Occupational and Environmental Medicine 1997;54:499-503 Medical insurance claims associated with international business travel

Objectives-Preliminary investigations of whether 10 884 staff and consultants ofthe World Bank experience disease due to work related travel. Medical insurance claims filed by 4738 travellers during 1993 were compared with claims of nontravellers. Methods-Specific diagnoses obtained from claims were analysed overall (one or more v no missions) and by frequency of international mission (1, 2-3, or ¢4). Standardised rate of claims ratios (SRRs) for each diagnostic category were obtained by dividing the age adjusted rate of claims for travellers by the age adjusted rate ofclaims for non-travellers, and were calculated for men and women travellers separately. Results-Overall, rates of insurance claims were 80% higher for men and 18% higher for women travellers than their non-travelling counterparts. Several associations with frequency of travel were found. SRRs for infectious disease were 1.28, 1.54, and 1.97 among men who had completed one, two or three, and four or more missions, and 1.16, 1.28, and 1.61, respectively, among women. The greatest excess related to travel was found for psychological disorders. For men SRRs were 2.11, 3.13, and 3.06 and for women, SRRs were 1.47, 1.96, and 2.59. Conclusions-International business travel may pose health risks beyond exposure to infectious diseases. Business travellers file medical claims at a greater rate than non-travellers, and for many categories ofdisease, the rate ofclaims increases with frequency of travel. The reasons for higher rates of claims among travellers are not well understood. Additional research on psychosocial factors, health practices, time zones crossed, and temporal relation between travel and onset of disease is planned. (Occup Environ Med 1997;54:499-503)