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AIDS is changing public perceptions about communicable diseases. Although AIDS is not communicable in most workplaces, it is alerting lawyers to the compensability of workplace-acquired infections. Concern with discrimination against the disabled and HIV-infected persons led Congress to pass the Americans with Disabilities Act (ADA) in 1990. As discussed in Chapter 30, the ADA reduces employers' right to ask about a potential employee's health. It also limits the right of employers to refuse to hire persons who are at increased risk of injury in the workplace or who may pose a risk to others.

These limitations come as the courts and legislatures are expanding employers' duty to protect workers and the public. With diseases such as tuberculosis on the rise, employers need comprehensive plans to manage communicable diseases in the workplace. With the ADA's stress on the individual evaluation of employees, physicians must play the central role in these communicable disease plans. This requires assessing the risk posed by individual infected employees and developing legally sound protocols for balancing the risk of contagion against the employee's right to continued employment. The ADA and its administrative regulations provide little guidance because they are silent on all communicable diseases except for those that are foodborne. This chapter presents a general approach to communicable diseases in the workplace. Medical care workplaces have been treated as a special case of the general communicable disease plan.

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