Article

Country Factors Associated With the Risk of Hospitalization and Aeromedical Evacuation Among Expatriate Workers

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Abstract

: To assess country factors associated with the risk of requiring aeromedical evacuation and hospitalization among expatriate workers and their dependents. : The 2009-2010 data including 5725 aeromedical evacuations and 17,828 hospitalizations, and 2009 data of hospitalizations and aeromedical evacuations among 94,651 at-risk expatriates, were analyzed to assess 2 country risk rating tools. Each tool utilized four risk categories and reflected level of development and medical capabilities. : Country risk category was strongly associated with risk of evacuation and/or hospitalization for each risk rating tool (eg, 46-fold increase from lowest to highest country risk category). : Country risk tools strongly associate hospitalization and aeromedical evacuation with country risk category, and thus can be important indicators of relative medical risk. Employers may use these results to implement targeted prevention programs to support expatriate workers and their families.

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... Currently, MNCs place international expatriates or assignees in more than 20 countries on average, and the number of countries continues to grow. For MNCs, 95% of the consumers are outside the United States, and the growth in revenues from developing countries will drive continued globalization and the need for business travel and overseas assignments [12][13][14]. ...
... Business travelers' health and safety risks have historically been considered "low". However, studies have shown that these risks are similar to the risks of other international travelers [14,15]. In fact, in a recent study of travelers to Asia, more than 60% of high risk travelers listed a business reason for the trips [16]. ...
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The epidemiology of Japanese Encephalitis and risk to the traveler has changed and continues to evolve. The spread of Japanese Encephalitis virus into new environments, changes in agricultural practice and animal vectors, climate change, peri-urban growth, changes in international travel to Asia, personal risk factors, mosquito vector free transmission, interactions with other flaviviruses and better information on infections without encephalitis and other factors make Japanese Encephalitis an underappreciated risk. There has also been a change in the incidence of Japanese Encephalitis cases that questions the current travel duration and geographic based recommendations. A safe, effective vaccine (Ixiaro) that may be administered in a short course regimen is now available in the United States without the risks of the previous vaccine. However, the vaccine is significantly underutilized. These changes in the epidemiology and new data on the risks of the Japanese Encephalitis virus require a review of the practice guidelines and expert recommendations that do not reflect the current state of knowledge.
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... Although using data on general travelers to make interferences about travel-related illness in occupational travelers is possible, there is evidence that business travelers (especially expatriates, i.e. occupational travelers with an assignment for a longer period abroad) may be confronted with higher rates of illness, injury and psychiatric disorders [7,8,9,10,11]. ...
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... 38 The risk of hospitalization and evacuation of expatriate workers has been strongly linked to the World Health Organization Human Development Index for the destination country. 39 We found that expatriate workers appear less likely to require evacuation for medical problems than nonexpatriate business travelers, perhaps due to more stringent screening, better knowledge of local resources, and better local support structures, or reporting bias. ...
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Incl. bibl., statistical annex, pp. 207-236, biographical note on the author
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