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Communicable diseases in the workplace pose three classes of risk: (1) worker's compensation liability, (2) third-party liability, and (3) productivity losses. All three are potentially very expensive yet have been accorded scant attention from employers or employees. The HIV epidemic has sensitized employees and employers to the problems of workplace-acquired infections. As declining health insurance coverage forces more persons to seek compensation through the courts for illness, worker's compensation claims for workplace-acquired infections will increase.

Worker's compensation laws are not limited to accidents or occupational illnesses; they cover all illnesses and injuries acquired in the workplace, including communicable diseases and intentional injuries such as rape in the workplace. The employee is entitled the cost of medical care, disability, and lost time for work. In return, the law prevents the employee from suing the employer for the more extensive damages available in tort litigation. This exemption is important because some usually mild diseases can cause serious injuries in adults. Mumps can cause sterility, measles sometimes kills, chicken pox can cause brain injury, and tuberculosis can require long-term treatment. Drug-resistant tuberculosis, on the increase in the United States, cannot be effectively treated; it requires prolonged hospitalization and eventually kills many of its victims.

Earlier in this century, it was common for employees to claim compensation for communicable diseases such as typhoid caught from the company water supply. As the public awareness of communicable diseases diminished, claims for workplace-acquired infections decreased. Even health care workers, who have a high rate of morbidity from workplace infections, have tended to rely on group health coverage for workplace-acquired infections rather than worker's compensation. Progressive reductions in group health coverage and reduced job security are causing workers to seek worker's compensation for illnesses that in the past would not have resulted in compensation claims. This will require physicians to be more sensitive to the epidemiology of workplace-acquired infections.

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