18 Jun 2015
Personal safetyTaking care of your personal safety abroad
Travellers should take precautions to maintain their personal safety abroad.
The Foreign and Commonwealth Office advice on safety and security for the destination should be checked (ideally before booking the trip).
Road traffic accidents are an important cause of injury and death for travellers. These are more common in low and middle income countries.
Alcohol is a frequent factor in accidents and injuries and can promote risky behaviour. Excessive alcohol use may invalidate insurance claims.
Informal and illicit production of alcohol is common in many parts of the world. Such drinks may pose a poisoning hazard (e.g. methanol). Methanol poisoning can be fatal.
Travel health insurance should be obtained to cover planned activities, pre-existing health problems and belongings.
Most travellers have a safe trip without experiencing problems, but basic precautions should be taken to maintain personal safety. The Foreign and Commonwealth Office (FCO) website contains destination specific safety advice. Travellers should research their destination before departure (ideally prior to booking a trip), and follow the advice. Care should be taken to look after important documents, insurance details, contact numbers and belongings. Travellers should dress and behave appropriately, avoid obvious displays of wealth and learn about local laws and customs before they travel. For example, public displays of affection are unacceptable in some regions and alcohol is banned in certain countries.
Road traffic accidents (RTAs) are an important cause of injury and death in international travellers and young travellers are at greatest risk [1, 2]. The World Health Organization (WHO) estimates that 1.2 million people are killed and 20-50 million people are injured worldwide every year as a result of RTAs [3, 4]. Most of these deaths and injuries occur in low and middle-income countries [3, 4].
Some accidents and injuries can be prevented by careful behaviour. Alcohol may be a factor, as it can affect judgement and lower inhibitions. Ideally alcohol should be drunk only in moderation.
Risk for travellers
Travellers may feel safe because they are not planning to drive whilst overseas. However, they can be injured as passengers, pedestrians or cyclists. Of the estimated 1.2 million road traffic deaths each year, about 65 percent involve pedestrians . Factors identified as increasing risk of traffic injuries include: excessive speed, not using seat belts and/or child restraints, drinking and driving, drivers of two and three wheel motorised vehicles (motor bikes and Tuk Tuks) not wearing helmets and old, poorly designed and/or badly maintained roads and vehicles.
Availability of emergency care, such as ambulance services and accident and emergency departments varies worldwide and can be very poor or even non-existent in low income countries. Lack of emergency care can adversely affect the outcome of accidents or injuries . The death rate after RTAs is higher in resource poor countries. Approximately 70 percent of RTA deaths occur in resource poor regions of the world. Countries in South East Asia account for more than a third of all road traffic injuries. Africa has the highest death rate, 28 deaths per 100,000 persons [5, 8].
Even in resource rich countries like New Zealand, foreign drivers have been identified as a major problem in rental car crashes . Many hire car drivers were not used to driving on the left side of the road. Lack of familiarity with driving on the right hand side of the road can be dangerous for UK drivers abroad. In the US, tourists were found to be at greater risk of injury from a RTA than local people .
Rail, air and large cruise ship travel is usually safe. However, overcrowding and poor maintenance may lead to unsafe conditions on many local buses and ferries.
Other safety risks
Drowning is a risk that travellers may associate with holiday travel, in one study analysing tourist accidents, it was second to RTAs as a cause of death.
Falls from balconies have become more common in UK travellers and can cause serious injury and death .
Counterfeit medicines and alcohol can be an issue in some countries. Poisoning is occasionally reported in travellers who have consumed local spirits spiked with methanol [13, 14].
While most trips are trouble free, the FCO reports that sexual assault of female and male travellers is being reported more often. Unfamiliar surroundings and lack of local knowledge may increase vulnerability. Sexual assault is traumatic anywhere, but can be more difficult to deal with abroad, in unfamiliar surroundings. Specific advice on rape and sexual assault for travellers is available from the FCO. Returning travellers can get support and advice from their local sexual health clinic if they have not been able to access these services abroad.
When the overseas deaths of British nationals are analysed, the same trends are seen: deaths from natural causes (such as heart disease) are most common with those from accidents and injuries second most common [11, 15]. Travellers should make sure that any pre-existing medical conditions are evaluated and stable prior to their trip.
FCO advice on specific risks should be consulted before travel. Travel insurance is likely to be invalidated if visiting a country contrary to FCO advice. Travellers should research their destination and cultural sensitivities and pack appropriate clothing. Consider if other equipment will be necessary such as car seats for children. Carrying a medical / first aid kit tailored to the destination is worthwhile.
It is sensible to take photocopies or scan in travel documents, passports and emergency contact details and store in a place away from the originals and/or store online in a secure place. Family/friends should be kept informed of travel plans.
Travel health insurance should be obtained; the FCO website contains advice on what the policy should cover. Travellers should be aware that pre-existing health conditions and certain activities such as adventure sports may be excluded unless they have been specifically mentioned to the insurance company. An EHIC card should also be obtained if travelling to countries within the European Economic area and Switzerland.
Travellers should be aware of the risks and follow the common sense precautions outlined below:
- Check the tyres, brakes, lights and safety belts on any hire vehicle and use vehicle safety belts and child safety restraints (take these from UK if necessary). Never exceed local speed limits.
- Avoid driving or being driven at night in areas with poor roads and lighting where possible.
- Be aware of local traffic patterns even if walking or cycling.
- Avoid travelling alone at night unless you are sure of the area.
- Wear a helmet if riding a horse, bicycle or motorbike.
- Consult with a reputable source (e.g. airport or hotel information, restaurant) for a reliable taxi service.
- Consider obtaining safety statistics for your airline, cruise ship, or for driving in your destination country (see resources below).
- Try to drink alcohol only in moderation, don’t accept drinks from strangers or leave your drink unattended. Never drink and drive or swim after drinking.
- Buy alcoholic drinks from a reputable vendor and check bottle seals are intact. If the price of alcohol looks too good to be true, it probably is. Check branded products, do not purchase products with labels that are poorly printed or with typographical errors.
- Dress modestly and avoid wearing expensive jewellery or clothing that attracts attention. If appropriate, use a safe to store valuables.
- Remain vigilant at all times with money and other valuables
- Be aware of scams and be cautious of strangers approaching you in the street. It is generally advised not to resist muggers.
- Check fire exits in discos, clubs and hotels.
- Avoid sharing rooms with strangers and try to book accommodation ahead.
- Check locks work properly.
- Seek reliable local advice on avoidance of marine or land animal hazards, safe places to swim.
- Check depth of water before diving (feet first, first time) and avoid swimming alone.
- Supervise children at all times when near water.
- NEVER dive into a swimming pool from a balcony.
- Remember that when you are abroad, you need to obey the laws of the country you are in, which may be very different from laws in the UK.
- Never use illegal drugs or carry them for others.
- UK Government: Foreign Travel Advice
- Foreign and Commonwealth Office: Rape and Sexual Assault abroad
Airline safety information
Road safety information
First Published : 18 Jun 2015
Last Updated :  11 Oct 2016
- Hargarten SW, Baker SP. Fatalities in the Peace Corps: a retrospective study: 1962 through 1983. JAMA 1985;254:1326-1329.
- Hargarten SW, Baker TD, Guptill K. Overseas fatalities of United States citizen travelers: an analysis of deaths related to international travel. Ann Emerg Med 1991;20:622-626.
- Prociv P. Deaths of Australian travellers overseas. Med J Aust 1995;163:27-30.
- Sniezek JE, Smith SM. Injury mortality among non-US residents in the United States 1979-1984. Int J Epidemiol 1991;20:225-9.
- Hargarten SW, Bouc GT. Emergency air medical transport of U.S.-citizen tourists: 1988 to 1990. Air Med J 1993;12:398-402.
- World Health Organization. The global road safety crisis: progress on theimplementation of General Assembly resolution 58/289. UN Secretary-General 2005, Geneva. [Accessed 27 May2015]
- US. Center for Disease Control and Prevention. Health Information for International Travel. Injuries and Safety.1 August 2013. [Accessed 27 May2015]
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- Bewes PC. Trauma and accidents. Practical aspects of the prevention and management of trauma associated with travel. Br Med Bull 1993;49:454-64.
- Odero W, Garner P, Zwi A. Road traffic injuries in developing countries: a comprehensive review of epidemiological studies. Trop Med Int Health 1997;2:445-460.
- Page SJ, Meyer D. Tourist accidents: an exploratory analysis. Ann Tourism Res 1996;23:666-690.
- Foreign and Commonwealth Office. Holiday Brits risking their lives on balconies. 28 June 2013. [Accessed 27 May 2015]
- World Health Organization, Information note, Methanol poisoning outbreaks. July 2014. [Accessed 22 July 2015]
- Giovanetti F. Methanol poisoning among travellers to Indonesia, Travel Medicine and Infectious Disease, 2013; 11, 190-193
- Paixao MLTDA, Dewar RD, Cossar JH, Covell RG, Reid D. What do Scots die of when abroad? Scot Med J 1991;36:114-116.
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