#### NPR 1810.1A Responsible Office: Office of the Chief Health & Medical Officer 

#### Effective Date: August 2, 2006

#### Expiration Date: August 2, 2011

## Health Services for International Travel or Assignment 

## 

## 

##  

# TABLE OF CONTENTS

## Preface

P.1 Purpose\
P.2 Applicability\
P.3 Authority\
P.4 References\
P.5 Cancellation

## **[Chapter 1.]{.underline}** Responsibilities

## Chapter 2: Traveler Health Services

## Chapter 3: Immunization and International Certificates

## Chapter 4: Travel Medical Kits 

## Chapter 5: Medical Services **[During]{.underline}** International Assignment

## Chapter 6: Compensation Benefits 

## [Chapter 7: Centers for Disease Control and Prevention (CDC) Publications]{.underline}

## 

## 

## 

## 

##  Preface

## 

## P.1 PURPOSE

This NASA Procedural Requirement (NPR) prescribes the Occupational
Health (OH) responsibilities and procedures for safeguarding the health
of NASA employees on international travel or assignment. It establishes
the minimum content for the traveler health program and ensures that no
official international travel orders shall be utilized by NASA civil
service employees until medical clearance is obtained, in accordance
with Agency travel policy.

## P.2 APPLICABILITY

This NPR applies to NASA Headquarters and Centers, including Component
Facilities, and to the Jet Propulsion Laboratory (JPL) to the extent
specified in its contract with NASA, hereinafter referred to as "NASA
Centers."

## P.3 AUTHORITY

a\. 42 U.S.C. § 2473 (c) (1), Section 203 (c) (1) of the National
Aeronautics and Space Act of 1958, as amended.

b\. 5 U.S.C. § 7901, Health Service Programs.

c\. 5 U.S.C. § 8101 et seq., Federal Employees\' Compensation Act, as
amended.

d\. 5 CFR, Chapter 1, Part 339, Medical Qualification Determinations.

e\. 48 CFR, Part 1852.242-78, NASA FAR Supplement, Emergency Medical
Services and Evacuation.

f\. 29 CFR Part 1960, Basic Program Elements for Federal Employee
Occupational Safety and Health Programs and Related Matters.

## P.4 REFERENCES

## a. 5 U.S.C. § 552a, the Privacy Act of 1974.

b\. NPD 1800.2, NASA Occupational Health Program.

c\. NPD 1840.1, NASA Workers\' Compensation Program.

d\. NPD 1810.2, NASA Occupational Medicine Program.

e\. NPD 8710.2, NASA Safety and Health Program Policy.

f\. Centers for Disease Control and Prevention (CDC) Health Information
for International Travel (Latest Edition) ("Yellow Book").

g\. National Center for Infectious Diseases, Travelers' Health Web site
at <http://www.cdc.gov/travel/yb/index.htm>[l]{.underline}).

h\. Agreement Between the Office of Medical Services (M/MED) Department
of State and the National Aeronautics and Space Administration, January
1980.

i\. FMM 2700, NASA Federal Travel Regulation Supplement (NFTRS).

j\. NASA Financial Management Requirements, Volume 12, Chapter 1, Travel
Web site at
[http://www.nasa.gov/pdf/115628main_FMR%20Volume%2012%20Travel%204-29-05%20final.pdf](http://www.nasa.gov/pdf/115628main_FMR Volume 12 Travel 4-29-05 final.pdf).

## P.5 CANCELLATION

NPR 1810.1, Health Services for International Travel or Assignment with
Change 3 (12/22/04).

## 

## /s/

## Richard S. Williams, MD, FACS Chief Health and Medical Officer

##  

# 

# 

# 

# 

# 

# 

# 

# 

# 

# **CHAPTER 1.** Responsibilities

## 

1.1 NASA Center Directors are responsible for safeguarding the health of
their employees.

1.2 NASA Health Clinics shall:

a\. Ensure that specific health-related travel requirements as
stipulated in the CDC Health Information for International Travel
(Latest Edition) "Yellow Book" are met.

b\. Offer traveler health services as an integral part of their
occupational health services and are responsible for contacting the NASA
Chief Health and Medical Officer (CHMO) in the event that a traveler
from its NASA Center is involved in a medical incident or evacuation.

1.3 NASA civil service travelers shall:

a\. Secure requisite information and medical clearance prior to going on
foreign travel, including compensation claims information.

b\. Confirm that their personal medical insurance carrier provides
adequate coverage for work-related and personal injury/illness medical
costs.

c\. Return recyclable medical kit containers to the Health Clinic upon
completion of travel.

## **1.4 Contractors are responsible for establishing their medical clearance policies and for making all arrangements for their own employees' emergency medical services and evacuation while performing work for NASA outside the United States (U.S.) or in remote locations in the U.S., in accordance with their contract as prescribed in NASA FAR Supplement, Clause 1852.242-78.**

##   

## 

## 

## 

# **CHAPTER 2.** Traveler Health Services

## 

2.1 Official international travel orders shall not be approved or
utilized by NASA civil service employees until medical clearance is
obtained, in accordance with Agency travel policy.

2.2 A NASA Health Clinic physician shall certify all travel clearances
provided by private physicians.

2.3 The NASA Health Clinic physician shall determine the length of
clearance up to one year.

2.4 All NASA Centers' comprehensive travel services shall include the
following: 

a\) General pretravel briefing and information.

b\) General health risk assessment.

c\) Immunizations.

d\) Traveler\'s diarrhea information and advice.

e\) Malaria risk assessment and advice, if appropriate.

f\) Air travel and health information (including \"Jet Lag\" advice).

g\) Destination safety information.

h\) Travel kits, in accordance with NASA Center policy (see Chapter 4).

i\) Pretravel evaluation of any environmental health issues/concerns,
identification of personal protective equipment, or training needs.

j\) Personal protective equipment and all applicable training.

k.) Other sources of health-related information including:

> 1\. U.S. Embassy or consulate location and telephone numbers.
>
> 2\. Hospital/clinic locations and telephone numbers.
>
> 3\. Procedures to access emergency assistance.

4\. Insurance advice.

5\. International SOS assistance cards and information.

l\. Post-travel follow up scheduling and advice as required.

2.5 All special medical surveillance clearances or NASA
job-certification examinations must be performed or reviewed by the NASA
Center Occupational Health Services.

## 

## 

## 

## 

## 

## 

## 

## 

## 

## 

## 

## 

## 

## 

## 

## 

## 

## 

# **CHAPTER 3.** Immunization and International Certificates

## 

3.1 NASA Centers shall ensure that the traveler possesses immunizations
required by CDC and vaccination certificates and shall ensure that the
employee has no health condition which would put the employee or others
at risk during travel or for any work to be done while on foreign travel
assignment.

## 3.2 NASA employees shall be provided with CDC-recommended immunizations indicated for the area of travel and required immunizations for country of destination.

## 3.3 Tuberculosis (TB) Skin Testing

3.3.1 Depending upon the destination, pretravel confirmation of the TB
intradermal skin test status with Purified Protein Derivative (PPD) may
be required. If the skin test is positive (abnormal), a chest X-ray
shall be prescribed. Appropriate referral for evaluation and/or
treatment shall be documented by the Center before travel. Post-travel
evaluation of the skin test status (at about three months post-return)
is necessary for those who travel to areas where there are high
incidences of TB.

3.3.2 Skin tests shall not be repeated for travelers with a known,
documented history of a positive skin test. A baseline chest X-ray shall
be obtained and, if normal, repeated in the future at the physician\'s
discretion.

## 3.4 International Certificates of Vaccination

The U.S. Public Health Service and the CDC have authorized NASA to
validate International Certificates of Vaccination against yellow fever
and cholera with authorized NASA validation stamps, when such
vaccinations are performed at NASA Centers. Medical Directors of NASA
Health Clinics, or their designee, shall affix the NASA-approved
validation stamp and sign the International Certificates of Vaccination.
Each stamp bears the number unique to the user Center or Component
Facility. Duplicate stamps shall not be issued or otherwise made
available. Stamps shall be inventoried and safeguarded when not in use.
Loss or theft of a stamp shall be reported immediately to the CHMO or
his/her representative.

## 3.5 General Immunization

Immunizations shall be offered to NASA employees and to employees of
other Government agencies assigned to the NASA Center or Component
Facility, in accordance with current CDC guidelines.

# **CHAPTER 4.**Travel Medical Kits

## 

4.1 Centers are authorized to assemble and issue medical kits to NASA
employees traveling on official NASA business. Instructions for the use
of the contents shall be developed by each NASA Center and Component
Facility and included with the kit.

4.2 At a minimum, the kit shall contain the following
\"over-the-counter\" medical items: analgesics for minor pain control,
motion sickness prevention, treatment for diarrhea prevention, a
decongestant, antacid, antihistamine, cough suppressant, and eye wash.
Topical preparations shall include steroid cream, antibiotic ointment,
antiseptic preparations, bandages, gauze, and tape.

4.3 A summary of the traveler\'s past and current medical history,
including allergies, medications, and special diet, shall be provided to
the traveler with the medical kit, in accordance with all
privacy-related regulations and laws. A copy of this record shall be
maintained at the respective NASA Health Clinic. This record is
maintained by NASA in the Health Information Management System (10HIMS)
and is protected by the Privacy Act of 1974, 5 U.S.C. 552a, and NASA's
implementing regulations at 14 CFR Part 1212.

##   

## 

## 

## 

## 

## 

## 

## 

## 

## 

##  **CHAPTER 5. Medical Services During International Assignment**

## 

## 5.1 International SOS Service

5.1.1 NASA has contracted with International SOS Assistance, Inc., to
provide medical assistance for NASA civil service employees traveling
globally on official NASA-related business. SOS Access Cards are
available at NASA Center Occupational Health Clinics during business
hours. Each civil service employee is authorized to carry an SOS card
which contains telephone numbers for the three worldwide alarm centers
(Philadelphia, Geneva, and Singapore). Family members of the traveler
are not covered by NASA's contract with International SOS Assistance,
Inc., and should make other arrangements for medical assistance while
traveling abroad.

5.1.2 Contractors are responsible for facilitating arrangements with a
medical service provider for their employees, in accordance with their
contract. The final responsibility for international emergency medical
services remains with the contractor and contracted employee, as
specified in NASA FAR Supplement, Clause 1852.242-78.

5.2 Medical services provided on non-NASA-related travel are the
responsibility of the employees.

## 5.3 International Cooperative Administrative Support Service (ICASS)

5.3.1. Availability, extent, and authority for Department of State (DOS)
ICASS services shall be confirmed prior to long-term TDY and Permanent
Change of Station travel by contacting the NASA External Relations,
Resources Management Office. Any DOS non-reimbursable coverage is only
applicable to a DOS medical facility for any Government employee posted
overseas on Government business.

##   

## 

## 

## 

# **CHAPTER 6.** Compensation Benefits

## 

6.1 NASA civil service employees who suffer a traumatic injury or
occupational illness while in performance of their official duties may
be eligible for compensation benefits under the Federal Employees\'
Compensation Act (FECA).

6.2 NASA civil service employees who are injured must report the mishap,
in accordance with NPR 8621.1, NASA Procedural Requirements for Mishap
Reporting, Investigating, and Recordkeeping.

6.3 Medical assistance shall be obtained as outlined in Chapter 5.

6.4 The Compensation Claims Officer at the parent NASA Center shall be
contacted for necessary instructions and for forms to report the injury
or work-related illness and to claim compensation benefits.

##   

## 

## 

## 

## 

## 

## 

## 

## 

## 

## 

## 

# **CHAPTER 7.** CDC Publications

## 

7.1 Each NASA Center Occupational Health Service Medical Director shall
have current issues available of the following CDC publications:

a\. Health Information for International Travel (Yellow Book).

b\. Morbidity and Mortality Weekly Report.

c\. Weekly Summary of Countries with Areas Infected with Diseases
Requiring Quarantine.

d\. Advisory Memoranda.

e\. Biweekly Summary of Health Information for International Travel
(Blue Sheet).

##