British Antarctic Survey Medical Unit (BASMU)
Medical Information Form for Polar Service Application

These guidance notes introduce the medical requirements for Polar service and serve as the first level of the medical screening process. It is essential that you read the guidance notes below and complete the information and declaration at the end. Please then submit the completed form to the BAS External Visitors Inbox (externalvisitors@bas.ac.uk).

Many medical conditions can be safely supported in the Polar sphere, but declaring all known medical issues is important so that we can assess your risk and ensure that you are as safe as possible. We supply limited medications for a limited range of medical issues that you may develop. If you are on regular medications, you will need your own supply for the entire time you deploy.  

Developing a medical emergency while working in the polar regions carries with it high personal risk due to limited medical capability in that environment. Getting a patient to high level medical care often takes many days (sometimes weeks) and can be much longer than you expect. There is usually limited capability for winter medical evacuations, with significant operational and personal impact and sometimes risk for rescuers. 

It is essential that you have read and checked that you do not have the conditions listed. If you do, ensure that you contact us using the details above before continuing with your application. 

Please consider your own FITNESS TO DEPLOY. Speak with BAS if you are unsure. 

Do you have the physical ability to do the job? 
Do you have the physical / psychological attributes to live in the Polar environment? 
Do you have the physical ability to help / rescue others? 

You should be aware that BASMU will undertake a detailed medical and dental screening to exclude preventable causes of evacuation. 

FAILURE TO DISCLOSE A MEDICAL PROBLEM DURING SCREENING MAY PUT YOUR LIFE AND THAT OF OTHERS AT RISK.

BASMU staff will always be happy to discuss any medical condition with you, with the aim of getting you cleared for Polar service.  Certain conditions will preclude Polar service, but this is uncommon. There are many conditions that can be safely managed or well-controlled in your home environment. However, some may not be as stable or may carry higher risk in remote polar environments. This is why it is important that all conditions, even historic and well controlled, should be declared- even if you are completely well at the moment. 
Should you be selected by BAS or by your employer for a Polar trip, further screening will be required. This will include a medical questionnaire and an examination by a doctor. Medical problems can often be resolved by early and open discussion, and BASMU will work to understand risks and mitigate where possible, sometimes with further investigation or specialist review.  

In the event of any query, one of the BASMU staff may contact you directly and we will ask for permission to approach your doctor (GP) for clarification.
A guide to current or historic conditions that may cause concern (non-exhaustive)
Conditions that preclude service 

Decisions depend on many different factors and will be made on an individual basis. 	Conditions which may preclude service. 

These will be assessed on an individual basis and in relation to the capacity to undertake activity/work in the anticipated environment. 	
Cardiac & Circulation problems 

Angina & Heart Attacks 
Leaky Heart valves & Rheumatic Fever 
Previous Heart Surgery 
Uncontrolled High Blood Pressure 
Heart Rhythm Abnormalities 
Heart Failure 
Arterial Disease
	
Treated abnormal rhythms 
Severe varicose veins 
Previous Frostbite 
Severe Reynaud’s disease 
Previous leg thrombosis 
Previous clot on the lung	
Respiratory (chest) problems 

Recurrent pneumothorax 
Cold induced or severe asthma 
Chronic Bronchitis or emphysema 
Active Tuberculosis 
Sleep Apnoea/ use CPAP
	
Single episode of pneumothorax 
History of moderate Asthma 	
Gastrointestinal problems 

Active stomach / duodenal ulcer 
Liver Disease 
Pancreatitis 
Untreated Hernia 
Inflammatory bowel disease	
Previous exploratory abdominal surgery 
Severe piles 
History of stomach/duodenal ulcers 
	
Genito- urinary problems 

Recurrent Kidney Stones 
Kidney failure 
	
Renal colic 
Recurrent kidney infections 	
Neurological Conditions 

Epilepsy or fits 
Non – traumatic Brain Haemorrhage in past 
Unexplained episodes of loss of consciousness 
Degenerative N.M. conditions 
Significant Neuro Deficit secondary to Trauma 
	
Previous brain surgery 
ME 	
Metabolic Conditions 

Most diabetes 
Cushing’s Disease 
Addison’s Disease 
Obesity BMI >35 
	
Well-controlled mild type ll diabetes (ENG 1 criteria) 
Other endocrine disorder 
Thyroid disease 
Obesity BMI 30-34 	
Musculoskeletal and Rheumatological conditions 

Untreated Slipped disc 
Recurrent dislocations (untreated) 
Rheumatoid Arthritis 
Ankylosing Spondylitis 
	
Recurrent back pain 
Severe knee problems 
Unstable joint 
Frequent Gout 
Lower Limb Amputation 
	
Cancer and Haematological Disorders 

Most cancers 
Clotting or bleeding disorders 
Anticoagulant Medication 
Active bone marrow disease 
	
Treated cancer with low risk of recurrence 
Treated leukaemia 
Treated Hodgkin’s disease 	
Gynaecological conditions 

Current Pregnancy 
	
Pelvic inflammatory Disease 
Ovarian disease 	
Dermatological conditions 

Blistering Skin diseases 
Severe psoriasis 		
Mental Health Problems 

Current psychiatric Illness 
Schizophrenia 
Manic depression (Bipolar Affective Disorder)
Personality Disorder 
Current Drug or alcohol abuse 
	
Depression 
Self-harm 
Previous drug / alcohol problems 
Previous severe mental illness 
Eating disorders	
Other conditions 

Immunosuppressant medication
Immunomodulatory medication
Immunological disorders
Immune suppression
Anaphylaxis to non-drugs
Prescribed EpiPen
	
Allergic reaction to food
Prostatic hypertrophy (untreated)

Immunisations

FOR EVERYONE  
When completing the online BASMU 3 form please give dates of the last time you had these vaccinations: 
GENERAL ADVICE The following websites offer very good information for travellers in respect of immunisations and ways to avoid diseases:  
www.nhs.uk/conditions/travel-immunisation  
www.fitfortravel.nhs.uk or www.hpa.org.uk/infections  
www.nathnac.org/travel 
Complete any initial courses before you travel. 
All of the vaccines are available from your GP or travel clinic. 

Please update BASMU on your immunisation status. 
Yellow Fever is no longer required when travelling by RAF flights from Brize Norton to the Falklands. 
For those returning home directly by air or BAS ship, there are no specific requirements. 
Those who plan to travel /return home via South America, Africa, Asia, India or the Middle East may need additional vaccination.  Advice changes frequently and it is important that up to date information is obtained from the latest Department of Health advice to travellers or from the websites mentioned above. This is the individual’s responsibility. 
Malaria is probably the most prevalent and dangerous tropical disease that you may encounter. Advice is country/region specific so please check www.cdc.gov for the latest advice regarding appropriate prophylaxis. Ensure you have enough medication for the duration of your trip as the station/ship doctor does not carry stocks of these medications. In the UK you can obtain this via private prescription or purchase from a pharmacist.  
Consultation with your doctor about your travel plans should take place 2 to 3 months before you travel.  
Please remember before you leave UK that some of the vaccinations, such as rabies, require more than one dose at set intervals. Be aware there may not be time to fully immunise you before your departure. 
Initial courses of travel vaccinations should be completed prior to leaving UK. If your cover lapses while you are in the Antarctic and you need a booster, as an independent traveller you would be able to call in to health centres/clinics located at major towns/cities en route to the areas in which you plan to travel.
The individual must have received at least one covid vaccine in their lifetime.

Please complete details on this page for any upcoming deployment and return completed to externalvisitors@bas.ac.uk  
Please complete name as on passport.

Surname		
Middle name(s)		
First name		
Date of birth		
Sex		
Gender		
Address	

Email address (that you are happy to use for medical info)		
Mobile number		
Occupation and destination		
Duration	Summer                               Winter                              	

Annual requirements:

You must complete a self-assessment and dental every year you are due to deploy.

BASMU 3 (self-assessment)- will be forwarded to you via email.

BASMU 7 or 8 - Dental forms will be forwarded to you via email.

BASMU 4 - Medical completion frequency below. A BASMU 4 may also be requested outside of these periods if there are any changes in your health condition or at the discretion of BASMU. This will be emailed for you to share with the person completing the medical.	
Up to 35 years 	Every 5 years 	
35 years to 50 years 	Every 3 years	
50 and above 	Annually including an annual ECG	

I declare that I have read the conditions listed above and (tick relevant box):
I have none of the conditions 		
I have one or more conditions, and I have contacted BASMU 
and been cleared to continue my application.		

Signed:					Print name:				Date: