Remote Medicine Other Facets Of Remote Medicine

Expatriates and paramedics at remote sites are not the only concerns of oil industry corporate medical departments.

There is a great deal that can and should be done before the traveler or expatriate ever leaves home base.

Even the traveler without the support of a corporate medical department can find plenty of essential expertise to prepare for a trip. Travel-related medicine centers, especially in international oil towns like Houston, can prepare the traveler for any region on earth.

These experts know what diseases are prevalent and will get and give the medicines, pills, and shots to prevent them. For example, the International Medicine Center in Houston says a first-time traveler to Nigeria will require five to seven immunizations. This center also supplies travel medicine kits, one for western Siberia, another for the malaria zone.

Following are some examples of other areas that are getting attention at several major companies.

ARCO

Dr. David Clyde, ARCO Oil & Gas Co.'s medical director, emphasizes that the business traveler can also be at high medical risk.

"I have from a medical standpoint," he says, "great concern for American adventure travelers, the persons that head into areas with inadequate medical facilities and don't give a thought about the possibility that they could get sick or injured. In addition, many leave home without necessary immunizations."

He has put together a list of "dos and don'ts" that may surprise even seasoned travelers. Example: On the road, always drink bottled water and, unless it is a well-known brand, be sure it is sparkling or carbonated water. The carbonation produces a slight acidity that retards bacteria growth. More importantly, if your bottler is cutting corners, he would find it difficult to get carbonated water out of a common water tap.

Clyde also notes that the business traveler can become an adventuresome tourist on weekends. Resist the urge, he says, to start buying appetizing-looking food from street vendors or swimming in unknown waters just because the locals are doing it.

All this adds up to the fact, he says, that the international traveler needs to be well informed and cautious. Clyde regularly conducts a course on the medical risks of travel for ARCO employees at company headquarters in Plano, Tex. He will cover these risks in an article next week in Oil & Gas Journal.

Schlumberger

Schlumberger Ltd., Paris, is well into an ambitious program to gather medical data on its employees. Dr. Alexander Barbey, the giant oil field service company's health coordinator, described the project in a paper he presented late last month at the Occupational Health Offshore Conference in Aberdeen.

Barbey said Schlumberger has over 50,000 employees, representing 100 nationalities, working in more than 80 countries. The company's employees, Barbey said, are extremely mobile and exposed to health hazards linked to the work itself, the climate, local diseases, and epidemics as well as their own inherent personal health problems.

The aim of the program, which was launched in 1991 and is called "Med-Track," is to give the majority of the company's international staff physicals every 3 years. Barbey says the goal is to make sure that Schlumberger employees are in good health, can carry out their jobs in high health risk regions, and that they did not develop health problems during their travels abroad.

Schlumberger has certified 400 medical centers around the world to perform the physicals. The administration and coordination of the program is performed at the company's computer center in Paris.

The program is now into its fifth year, and 2,000 employees have had physicals. Some results of a preliminary analysis of the physicals are shown in Figs. 1 [91992 bytes], 2 [92857 bytes], and 3 [84267 bytes]. The tests employed and the problems detected are defined in Barbey's paper. Data for smoking and malaria came from questionnaires filled out by the subjects.

Some highlights:

Life style-40% of the population were smokers; chronic alcohol consumption was a problem for 10%.

Medical problems-Renal (kidneys) and respiratory problems were the most common.

Work-related problems-Serious lower back problems were discovered in 20% of those X-rayed. Some 10% of the population had a history of hepatitis A or B. This is understandable, says Barbey, because they worked in Africa or Asia. This is an argument for vaccination against hepatitis, he says. The use of preventive malaria tablets was poor. However, such data, Barbey said, prompted company malaria campaigns in 1992 and 1994 that reduced evacuations for cerebral malaria from 6 in 1991 to 0 in subsequent years.

Exxon

Exxon International Co., Florham Park, N.J., has developed a set of medical service guidelines for remote sites. They cover the expected level for on-site care and will be of interest to the entire industry.

Dr. K.C. Lindemann of Exxon says that health and safety must be addressed systematically, like all other aspects of business. The guidelines help Exxon select third-party health care providers and assure all are bidding to deliver a comparable set of services.

The guidelines cover three areas: medical personnel, facilities and equipment, and procedures. Procedures also cover the conduct of medical evacuations.

Lindemann and a colleague from Esso Production Malaysia will deliver a paper on the guidelines at a Society of Petroleum Engineer's meeting on health, safety, and the environment (HSE) in New Orleans June 9-12.