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The wide use of immunosuppressive drugs and HIV infection has resulted in a large number of workers with suppressed immune systems who are more susceptible to infectious diseases in the workplace. They also may spread diseases such as tuberculosis to others. (See Chapter 21.) Until recently, significant immunosuppression was not a workplace issue because it occurred only secondary to severe illness. Because otherwise healthy immunosuppressed workers are a new phenomenon in the workplace, their legal status is not well defined.

Immunosuppressed individuals are disabled under the federal law and are entitled to work if they meet the other requirements of the law. If a secondary infection such as active tuberculosis threatens other workers or third parties, the infected person may be removed from the workplace. The difficult question is whether immunosuppressed persons may be denied employment to protect them from workplace-acquired infections. It is argued that the worker has the right to accept the risk of infection. Worker's compensation laws, however, do not allow the worker to accept the financial risk of workplace injury. The employer must pay for the costs of treatment or disability if the immunosuppressed worker becomes infected in the workplace, irrespective of the employee's assumption of the risk of infection.

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