Safe travels

Aspirin is not effective against the development of venous thrombosis as it only acts upon arterial thrombosis, according to British Airways’ (BA) head of aviation medicine.

Dr Michael Bagshaw discussed the myths and misconceptions surrounding air travel, as well as the health effects of flying and crossing time zones.

BA 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.

Bagshaw encouraged the audience to view the information given on the BA website,1 which offers a wealth of information, including downloadable leaflets such 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.

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 completely changed every two to three minutes. He also said 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 required under legislation. She explained that an ex-pat worker can expect health and safety rights, which are confirmed by a raft of legislation derived from Europe.3

The BBC’s OH department deals with workers journeying to all manner of places, including war zones and famine areas – often facing danger. Forty journalists have died in the recent Iraq conflict – 95% of which were of traumatic injuries.

Dr Dipti Patel, OH physician at the BBC, explained the work of the BBC in preparing staff to be aware of the risks, how to ensure 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. The role of OH is given in the box above.

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’ Hospitals, talked about working with UK diplomats and overseas workers.

Foreign Office staff 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.

Snashell 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 (NaTHNaC),6 talked about the work of this advisory organisation, set up by the government and open daily from 9am to 12pm and 2pm to 4.30pm. 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 (MASTA) has to offer business travellers in the way of advice and immunisations.7

To download a list of business travel resources go to


3. Lewis J, (2004) Far Away Places, Occupational Health, August 2004, p12
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

Incidence of risk of traveller’s thrombosis

  • Incidence of thrombosis in the general population: 1:1,000 per annum
  • Risk of traveller’s thrombosis without additional factors: 1:2m
  • Risk of traveller’s thrombosis with additional factors (age, gender, hormones): 1:100,000

Role of OH in business travel overseas

  • To assist with risk assessment for the trip
  • To help ensure staff are fit and prepared
  • To ensure overseas work suits the individual’s medical needs
  • Immunisation, malaria prophylaxis and advice on other preventative measures to protect against illness and injury
  • Medical kits/equipment
  • To ensure access to medical care while staff are overseas
  • Appropriate follow up on return

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