Employee health: Reducing the risks

Workers in today’s global economy face a variety of health risks. With comment from experts, Louise Whitson considers how organisations and their employees can manage and mitigate them.

Around the world, health has been hitting the headlines. From the Ebola virus in West Africa, to air pollution and bird flu in China, to Middle East respiratory syndrome coronavirus (MERS-CoV) in Dubai, it seems that every day brings employers based in affected areas and those managing international assignments – not forgetting employees and assignees – new cause for concern.This coincides with growth in the number of business travellers and expatriates being sent to countries with higher medical risks, according to research from medical and travel security services group International SOS.The study found that, in 2013, more than 40 per cent of medical cases occurred in countries classed as ‘high’ or ‘extreme’ risk, up from less than 25 per cent in 2010. In countries classed as extreme risk, 11 per cent of cases were due to cardiovascular disease, while another 11 per cent were attributable to infectious illnesses, including malaria and dengue fever. Of cases in Asia and the Middle East, 50 per cent were in high-risk countries, with assistance most commonly required in Indonesia, India, China and Vietnam. This compares with 29 per cent in 2010.Scott Sunderman, group CEO of global medical, security and travel assistance services provider Healix International, winner of Re:locate’s new Global Health & Wellness award, points out that, as companies look further afield for new sources of business and operational capability, even traditionally conservative professional services firms, which might once have sent people almost exclusively to major first-world cities, are starting to operate in remote parts of Africa and Asia.He adds, “Energy and mining companies used to dominate in terms of exposure to high-risk locations, but now we see manufacturers, FMCG companies, non-government organisations and inter-government organisations doing business in these places as a matter of routine.”Inevitably, this is leading to an increase in the number of expatriates needing medical assistance from Healix. The group is finding, however, that conditions on the ground have not progressed in most instances.Scott Sunderman explains, “Even in relatively developed parts of the world, expatriates may struggle to adapt to the standard of medical care available. This is especially true in areas such as post-operative support, where the quality of nursing care may be poor – and often non-existent – and language issues may prove problematic.”It’s important, therefore, that employers manage employees’ expectations and have appropriate medical evacuation plans in place.Reducing and managing riskThe challenges for employers sending employees overseas are reducing risk wherever possible, managing any remaining risks, and – crucially – convincing employees that they are valued and will be looked after.To reduce risk, planning and preparation, by both employer and employee, are crucial. Healix has found that a well-thought-out plan to assess and prepare employees will provide both an understanding of the risks that the employer is taking by sending an employee (and possibly also his or her family) overseas, and a better-supported workforce.Risks, Scott Sunderman says, can be both financial – a chronic medical condition that needs to be supported in a high-cost country can lead to substantial unforeseen expense – and physical – an individual with a chronic medical condition who travels to a country that cannot adequately support that condition will be placed at significant risk. An employer who understands the risks of sending an individual to a given location will be able to make a considered judgement about the cost and benefits of the assignment.“By properly understanding factors such as pre-existing medical conditions,” Mr Sunderman adds, “the employer can take steps to prepare its workforce before international assignments. Even very basic issues, such as gaining access to prescription medication in a foreign country, can prove to be problematic, and can destabilise employees and their families. Most potential issues can be easily fixed prior to departure, making the employee feel well supported, and increasing the chances of a successful assignment.”The risks of not properly assessing and preparing employees include the potential for unforeseen costs, breaches of an employer’s duty of care, and, of course, the cost and operational implications of failed assignments.Empowering employeesInternational health benefits provider Aetna International was shortlisted in the Global Health & Wellness category of the Re:locate Awards. Its general manager for Europe, David Healy, believes that, as well as choosing an international medical insurance plan that meets the specific needs of their staff, employers should consider the add-on tools their insurer makes available as part of the insurance package, which can help employees to manage most aspects of their health.Aetna’s web and mobile tools, for example, include mobile apps that allow members to locate nearby providers, book appointments, and obtain directions. Mobile technology enables claims to be submitted via smartphone.Providing information, says Mr Healy, is also important. “The more knowledge employees have of their healthcare options, the less risk they are likely to face when working overseas. A staff member in a remote location needing urgent treatment, for instance, will benefit from understanding quickly where to find their local treatment centre.”Asked what steps employees can take to help ensure their own wellbeing while on assignment, David Healy says, “Employees will naturally differ in their approach to health and fitness, and moving to work abroad can often mean additional stresses from a new job and settling into a different environment. Employers typically want to encourage staff to stay healthy, and may look to provide local support and information on healthy eating and other important considerations.”Technology plays a key role in delivering wellness advice and information for Aetna’s members. The company provides health-related information via dedicated applications for smart devices and through the member portal on its multilingual website.Healix’s Scott Sunderman advises, “Expatriates should ensure they complete a medical assessment and follow advice. It’s critical, for example, to ensure that vaccinations are up-to-date, and to take malaria prophylaxis in malaria-affected zones.”Avoiding diseaseWhen it comes to the risks of the current well-publicised outbreaks of serious diseases like Ebola and bird flu, David Healy says, “Dealing with natural disasters and outbreaks of disease can be highly stressful and worrying for expatriates. Employers should check that their insurance provider is willing to help in these situations and can provide sufficient support.”International employee assistance programmes (IEAP) can support members in cases of disaster or serious infectious disease. Explains Mr Healy, “IEAPs can assist with a variety of topics, ranging from eldercare and childcare to legal, financial and relationship issues, and workplace conflict. They can also help members navigate difficult situations like disease outbreaks, whether from a practical perspective or to help deal with the emotional fallout.“If members are worried they will be travelling to a high-risk area, they can call the IEAP for advice.”Scott Sunderman says, “Employees should follow advice in terms of personal hygiene, and avoid contact with potential sources of infection, such as, in the case of bird flu, chicken carcasses in wet markets. Employers should ensure that they have up-to-date infectious-disease response plans that link to their business continuity plans.”However, he cautions, it is vital to keep a sense of perspective. “Many of these highly publicised pathogens are not particularly contagious and impact relatively few people. It’s important that employers and employees do not lose sight of the more common – and yet less well-publicised – diseases, such as malaria and yellow fever.Air pollution in China Of course, it’s not just disease that can affect the health of those travelling internationally: environmental factors can also pose a threat, particularly in emerging economies, as was demonstrated at the Worldwide ERC APAC Summit in Shanghai, during a session which highlighted the health risks posed by air pollution in China.Yi Zhong, China health project leader for General Electric (GE), explained that, while air pollution was a concern, she viewed smoking as the biggest challenge to health in China, where smoking-related deaths exceed a million per year. GE’s Health Ahead programme, she said, encouraged employees to take responsibility for their own health.Sammi Chen, IM adviser for BP, felt that pollution could affect the ability of companies in China to attract and retain foreign staff. To counteract this, organisations most commonly offered simple guidance, such as advice on reducing exercise on days when pollution was high. Paying a hardship allowance was another alternative.Ms Chen also emphasised the importance of communicating to expats that their employer cared about their wellbeing. Providing monitoring of indoor pollution was an option, as was installing air purifiers in apartments. Requesting indoor and outdoor pollution testing before a lease was signed could also be considered.

Related Articles