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Employee Global Travel

Hi I'm Jill, Chief Safety Officer with Vivid Learning Systems. I'm a former OSHA inspector and I'm here to help you identify and correct workplace safety hazards.

For this series we're at the University of Louisville in beautiful Kentucky to show you no matter where you work, safety is for everyone.

We often say that it's a global world with regard to the speed that information travels and the speed with which we can travel the globe actually and with that comes some responsibilities. If you happen to have a job where you are traveling for your work, it's your employer's responsibility to identify the hazards that could be associated with that travel with regard to your health. And it's the same as identifying any kind of workplace hazard. We're just thinking about it in a little different way, but it is the employers responsibility to be thinking ahead before you're making that next trip.

And today I am with Dr. Ruth Caraco at the University of Louisville, Dr. Ruth caracal is an associate professor in the division of infectious diseases and a family nurse practitioner and the associate founding director of the University of Louisville's Global Health Center and we're here to talk about global health. Particularly when employees are traveling and so can you talk with us maybe about some of those things employers should be doing to help their employees in that pre-travel planning to ensure that they are traveling safely. Their health is they're staying healthy while they're traveling and they're coming back feeling well.

Sure and I think you know we've all seen that commercial on TV that that goes something like you know what goes on in Vegas stays in Vegas. Well that only applies to Vegas, you know when you're traveling internationally whatever is occurring in any part of the world becomes important to individuals not only that live there but those that are going to be going there. We are comfortable with our own routine here in Louisville Kentucky we've got great water where we're used to to good food safe and good sanitation. When we travel it's different and it doesn't mean that any places unsanitary or dirty, it means it's different and so we need to be prepared to address that.

So as an employer we need to be thinking what type of environment are we sending our employees into and then thinking about how do we maintain their health, because remember those employees are going to come back right and so whatever they bring back to them may impact on only them their family but potentially others in their workplace so we need to be aware what is happening in the country or countries that they will be visiting as part of their work and then think about how do we protect them and how do we do that preemptively. You know how do we plan and think what can we provide for you now and not only what type of medication would type of vaccines but also how do we think about health behavior and health promotion when you meet with employees for an appointment. What sort of information do you share with them?

Well I talked about some of the things that everybody does. Everybody eats and everybody drinks and everybody breathes and interacts, so I'm going to start with the things that you drink. So we'll talk about you know, how do you how are you assured of safe drinking water what do you need to be considering before you drink?

So we'll do things like you know, give somebody props or those types of things that will prompt them to make safe decisions. So for example we'll say all right when you travel we only want you to drink bumped water or fluids that are commercially packaged and so start that from the time you get off of the airplane and make sure then that you always have access to safe drinking water that just helps people think ahead then we'll think about what are the things that you're going to be eating when you're there. So we'll promote the the notion of eat foods that are cooked eat foods that that can be safely consumed. So that may mean something that can't be cooked you need to peel it yourself before you eat it.

Then we'll think about well what are those little animals that you may come in contact with specifically those mosquitoes that are going to bite you and what types of illnesses can those mosquitoes transmit. And then we'll begin to think about you know, what is it that you need to do with respect to you know preventing you from being so attractive to a mosquito. And then what do we need to do in terms of vaccines that will help then not only prevent illnesses that may be transmitted by mosquito, you know yellow fever comes to comes to mind.

But also then what are those other vaccines that could prevent you from becoming ill with respect to what you eat or what you drink or the types of interactions that you're going to have while you're there. So we try to look at it as a whole picture how do we prevent disease and then how do we promote then the types of behaviors that are gonna help the individuals stay well. And so when it comes to vaccines specifically which is an engineering control measure what Is what we use in safety terminology.

So what sort of vaccines do you recommend or how do you determine which vaccines to recommend. Well we really depend upon surveillance the surveillance that has been done by both the the Centers for Disease Control and Prevention or our own US CDC, as well as what is being reported by the World Health Organization. Regarding where the people are going to be. Right, so we look to say what is happening in though in those countries and we gather information about what we can determine in a country and then we talk with that individual about, you know what are you going to be doing there.

So somebody that's going to be camping and maybe you know living in a tent or sleeping in a cave, we're gonna be focusing on things that are very different from someone who is traveling and maybe they're there on business then they're gonna be staying in a hotel so we try to really tailor it to what is the actual risk for that individual.

 Yeah, what kind of exposure they're gonna be having. Exactly so that it's so that it's meaningful to them. I don't want to be talking about you know don't be bitten by a bat by someone who's not gonna be near a bat you know but and then now but I want to talk to someone to say you know, I want you to stay away and not approach animals or and if an animal is aggressive toward you then then what should you do. So you know you really have to focus on on what it's going to be happening with that individual, but yet get those things that are going be familiar. So as I said everybody is going to eat when you're on vacation. So or when you're traveling for business so that would be an issue that we would talk about with every person and how you can minimize your risk and then look at what sort of vaccines really target the pathogens that can be transmitted through that act of just routine eating and drinking so you're asking a lot of questions when you're meeting with someone.

One of the questions that I would want to ask if I were your patient would be you know in preparation for travel. What sort of personal first-aid kit if you will of things could I be bringing from home that might help me, should things, you know go sideways. Right well you know and it's interesting that that you bring that up because you know the risk of getting hurt when you travel is a pretty significant risk. So we tell people you know think about the routine things. Like you know, buckle up if you have a seat belt put it on. But also be prepared to take care of yourself so take along those things like ibuprofen or something that will handle a fever or an ache or a pain what happens if you develop diarrhea you might want to take some over-the-counter medication as well as the antibiotic that I may prescribe for you but also maybe think about you know and am I going to be there for a long time maybe I need to have a thermometer. If I'm gonna have my children with me then I need to know is this gonna be a fever an elevated temperature that's serious enough for me and want to seek medical care and then I want to have routine medication that is familiar to me.

Now you can go into a pharmacy international pharmacy and you can find many different medication but it may not be what I'm familiar with and you know we we really promote that idea that we have a Food and Drug Administration the FDA that really helps to protect us and provide us with safe medication. So I'd much rather you take something with you then try to find something while you're away. Or a label that you can't read. Exactly, right, right. And even you know taking things like what we call oral rehydration salts that's just something that you can mix with water if you become dehydrated that can really help you regain you know some health and not either interfere with your business travel or kind of set up that down downward cascade that may end up winding up in you know needing medical intervention.

So we want people to have an excellent business trip, an excellent international travel experience and so really many times it's kind of armed with just that basic reminder so we'll give them a list. Here's your here's your first aid kit things that you can gather at home if they need something beyond that then we can certainly help them and that's really why they would seek advice from individuals who have expertise in in international travel medicine right. I recently did some travel and before I went I met with an infectious disease specialist who coached me through many of the things that we're talking about today including a vaccine and so I guess a question is if an employer is going to seek an appointment for their employee to do what you do who should they be looking for and what kind of appointment should they be asking for? You know if you are going to be traveling internationally there are two big issues and one is what who has expertise that can help me know what I need to do before I travel and then what happens if I'm sick during travel or I return home sick.

So areas of expertise that I think sometimes we forget about is not only that before you travel but how do I access information. -Oh while you're gone. That's right, that's right. So we will have patients that will call us from outside the US that will say I'm here and this is what I'm experiencing, you know, can you give me some advice or someone that will return home that maybe we didn't see them before they left and they're like oh you know I didn't really take that whole malaria thing very seriously you know I'm home I've got fever I don't feel well. And so we see patients not only before travel but we consult with them during travel and after travel those aspects I think really you can't underscore the importance enough that what we are seeing in the world now and the adventurous behaviors that people have. Business traveling combining business with some leisure some pleasure travel then that means we need to really look at our health and our safety a little bit differently. So seeking someone that has that expertise in international travel medicine not only just pre travel counseling but post travel care as well.

Makes sense so if a community doesn't have a practitioner such as yourself what other resources would you recommend that employers can go to and employees can go to try to arm themselves with information? I think everybody we're all familiar with what you can achieve and attain via the internet so I would also always start with going to the CDC website and then there are very specific in the search engine you can just put the type in travel health and that will take you then to a very comprehensive set of pages that you can look at countries maps are there for you to become familiar with. And then look and see what is present in in a particular country.

Our job then is to say alright let's take that information that is general and very comprehensive, and let's tailor it to you. So the CDC may say if you're going to this particular country here's a list of vaccines that we would recommend that maybe not be right for every single traveler, so our idea is to tailor it to what they need and make sure that you have. Right, right and while at the same time we're looking at alright now that I've got you here I also want to use this as our reality check moment to say how are you with respect to your routine vaccines.

So you may not need for example a tetanus shot before you travel internationally as part of general travel health but that that's my chance to say you know when you go there you may be cut you may be hurt you may step on a nail you may be in a motor vehicle accident and so a tetanus vaccine may be relevant at that point. So let's make sure that you're up to date right just on your routine as well as travel vaccines. Well this has been fascinating, thank you for sharing this information with us. Thanks for having me. It's been really important and remember if you have employees who travel as part of their work, it's the employers responsibility to ensure that we're mitigating risk for our employees. Just like we would for any other workplace safety hazard and so Global Health is certainly something to make part of your normal safety practices.

I hope you gained a safety skill today if you know someone who needs this go ahead and pass it on.

Safety is everyone's business.