Managing health risks for corporate travellers

This article is authored by Dr Samir Dwivedi, medical director, Assistance, International SOS.

India’s economy is expanding steadily, and along with it, business travel has also increased, both within the country and abroad. Employees are attending meetings in major metros, supervising projects in industrial belts, and many are posted at mining and construction sites located in remote areas. Our healthcare system has improved considerably over the last few years, but India is a very large country, and the climate, geography and disease pattern are not the same everywhere. Because of this, the health risk changes depending on where the traveller is going. Understanding this difference is an important part of an organisation’s duty of care, and it also helps employees to stay healthy and remain productive while on the move.

Corporate employee (Representational image). (Unsplash)

The nature of the risk depends largely on the nature of the trip. Travelers going to cities like Delhi, Mumbai, Bengaluru, Hyderabad, Chennai or Kolkata will generally get access to good tertiary hospitals, but at the same time they have to deal with heavy air pollution, food and water borne illness, influenza, and very dense traffic which makes road accidents a genuine concern. In Tier 2 and Tier 3 cities, specialist care may not always be available in the vicinity. Employees working at manufacturing plants, construction sites, mines, rural field locations, or offshore installations face one more layer of risk, which includes occupational hazards, heat stress, physical injury, and delay in getting emergency medical treatment.

The disease pattern in India also varies from region to region and from season to season. Dengue is common in urban and semi urban areas, particularly during the monsoon and immediately after it. Malaria is still present in parts of central, eastern, and northeaster India, although the case numbers at national level have come down. Scrub typhus is seen in the Himalayan foothills, in South India and in the Northeast, whereas Japanese encephalitis remains endemic in certain districts of Uttar Pradesh, Assam and Bihar. Leptospirosis is reported more frequently in high rainfall regions, mainly along the western coast. Rabies continues to be a serious concern after any animal bite and requires immediate medical attention. High altitude illness can affect travellers visiting Ladakh or other Himalayan project sites, and extreme heat becomes a major risk during the summer months in the north, west and central parts of the country.

A large share of medical incidents among business travellers is not related to infection at all. Road traffic accidents remain one of the leading causes of serious injury, especially during long distance travel and while using two wheelers. Heat exhaustion, dehydration, respiratory problems caused by poor air quality, cardiovascular events, fatigue due to long working hours and ordinary workplace injuries are also quite common. International travellers have some additional difficulties, since they must manage jet lag, unfamiliar climate conditions, and a health care system with which they are not familiar.

International assignees coming to India normally do not have immunity against the infections circulating here, and hence they are more prone to traveller’s diarrhoea caused by contaminated food or water. Depending on the itinerary and individual risk factors, pretravel vaccination may be recommended against hepatitis A, typhoid, tetanus, influenza and, in selected situations, rabies or Japanese encephalitis. Annual influenza vaccination should be considered for everyone, particularly those with chronic medical conditions. Travellers with any chronic medical condition should carry an adequate supply of their medications together with copies of their prescriptions. They should also ensure they have access to medical assistance services, including emergency medical evacuation where appropriate.

Indian employees travelling within the country should not assume that they are automatically protected simply because they are travelling in their own country. Moving from one region to another can expose a traveller to unfamiliar disease patterns as well as different environmental conditions. Travelers having diabetes, hypertension, respiratory conditions, or cardiovascular disease should ensure that these are properly controlled before they travel, especially when they are going to remote areas where specialist care may not be readily available.

Season plays an important role in deciding the level of risk. During summer, the chances of heat related illness and dehydration increase considerably. The monsoon brings a higher incidence of dengue, leptospirosis, malaria in endemic districts, diarrheal disease, and influenza in many parts of the country. Winter is associated with seasonal influenza and other respiratory infections, and the air quality also becomes very poor in northern cities, particularly in Delhi and the National Capital Region.

Effective prevention must begin well before departure. A destination specific risk assessment should be carried out, considering the medical history of the employee, the itinerary, the duration of travel and the local disease pattern. Travelers should be briefed properly on mosquito bite prevention, food and water hygiene, safe road practices, hydration, recommended travel vaccinations, and emergency contact procedures. On their part, employers should maintain a clear travel health policy, work along with occupational health providers, establish a referral hospital network for key locations, and arrange access to telemedicine and evacuation services wherever the same is required.

Urbanisation, the climate crisis, and changing patterns of infectious diseases continue to reshape the travel health risk landscape. As a result, protecting the health of corporate travellers should be viewed as an ongoing process rather than a one-time exercise. A structured travel health programme, incorporating pretravel risk assessment, preventive measures, and access to appropriate medical support, not only safeguards employee wellbeing but also minimises business disruption and strengthens organisational resilience.

(The views expressed are personal)

This article is authored by Dr Samir Dwivedi, medical director, Assistance, International SOS.