Aspirin is not effective against the development of venous thrombosis as it only acts upon arterial thrombosis said British Airways head of aviation medicine, Dr Michael Bagshaw who discussed the myths and misconceptions surrounding air travel as well as the health effects of flying and crossing time zones.
British Airways has the biggest medical services of any airline and Bagshaw, as both a pilot and a specialist in the field of aviation medicine, speaks from a sound knowledge base. He encouraged the audience to view the information given on the BA website (1), which offers a wealth of information, including downloadable leaflets on such topics as a guide to good health and a healthy journey.
He outlined the training and information that cabin crew receive and quoted some research on travellers thrombosis, some of which dates back as far as 1856 to present day.
According to the World Health Organisation (WHO) meeting in Geneva 2001 evidence of thrombosis attributable to flying is largely circumstantial(2).
Bagshaw also covered cosmic radiation and cabin air, and revealed that, contrary to public opinion, cabin air is totally changed every 2-3 minutes, that 50% is recirculated after passing through filters and that independent studies have shown that cabin air is bacteriologically cleaner than on any other form of transport.
Legal expert, Joan Lewis detailed the employment rights that are required under legislation. She explained that an ex-pat worker can expect and health and safety rights, which are confirmed by a raft of legislation derived from Europe. Her article in December 04 issue of Occupational Health journal complements her talk (3).
The BBC’s occupational health department deals with workers journeying to all manner of places, including war zones or famine areas and are often in danger – for example, 40 journalists have died in the recent Iraq conflict, 95% of traumatic injuries.
Dr Dipti Patel explained the work of the BBC in preparing staff to be aware of the risks, how to ensure that they are fit and prepared and that adequate overseas support is in place. She explained that all personnel attend a seven-day commercially available training course for overseas workers. Patel also talked about the epidemiology of travel related disease.
Gastrointestinal problems account for 45% of illness and traveller’s diarrhoea is the commonest, 80% of which is due to infective enteropathogens (4). The role of OH is given in Box 2.
Specific advice is needed on day-to-day living in foreign countries, particularly where communicable disease is rife. Dr David Snashell, head of OH at Guys and Thomas’, talked about working with UK diplomats and overseas workers.
Foreign Office people spend a long time abroad and their needs are different from short-term business or holiday travellers. There are family considerations, children travelling and living abroad and some individuals worry about the long-term effects of malarial prophylaxis. He says there is little research on the effects on health of long term expatriation although it is known that there is a reverse culture shock on returning to the UK, especially for aid workers. Snashell recommended the book endorsed by Michael Palin on Travellers Health (5).
Alexandra Jordon from The National Travel Health Network and Centre (6) talked about the work of this advisory organisation set up by the government and open daily 9-12 and 2-4.30. A revision of Health Information for Overseas Travel will be made available online during 2005.
Finally, Michelle Abbott gave a talk about what the Medical Advisory Service for Travellers Abroad has to offer business travellers in the way of advice and immunisations (7).
3. Lewis J, (2004) Far Away Places, Occupational Health Aug vol 56 no 8.
4. Steffan R et al (1983) Epidemiology of diarrhoea in travellers, JAMA
5. Dawood R, (2004) Travellers Health: How to stay healthy abroad, Oxford, Oxford University Press
Box 1 Incidence & risk of travellers thrombosis
Incidence of thrombosis in the general population: 1:1,000 per annum
Risk of traveller’s thrombosis without additional factors: 1:2 million
Risk of traveller’s thrombosis with additional factors (age, gender, hormones) 1:100,000
Box 2 Role of occupational health in business travel overseas
- To assist with risk assessment for the trip
- To help ensure staff are fit and prepared
- Ensure that overseas work suits the individuals medical needs
- Immunisation, malaria prophylaxis and advice on other preventative measures to protect against illness and injury
- Medical kits/equipment
- Ensuring access to medical care whilst staff are overseas
- Appropriate follow up on return