Foreign postings

With
more and more multinational companies sending employees abroad to work,
employers need to ensure staff are kept safe and healthy wherever they are.  By Monica Dobie, Alan Osborn & Mark Rowe

Sending
employees abroad or setting up overseas branches always takes some preparation,
and an important part of this is taking care of workers’ health needs. Not only
must local employment laws be followed, companies must ensure they can manage
the health risks faced abroad. We look at how employers cope with sending staff
to Europe, the US and south-east Asia.

Europe

There
are two main reasons why multinational companies generally find that sending
workers abroad to European countries poses significantly fewer health and
safety problems than sending them to other parts of the world. First, work in
Europe involves little or no exposure to tropical or other diseases.

Also,
and maybe more importantly, in contrast to other parts of the world, most
European countries now maintain relatively highly-developed systems for legally
enforcing health and safety in the workplace, together with comprehensive
health protection schemes, be they private or state-run.

But
despite this, preparations are still needed. Paul Mitchell, head of human
resources at the British American Tobacco Company (BAT), outlines the
arrangements the company makes for staff sent to or maintained in other
countries. The company is one of the UK’s largest multinationals with “tens of
thousands” of workers, including 3,400 managers, in a dozen or so European
manufacturing plants.

“When
we’re aware that someone’s going to be posted overseas, the occupational health
department is alerted, prompting them to conduct a full medical for the
individual and his or her partner and children,” says Mitchell. “This is very
comprehensive, including blood tests, an ECG, tests for lungs and eyes and so
on. There is also an annual medical which is either done in the UK or in the
host country, through an international clinic or a local hospital,” he says.

“We
also provide staff with reports on the country they’re going to, which
considers risk levels for specific diseases. For Hungary, say, there will be a
journey profile, which will list main diseases, such as tetanus, hepatitis,
rabies, dysentery etc, and provide advice on the risk level and any precautions
that might be necessary,” says Mitchell. “Of course, Hungary, as a central
European country, would be low risk, but something such as rabies is present,
and people would need to be aware of that and given appropriate advice.”

BAT
also provides its workers with contact details of the British embassy in the
host country and advises them to register as a family unit with the local
international clinic.

BAT
makes sure the company’s plants and factories abroad all fully respect the
local health and safety at work regulations. Mitchell adds that when the
company acquires a new operation, “our medical advisers would normally look at
the manufacturing facilities and make sure they were in line with our global
standards so the plant would meet local employment health and safety (EHS)
rules, as well as complying with BAT’s global EHS standards”.

There
is also additional security for expatriate BAT employees in other European
countries. Under a scheme run with the insurance company Allianz, employees are
guaranteed provision of any medical cover that may be beyond the local clinic
or hospital, including transportation to more advanced centres. “We’ve had
three medical evacuations in Izbekistan, and Allianz has covered the costs,
making sure that air ambulances got in as quickly as possible and taking people
to where they could get Western-style medical attention,” says Mitchell.

South-east
Asia

According
to the British Occupational Health Research Foundation, there is no single
point of information that any company looking to set up in south-east Asia can
turn to for OH advice. In Singapore, for instance, OH is run under the auspices
of the Occupational Health Department of Industrial Health, which answers to
the Ministry of Manpower. It has the remit to control health hazards at
workplaces and reduce the incidence of occupational diseases through assessing
and monitoring the work environment; conduct medical investigations and
surveillance; organise promotional activities; and provide advisory services.

The
result is an infrastructure as strict as anything in the UK. The Ministry of
Manpower is currently widening the scope of the key legislation in this field –
the Factories Act – which covers issues such as sanitation, ventilation and first
aid, as well as the appointment of safety officers, to cover non-industrial
workplaces. In the first phase, the healthcare sector, hotels, restaurants and
catering establishments, and research and development laboratories will be
included.

For
white-collar workers, companies face similar responsibilities to those in the
UK – for example, ensuring that the level of chemicals in the air do not exceed
permissible exposure levels and lower environmental noise levels are kept low.
However, the health risks are heightened for expats who work with machinery and
outside the major cities in the region. In particular, while many companies
have offices in Singapore, staff often go into the field in neighbouring
countries, such as Cambodia, Indonesia and Vietnam, where health and safety
rules are – if they exist at all – frequently ignored.

Most
UK companies sending staff to the region offer free medical insurance and staff
their OH departments with locals, or an occupational in-house doctor. They also
implement local OH laws. Unilever, for example, delegates all OH
responsibilities to the local factories and units in the country concerned. It
also has a general policy for all overseas operations, though it says this is
“not in the public domain”.

One
OH practitioner, who has recently returned from south-east Asia, said that in
spite of Singapore’s ‘squeaky-clean’ image, the region did present challenges.
“Malaria is an issue in some areas, and the region has a denial culture where
HIV/Aids is concerned,” she said.

“Malaysia,
for example, has a very good reputation on occupational health, but when you
get outside Kuala Lumpur, there are issues for workers. Many local people will
keep pigs, which attract mosquitoes that can transmit Japanese encephalitis.
Often the best thing to do is to consult the Lonely Planet guide, as
backpackers also go off the beaten track.”

BT
uses its in-house OH service in London to give advice on immunisation,
medicines and places to avoid. The staff that do travel tend to be managers,
and they are given free medical insurance and emergency repatriation if
necessary. Aside from that, staff will liaise with local offices on the ground
for OH support.

Like
most other companies, BT does not have a list of local laws to be aware of, as
staff are advised to gather this information from the regional OH in Singapore
or Hong Kong. However, if a crisis develops, such as SARS, then headquarters in
London takes over.

“During
the SARS outbreak, we did stop people travelling to the region and we stopped
our staff out there from travelling around,” says BT spokesperson, Roger
Westbury.

HSBC,
however, took a different approach. “We didn’t deviate from the advice given by
the World Health Organisation,” says Gail Scott, from HSBC’s OH department. “We
didn’t embargo travel but we told people to be sensible. People were fine about
it.”

The
United States

As
befits a land that is – as George Bernard Shaw famously said – divided from
Britain by a common language, the United States presents special challenges as
well as a certain familiarity for the travelling employee.

Ursula
Ferriday, senior medical adviser for Unilever, told Occupational Health that
her company’s employees are thoroughly briefed with regards to any health and
safety precautions that should be taken while in the US. For instance, when
sending its employees to the US, the Anglo-Dutch multinational provides them
with a comprehensive portfolio on living alongside Americans, among which are
the key OH problems that need to be considered. Some of this information is
basic administration, such as acquiring social security numbers. However,
guidelines on health and safety rules and regulations in the US are also
included, as well as specific advice on driving safety, how to safeguard
against violence, such as muggings, and basic health advice, such as preventing
sun exposure.

Prior
to leaving the UK, Unilever employees must undergo an overseas medical, which
entails a blood test, blood grouping, eye test, a weigh-in and blood pressure
checks, as well as an appointment with the in-house doctor for a physical
examination.

Unilever
staff in the US are insured with Bupa International policies, covering
long-term chronic illness, and are also provided with cover from International
SOS for urgent acute health treatment.

In-house
company doctors are also made available to staff to advise them on any
specialised medical assistance they may need, and can also help with smaller
problems, including health and safety issues.

Ferriday
says this triple coverage and assistance is essential for their employees: “I
think it helps with consistency in approach, in that Unilever has a global
network of doctors.” She adds that these doctors were able to help the
company’s component parts implement ‘global health standards’ written by
Unilever for all branches and subsidiaries, with the aim of providing a
harmonised OH policy. These include a demand that there is a named company
doctor and a named OH department available. This ‘framework standard for
occupational health’ also insists that Unilever’s businesses design OH policies
based on ‘local risk assessments’, which in the US, for instance, includes the
need to protect staff from violent crime.

Indeed,
if problems of this type develop locally, security officials working within the
company in the US are supposed to relay pertinent information to local OH
departments, who can alert Unilever employees about any risks.

Ferriday
adds that Unilever designated local representatives to advise staff on local
safety issues generally, with transferred employees being given named Unilever
contacts in their portfolios to deal with a range of personal issues.

With
regards to specific medical issues and their relation to the company’s
occupational health policies, Ferriday says: “These doctors are all aware of
the policies and can then initiate appropriate processes and systems to ensure
that those standards are complied with.”

Ferriday
says that if an employee does become ill while in the US, its health services
are generally of such a high standard that staff are usually treated locally,
even for long-term illnesses. She could think of only one instance where
Unilever repatriated an employee from the US to the UK, and that was for
personal reasons.

Of
course, with Unilever employing 21,000 employees in North America, the bulk of
its staff in the US are actually American citizens. Ferriday says that the
company also makes sure that these workers are supplied with adequate health
insurance coverage, in a country where free-delivery public healthcare is not
always available.

http://www.bupa-intl.com
www.internationalsos.com

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