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Identifying Employees at Risk or Who Pose Risks

Employees who are inadequately immunized against diseases such as measles and mumps are susceptible to the workplace spread of these diseases. Medical care workers who are not properly immunized may become infected and spread these diseases to patients. Medical care workers who are not immunized against hepatitis B may contract the disease in the workplace. Farm workers may acquire tetanus if they have not been immunized within the past ten years. Animal control workers should be immunized against rabies. Employers should know the immunization status of all employees and ensure that all employees are adequately immunized. OSHA requires that HBV vaccine be provided free of charge to employees at risk of infection. While other immunizations may not be covered by OSHA requirements, the employer should provide them at no cost. The employer may require employees to be immunized as a condition of employment.

Screening for contagious disease may be done on the employees, clients, or both. Screening has a bad reputation among health care professionals because many of the old screening programs included diseases that were not spread in the workplace. The health card system for food handlers is a good example. Until recently, most states and cities required that restaurant workers get a health card, obtained after tests for syphilis and tuberculosis. The tuberculosis test was a holdover from earlier times when it posed a general workplace risk; syphilis, however, has never been associated with food handling.

In contrast, requiring an annual test for tuberculosis on medical care and social services personnel does protect clients and the employee from the risks of tuberculosis. This is critical for all persons who work closely with HIV-infected persons. A worker who smokes and has hay fever may have a highly contagious cough for months before realizing that it is due to tuberculosis. If an employee is found who has infectious tuberculosis or another communicable disease, the health department should be contacted at once. The health department, in cooperation with the corporate medical department if one is available, will screen co-workers as necessary to prevent further spread at the worksite. This screening is mandatory, and the employer should ensure that the health department's recommendations are fully implemented.

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