Travel Health and Safety – Considerations for Work-Related Travel

Employers must identify all hazards to which their workers are exposed and take steps to mitigate the risks. They are also responsible for making workers aware of all applicable risks and how to best protect themselves.

To complete a risk assessment, consider all plausible scenarios that can affect workers’ health and safety. Determine the hazards during transit (e.g., plane, train, bus, hotels, etc.) and at the destination (e.g., country, state, town, etc.). Consider how diseases are spread to humans such as:

• The inhalation of respiratory droplets,
• Through contaminated surfaces, food, or water,
• The bite of infected insects or animals, or
• The exchange of bodily fluids.

Assess the risks once the hazards have been identified by following a structured risk assessment process. A risk checklist can help identify risks and suggest control measures.

Factors that can affect the risk of illness or injury while travelling include the destination, mode of transportation, frequency of travel, work activities, duration of stay, access to healthcare, and individual risk factors. Information on each of these factors is detailed below.

Destination: The location of travel may have region-specific endemic (regularly occurring) hazards. For example, an individual who travels to Argentina for work is at an elevated risk of contracting yellow fever. Travellers may be at higher risk of acquiring a disease depending on the destination visited, especially if the country has poor infrastructure, a lack of clean water and sanitation, or poor management of insects and animals that transmit disease. Refer to travel advice and advisories by destination to be informed of health, safety, security, and other risks outside of Canada.

Mode of transportation: Transportation can be by air (usually by plane), sea (boat), or land (cars, buses, trucks, trains, etc.). Concerns with the mode of transportation include an increased risk of exposure to a respiratory infectious disease due to poor ventilation and crowded environments. For example, a long flight on a full plane could potentially increase the risk of becoming ill (long duration and dependence on mechanical ventilation) compared to travelling a short distance in an uncrowded car with the windows open.

Frequency of travel: Frequent travellers may be at greater risk than those who travel for work occasionally. Exposure to hazards increases when there is more frequent travel.

Duration of stay: Exposure to hazards can be affected by how long the worker stays outside of Canada or works in a setting with a particular hazard. For example, the longer a worker is located in an area known to have mosquitos that transmit Zika virus, the more likely they will be exposed and potentially become ill.

Work activities: The type of activities the worker performs while abroad may increase their risk of coming into contact with certain pathogens (germs that cause disease) and other hazards. For example, a worker who works in an environment where rats are common would be at higher risk of diseases spread by rodents, such as hantavirus.

Access to healthcare: The availability and quality of medical care varies by country. Obtaining healthcare resources in some countries could be difficult, and treatment options could be limited. Generally, more care is found in urban areas than in rural locations.

Individual risk factors: Workers with pre-existing medical conditions may be at greater risk of illness or injury while travelling for work.

While working abroad, workplace control measures must be followed to reduce the risk of experiencing an injury or illness. Identifying hazards, recommending suitable control measures, and communicating with workers are employer responsibilities. The worker is responsible for adhering to control measures to protect their own health and safety and for reporting any concerns to their employer.

Workers are encouraged to follow good health and safety practices during non-working hours as well to help protect themselves at all times. Some hazards exist just as much during working hours as in personal time, such as mosquitoes, animals with disease, or unsafe food and drink.

The sections below provide guidance on reducing various risks when travelling outside of Canada for work, including bug bites, animal diseases, person-to-person infections, mental health and wellness, and more. Adopt the control measures based on the risk to the worker.

Many diseases are spread by the bites of infected bugs such as mosquitoes, ticks, or fleas. Workers who are exposed to bugs while on the job, or while travelling, are at an increased risk of infection. To protect workers from bug bites, consider the following general control measures:

• Use insect repellent containing DEET or Icaridin (follow manufacturer’s recommendations for use)
• Make sure indoor areas, especially sleeping areas, are completely enclosed or well-screened
• Treat clothing and gear with products containing 0.5% permethrin, or wear permethrin-treated clothing
• Wear light-coloured long-sleeved shirts, long pants, and long socks
• Provide training about the risk of bug bites and how to prevent them, symptoms of diseases, and the safe use of insect repellents

Learn more about some of the diseases bugs spread and specific control measures in the table below.

See the Resources section for useful links related to the diseases mentioned above.

Refer to the insect bite prevention resource from the Public Health Agency of Canada for additional guidance.

Workers can become ill from animal bites or from contact with animal fluids or feces. While travelling, it is best to stay away from all animals. Learn what types of animals are present at the travel destination and workplace, and the symptoms of the diseases they spread. Common diseases and precautions are listed below.

See the Resources section for useful links related to the diseases mentioned above.

Diseases transmitted through blood, such as hepatitis B, hepatitis C, and HIV infection, are spread from person to person by direct contact with infected blood or other bodily fluids. Certain diseases can be spread from person to person without direct physical contact, such as respiratory viruses. Respiratory viruses spread between people in several ways, such as when an infected person coughs or sneezes, or through contact with contaminated surfaces. Close contact with people in enclosed spaces (e.g., in buses or planes) may increase the risk of becoming sick, so frequent handwashing and wearing of a high quality and well-fitting mask or respirator may be recommended depending on the situation.

When travelling for work, eating or drinking contaminated food or drinks can cause diseases such as travellers’ diarrhea, hepatitis A, or typhoid fever.

By following these general precautions, workers can reduce their risk of illness while travelling:

• Avoid uncooked foods (like shellfish and salads) and food from street vendors. Fruits and vegetables that can be peeled are usually safe to eat
• Avoid unpasteurized dairy products, including ice cream
• Only drink and use ice made with purified water or commercially bottled water in sealed containers
• Brush your teeth with bottled water
• Wash your hands often, especially before eating or drinking or after using the washroom, with soap and water for at least 20 seconds. Use alcohol-based hand sanitizer (containing at least 60% alcohol) if soap and water are not available
• Do not consume food or drink when near animals
• Avoid eating wild animals
• Consider oral rehydration solutions, which are used to treat dehydration caused by diarrhea, if warranted

For more information refer to eat and drink safely abroad from the Government of Canada.

Work-related travel can lead to mental stress, and it can also exacerbate existing mental illness. Risk factors for experiencing high stress include frequent travel for work, working in a foreign environment, or performing humanitarian and disaster work. However, any worker can experience unpleasant or frightening emotions while travelling, which can be caused by a change in culture, jet lag, or even post-traumatic stress disorder (PTSD). Stress associated with work travel can be reduced when workplace control measures and coping strategies are implemented.

Consider the following strategies to improve mental health and well-being while travelling outside of Canada:

• Recognize the symptoms of changes to emotional well-being, which can include feeling stressed, anxious, angry, or depressed
• Provide cultural adaptability training for workers that may work with people from other cultures
• Eat healthy, regular meals while travelling
• Avoid alcohol, which can disrupt sleep patterns
• Exercise regularly during travel
• Stay in touch with friends and family at home
• Consider setting aside time for doing personally enjoyable activities, like listening to music, going for a walk, or practising a familiar hobby
• Practise relaxation techniques (e.g., yoga and meditation) to allow for slowing down and paying attention to thoughts, feelings, and experiences happening in the environment
• Consider altering sleeping schedules before travelling to reduce symptoms of jet lag
• Where jet lag may occur, avoid scheduling work until 24 to 48 hours after arrival
• Take short naps (15-20 minutes), where possible, if symptoms of jet lag are present

Refer to mental health and wellness for more general information.

The use of drugs and the consumption of alcohol can impair a worker’s ability to perform work safely. Substance use while travelling should be considered as part of a comprehensive workplace impairment policy.

Possessing drugs (legal and illegal) and being impaired in a foreign environment presents unique challenges. Workers abroad are subject to the laws of the country where work is being performed. For example, medications containing stimulants are illegal in Japan, or a drug conviction in Singapore or Myanmar could result in a death sentence.

Travel Advice and Advisories provides destination-specific information on drug-related laws. Refer to the Government of Canada’s drugs, alcohol and travel and do's and don’ts pages for more advice.

Workers travelling to an altitude of 2500m above sea level or greater can develop altitude illnesses due to the lack of oxygen present at higher elevations. Altitude illness sometimes occurs at lower elevations, but the risk increases with altitude and with subsequent elevation gain. There are 3 types of altitude illnesses, which include acute mountain sickness (AMS), high-altitude pulmonary edema (HAPE), and high-altitude cerebral edema (HACE). Symptoms can include breathlessness, dizziness, fatigue, headache, interrupted sleep, nausea, vomiting, confusion and loss of consciousness. High-elevation environments can also expose workers to extreme temperatures and increased ultraviolet radiation, which can cause hypothermia and sunburns.

Workplace control measures that can prevent the risk of developing altitude illnesses include:

• Acclimatize by gradually ascending to high elevations. Avoid travelling from low to high elevations (2500m above sea level) in 1 day (the extent of acclimatization may be limited by certain medical conditions, especially lung disease)
• Spend at least 1 night at 2500m before ascending higher and spend an extra night for acclimatization every 600-900m if continuing to ascend
• Once at a high elevation, move sleeping locations by no more than 500m per day
• Drink plenty of water
• Consider a high carbohydrate diet while ascending
• Avoid alcohol and heavy exercise for 48 hours after arriving at a high elevation
• Provide training to workers to understand the symptoms of altitude illnesses and control measures to prevent the risk

Workers with pre-existing medical conditions, such as cardiovascular or pulmonary disease, should seek medical advice before travelling to high altitudes. Workers should also talk to their doctor about medicines that are available to prevent acute mountain sickness and shorten the time it takes to get used to high elevations.

Workers who are exposed to extreme heat or spend time in hot environments may be at risk of developing heat-related illnesses, such as heat exhaustion and heat stroke. Work involving strenuous physical activity increases the risk of heat stress. Spending time outdoors can also cause adverse health effects from exposure to ultraviolet (UV) radiation, like sunburns, skin cancer, and damage to the eyes. These outcomes can happen even when it is cloudy. The risks for sun-related injuries and illnesses are highest during the summer months, in countries near the equator, at high elevations, and during the day.

Employers are required to prevent heat and sun-related illnesses. A prevention program should include the identification of conditions that pose a risk of illness (e.g., travelling to hot destinations), and the development of workplace control measures. Recommendations for safe heat and sun exposures while travelling include:

• Limit time in the sun between 11 a.m. and 4 p.m. Perform work indoors, or in areas with shelter and shade (e.g., awnings, canopies). Schedule work in the heat or in the sun during cooler periods of the day
• Ensure acclimatization prior to performing a full workload while travelling. Increase the duration and intensity of work performed in hot environments gradually
• Provide an appropriate work-rest schedule
• Provide workers training and education on potential hazards of working in the heat and sun, and ways to prevent adverse health effects from being exposed to these environments
• Apply a broad-spectrum sunscreen with an SPF of 30 at minimum
• Stay hydrated by drinking cool, non-alcoholic liquids, especially water, in frequent small portions
• On hot days, maintain a healthy diet by eating light foods and avoiding protein, which can increase body heat. Consume salt-containing food and drink to help replenish electrolytes
• Wear light-coloured, long-sleeved clothing and a wide-brimmed hat. Wear sunglasses that provide protection against UVA and UVB rays

For additional information refer to sun and heat safety tips for travellers and hot environments fact sheets.

Physical assault, threats, and harassment can occur during work as well as outside of work. The risks can be higher where safety and security concerns exist (refer to travel advice and advisories by destination). Additionally, not all countries offer the same level of workplace violence and harassment protections as in Canada. Some work-related factors that can increase the risk of violence and harassment include working with members of the public, unstable or aggressive people, alone, and during nighttime.

A policy can form a guide on how workers can protect themselves. It can include what are considered inappropriate or dangerous behaviours and how to respond to incidents of violence and harassment.

Some control measures that can be implemented according to the worker’s circumstances include:

• Be aware of the worker’s location (e.g., in countries where there is risk of human trafficking or kidnapping, knowing the whereabouts of the worker is especially important)
• Work in teams (avoid lone worker situations), or always be accompanied by a local worker or security officer
• Perform work during daylight hours
• Promote de-escalation of conflicts
• Discourage carrying and flaunting valuables (e.g., jewelry) if there is a risk of robbery
• Hire private security if there is a high risk of violent crime
• Contact local law enforcement if there is serious threat or incident of physical harm
• Provide workers with guidance on how they can protect themselves both on the job and in their personal time
• Encourage and inform workers how to report breaches of the policy (assaults or threats abroad should be reported to the nearest Canadian government office or the Government of Canada’s Emergency Watch and Response Centre).

Refer to Violence and Harassment in the Workplace for more information on developing a policy and selecting control measures.

While the goal is to avoid illness or injury altogether, sometimes they still occur. A worker who becomes ill or is injured as a result of work should inform their employer and take appropriate measures for treatment. If appropriate treatment is limited or unavailable in the country where work is being performed, the employer and worker should make arrangements for a return to Canada for healthcare. An emergency response plan created by the employer should provide guidance on how to respond to illness.

In Canada, occupational diseases or illnesses are reportable to jurisdictional occupational health and safety departments and workers’ compensation boards. When work is being done outside of Canada, the same reporting requirements may or may not apply. The employer should contact their workers’ compensation board prior to work-related travel to inquire about health care coverage, and how to report injuries or illness while abroad.

Most post-travel infections become apparent soon after returning from abroad, but incubation periods vary, and some illnesses can present months to years after the initial infection

A worker who feels sick during the return trip should inform the flight attendant or cruise staff, or a border services officer upon arrival. As a precautionary measure, the worker can wear a mask to prevent the spread of the disease. The worker may be referred to a quarantine officer for a health assessment and further direction when they arrive.

A worker who becomes ill or injured upon returning from work-related travel must report their injury or illness to their employer. The appropriate workers’ compensation board can also be contacted for advice and make a claim for occupational illness (note that the onset of illness can be delayed due to the disease’s incubation period). An employer may also be required to report the occurrence to their occupational health and safety regulator. Refer to your local health and safety legislation to confirm reporting criteria, timelines, and necessary information to be shared.

A worker who seeks medical attention for their illness may choose to share information about their trip to help diagnose and treat the disease such as the countries traveled to for work, activities performed, work environment, and public health hazards (e.g., worked in a setting with a lot of mosquitoes).

National Advisory Committee on Immunization (NACI): Statements and publications – Public Health Agency of Canada

Diseases and conditions – Public Health Agency of Canada

Physical assault abroad – Government of Canada

Sexual assault abroad – Government of Canada