The Impact of International Health, Safety and Productivity Programs

The recent internationalization of the U.S., European and other Western companies has increased demand for Global Health, Safety and Productivity programs.  There are unique risks for expatriates, short term assignees and international travelers that do not exist in the home country.  Legal requirements in health, safety and environment are very different.  Health services may not meet required "Western Styled" medical requirements.   However employee expectations remain high.  These groups are often managers or engineers and include higher paid workers.  The expectation is that they will be highly productive throughout the time abroad.  Therefore a focus on absenteeism and presenteeism is growing rapidly among expatriates, travelers and home country nationals.  Well designed health and productivity programs require a detailed knowledge of the risks of each country or region type and quality of services, customs and practices.  In addition access to quality care, access to care is a challenge in many countries.  Payment mechanisms vary widely and early planning of healthcare is needed.  Facility safety is often not consistent with Western standards and fatal vehicle accidents are often more than five times more likely in developing countries.  Expatriate failure averages 5-7% per year abroad and the repatriation of a family can cost up to $1 million dollars and significant business disruption.  Effective screening of potential expatriates can save five to ten times the direct costs and of repatriation with similar indirect costs.  Therefore the demand for Global Health, Safety and Productivity is rapidly increasing.  The occupational physician has special challenges to evaluate and control risks globally. However, the supply and training of occupational and other health professional lags behind the current and future demand and will be a continual challenge for the field.