoms and both the work duties and the travel destination itself. Until proven otherwise, it is safest to assume new symptoms—especially fever or other signs of infection—are related to the travel.
Workers need to resume routine personal medical care upon return. This includes actively managing ongoing chronic conditions, illness or injury that may have occurred during travel, as well as check-ups, screenings, and medical or dental visits that may have been missed while on travel status.
Depending upon the nature of the work performed during travel, employers and returning workers should assess whether work-specific medical monitoring related to hazardous exposures is necessary. This may include medical examinations, surveillance questionnaires, laboratory work, or other medical monitoring. If needed, specific guidance on this issue can be obtained from a qualified occupational health specialist.
Lessons Learned: Revisit Travel Health and Safety Plan
It is important that workers returning from work-related travel share what they learned on travel with employers and coworkers to help assure the health and safety of future travelers. Revisions of pretravel safety and health plans can be guided by considering these issues:
- Unexpected events related to the type or location of job duties.
- Availability of all equipment and PPE.
- Unexpected weather, local conditions, safety, travel arrangements, and accommodations.
- Challenges related to culture, customs, and language.
- Unexpected sources of conflict or stress.
During work-related travel, personal health factors and leisure activities not related to work are important to consider, along with job hazards at worksites abroad. Pretravel planning should assess risks related to the type of work, as well as the travel destination and opportunities to achieve optimal personal health. Other chapters in the Yellow Book give important information related to travel destinations (such as food and water precautions, sun exposure, environmental hazards, and infectious diseases) and personal health factors (such as chronic illnesses). Job duties, work locations and conditions, equipment needs, and conditions unrelated to work may change while traveling. While on the travel assignment, be sure to periodically reassess changes and develop strategies to reduce risks. Returning workers should address issues of transitioning back to work life, reporting incidents and exposures, determining whether medical monitoring is necessary based on travel-related work exposures, and documenting lessons learned for the benefit of future travelers. Carefully consider the special circumstances associated with work-related travel during the pretravel, travel, and post-travel phases. This gives employers and workers the information needed to help travelers both complete their work and stay safe and healthy.
Margaret Kitt, Kristin Yeoman, Casey Chosewood, John Gibbins, Leslie Nickels, Donna Van Bogaert, John Piacentino