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Business Travel and Behavioral and Mental Health

Rundle, Andrew G., DrPH; Revenson, Tracey A., PhD; Friedman, Michael, PhD

Journal of Occupational and Environmental Medicine: July 2018 - Volume 60 - Issue 7 - p 612–616
doi: 10.1097/JOM.0000000000001262

Objective: Assess associations between business travel and behavioral and mental health.

Methods: Cross-sectional analyses of de-identified electronic medical record data from EHE International, Inc. a provider of corporate wellness programs.

Results: Higher levels of business travel were associated with poorer outcomes. Compared with traveling 1 to 6 nights/mo for work, those who traveled 21+ nights were more likely to: smoke (prevalence ratio [PR] = 3.74, 95% confidence interval [CI] 2.56, 5.46), report trouble sleeping (PR = 1.37, 95% CI 1.09, 1.71), be sedentary (PR = 1.95, 95% CI 1.56, 2.43), and score above clinical thresholds for alcohol dependence (CAGE score >1: PR = 2.04, 95% CI 1.26, 3.29), and mild or worse anxiety (Generalized Anxiety Scale [GAD-7] score >4: PR = 1.69, 95% CI 1.29, 2.21), and depression symptoms (Patient Health Questionnaire [PHQ-9] score >4: PR = 2.27, 95% CI 1.70, 3.03).

Conclusions: Employers should provide programs to help employees manage stress and maintain health while traveling for work.

Department of Epidemiology, Mailman School of Public Health, Columbia University (Dr Rundle); Department of Psychology, Hunter College and the Graduate Center, City University of New York (Dr Revenson); Medical Advisory Board, EHE International (Dr Friedman), New York, New York.

Address correspondence to: Andrew G. Rundle, DrPH, 722 West 168th Street, Room 772, New York, NY, 10032 (

Funding: EHE International, Inc., provided unrestricted financial support to Drs Rundle and Revenson to conduct open ended public health and clinical epidemiologic research with de-identified EHE International medical record data. EHE International did not direct, select, suggest or influence the research questions to be addressed by the authors.

Conflict of Interest: Drs Rundle and Revenson serve on the Life Extension Research Institute board which is supported by EHE International, Inc. to conduct public health research using de-identified EHE digital medical record data; Drs Rundle and Friedman serve on EHE International's Medical Advisory Board. The research questions and analytical plan were determined solely by the authors and EHE International, Inc. did not play a role in analysis, interpretation of the results of analysis, or in the decision to publish the findings. EHE International, Inc. did review a draft of the manuscript to ensure that statements made about the company and its programs were factually correct. Dr Rundle had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Copyright © 2018 by the American College of Occupational and Environmental Medicine