Their lives may be portrayed as glamorous. In fact, they’re often the opposite. Pity frequent business travelers.
Doctors at organizations including the Centers for Disease Control and Prevention and the International Society of Travel Medicine say they are hearing of a range of health problems in frequent travelers, from insomnia and weight gain to viruses. And they said they see a need for more comprehensive research into the health compromises made by business travelers, both short haul and long haul.
“The whole non-communicable disease side of travel health is something that’s been under-researched,” said Dr. Martin Cetron, director of the division of global migration and quarantine at the C.D.C.
Lin Chen, the incoming president of the International Society of Travel Medicine and an associate professor of medicine at Harvard Medical School, said that jet lag, combined with a lack of access to exercise and fresh food while on the road and sporadic engagement at home, need rigorous study. “Right now, it’s hard to know the impact because not enough research has been done,” she said. “But certainly it’s significant.”
Dr. Cetron said the image of the jet-setter who flies around making million-dollar deals no longer reflects the experience of most business travelers. “The reality is that the full spectrum of the work force now travels. Not just C.E.O.s but the more modest businessperson — think of junior employees at multinational companies, or aid workers who are called to respond to international crises. Some of these people have to travel on really shoestring budgets.” For them, flying business class or staying in fancy hotels is not an option.
In 2011, Catherine Richards, a doctor at Boston Health Economics, and Dr. Andrew Rundle, a professor of epidemiology at Columbia University, co-authored a report, “Business Travel Linked to Obesity and Poor Health,” published by the Mailman School of Public Health at Columbia.
That study tracked the body mass index; levels of low-density lipoprotein cholesterol, what’s known as “bad” cholesterol; and self-rated healthiness of more than 13,000 business travelers. Dr. Rundle, who has just completed a follow-up study, said the new findings, currently under peer review, “are pretty much the same as the old ones,” he said. ‘What we’re seeing is kind of like a U-shaped curve. People who travel the most and people who don’t travel at all have the worst health.”
An explanation for nontravelers’ poor health may be that chronic conditions prevent them from boarding planes in the first place, he said. The culprits of the poor health among constant travelers are the usual suspects: bad airport food, uneven exercise habits and jet lag. If there is a sweet spot, Dr. Rundle said, it may be with those who travel for work only a few times a year.
Dr. Rundle, who lives in western Massachusetts and commutes to Manhattan about five days a month, said he was inspired to look into the health effects of professional travel by his own experience. On a business trip, he said, he learned his options were limited to ordering dinner from a Cheesecake Factory restaurant. “I was just, like, this is not good,” he said. “Catherine and I started looking at business travelers’ B.M.I. data.”
What they found in the initial study was that the average body mass index of travelers who are on the road 21 or more nights a month was higher than in travelers who were away from home one to six nights per month. “For a 6-foot-tall person, the difference amounted to a 10-pound difference in weight.
That finding supports what Dr. Rundle said he suspected was a problem for traveling employees. “If you’re in your 30s and you’re traveling a lot and you’re eating poorly and you have poor access to physical activity, that starts to catch up with you,” he said. “Over the next 10 years or so, the consequences start to become things like high blood pressure and diabetes and obesity. Long-term chronic issues.”
His yet-unpublished sequel study looks more closely at business travelers’ mental health — an area both Dr. Cetron at the C.D.C. and Dr. Chen at the International Society of Travel Medicine said was important but fell outside their purview. It includes factors like alcohol abuse and accidents and injuries caused by lack of sleep and jet lag. “These are things that can have really immediate consequences for yourself and your career,” he said.
A Harvard Business Review article in 2015 noted that frequent business travel accelerates aging and increases the likelihood of suffering a stroke or heart attack, and that more than 70 percent of business travelers report some symptoms of an unhealthy lifestyle, including poor diet, lack of exercise, excess drinking, stress, mood swings and gastrointestinal problems. “All of which impair job performance,” it said.
If corporations are taking note, they’re not always taking action. “Travelers themselves are concerned about their health and the amount of time they’re away from home,” said Greeley Koch, executive director of the Association of Corporate Travel Executives, a nonprofit organization with board members from companies including MasterCard and Tesla. Policies to limit travel, or to make it less toxic through measures like upgrades to business class or added time for taking in fresh air during a work trip, depend on bosses and are entirely unregulated, he said. “It’s really a mixed bag when it comes to addressing these issues. It depends on the company.”
Doctors like Phyllis Kozarsky, a professor of medicine in the division of infectious diseases at Emory University School of Medicine and the medical director of TravelWell, a clinic in Atlanta for international travelers, said they see the need for more company attention to the issue.
“A lot of times, I’ll have people come in and say, ‘I was in so-and-so country, and I think I have a sinus infection,’” she said. “Then when I close the door to the exam room, they’ll burst out crying. They made the appointment ostensibly for a sinus infection, but they’re so tired and worn out from traveling that they just need to see someone and talk about it. They don’t want to share it with their business because they’re concerned about walking up the corporate ladder and their ability to succeed.”
Sharing tales of travel weariness at home may not be an option, either.
“I’ll hear things like, ‘My kid had a performance last week and my husband’s upset with me because I wasn’t there,’ or ‘I can’t do this any more and I don’t know how to tell my family,’” Dr. Kozarsky said. “You’re leaving people at home who are not happy you’re gone for a number of reasons, and when you get home you’re trying to catch up on all the things that happened while you were gone, but all you can think about is how tired you are. The only thing you can do as a doctor is to reassure them, to give people permission to feel the way they’re feeling.”
A frequent traveler, Brian Kelly, founder of the Points Guy, a digital platform for travel tips, said his world had been “flipped upside-down” when his dog had an illness recently. “It makes me sick to my stomach to think of leaving him. I have this business, and I have all these events I need to go to, but all I want to do is stay home and take care of my dog. In the back of my mind I know I need to take a 30-day health break,” he said.
Such a break would set off its own work-related stressors, though, he said.
And that is in keeping with what Dr. Centron of the C.D.C. has been seeing.
“Things are merging and changing in the world of business travel,” he said. “Whether trips are frequent short ones or long ones, the intensity of travel schedules is putting people under a lot of pressure.”