Managing Travel Health Risks, Behaviors, & Outcomes: Best Practices - Seminar, April 28, 2000

H. Lynn Rogers, RN, MN, OHNC, President, Workplace Health International, Ltd., Calgary, Alberta, Canada

DR GRIZZARD: Lynn, it's all yours.

MS. ROGERS: Mike suggested that we tell you a little bit about what we do in our current practice and maybe some of the issues that we see. I thought I would also introduce a couple of challenges that I think exists for us in occupational health, and that we are faced with, so that maybe from a provocative point of view it might generate some discussion.

What about my practice now? Well I have worked for a number of years in a clinical occupational health role, but mostly now I work with organizations in a consulting role, and I support and provide resource and project development work to companies and their occupational health staff. So with my own clients and my own network in western Canada, I basically write a lot of policies and do a little bit of small "r" research.

But this topic has been an area that has interested me for a long time, and I think by the numbers that we are seeing here at this symposium, it's an area of interest for a lot of people.

I think one of the first issues or challenges that we face as occupational health professionals when we work with international business travelers, is the complexity of the international workplace environment. When we talk about workplaces, for those of us who are used to working in plants and offices, we know our workplaces, we know our hazards, we know the risks that we deal with. But we face a whole different set of challenges when we are talking about an international workplace. Now not only is it the plant that the employee is traveling to or the office that they're going to, but it's also the city and the whole living environment. And so it's not an 8-hour day anymore. It's a 24-hour day and we're challenged with trying to help them and prepare them and sort out some of their health problems and general living problems.

The other element when we speak of the international environment beyond the workplace, be that the city or rural area that they're traveling to, is the additional airplane environment that they have to deal with. So understanding the environments that we're faced with when we talk about an international workplace is very different and presents a challenge for our practice.

For those of us who work in corporations that may or may not have a sense of responsibility, that's another huge issue, and I think probably a lot of that discussion is going on in the next room as well. I think that we as occupational health professionals certainly have a role in promoting a sense of responsibility with corporations to adequately prepare these workers from a health perspective.

The skill level of occupational health professionals is another huge issue. When I describe what it is that I do, occupational health is my first specialty. I'm not the expert in travel medicine or travel health nursing. But it's more or less a sub-interest group. So I think for those of us who have adopted this area by default or by interest, we have to examine what our skill levels are with respect to travel health, and then engage and align ourselves with travel health professionals and travel medicine specialists in our own communities. So there might be some interest and discussion around the role of occupational health professionals and our skill levels.

Another area that is an issue that I think brings us more to what we are talking about concerning high risk behaviors and preparing travelers is the idea of where do employees get their information, their pre-travel information. The sources that they access have to be a concern of ours, because at least in our part of the world, we have a lot of different options for employees. In my own study, the employees accessed on average four different sources for information. A lot of the literature that you read out there, about the quality of information, the accuracy, and the conflicting information that you might get from different sources of information shows this is a concern.

Regarding the area of program delivery and program development, I'm interested in knowing what some of your thoughts are with respect to pre-travel fitness-for-work examinations, health surveillance post-travel, and the idea of developing a comprehensive program for international travelers—what does that entail. These are all issues and challenges in our clinical practices, no matter whether you're an in-house occupational health service or whether you're an external service or whether you're some sort of combination of both.

And the final challenge that I think we face is the work-relatedness of the health outcomes from travel and whether or not this is an issue that we should be discussing and talking with the workers' compensation boards in our respective parts of the world. I know it's a big issue for us. It seems a lot of corporations are not interested—maybe I shouldn't necessarily admit this, but they're not interested in submitting claims for a WCB when, in fact, if these people are offshore and acquiring infectious diseases or any other types of injuries or problems, these are workers' comp issues. For us in Canada, anyway, they're covered under workers' compensation when they leave the country.

So I am just throwing out a hodgepodge of ideas, and hopefully they will generate some discussion. Thank you.

DR. GRIZZARD: Thank you, Lynn.

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