The HIV epidemic and the reemergence of other infectious diseases have lead
to increased interest in communicable disease control in the workplace.
Concern with discrimination against the disabled and HIV-infected persons led
Congress to pass the Americans with Disabilities Act (ADA) in 1990. 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
section presents a general approach to communicable diseases in the
workplace. Medical care workplaces are treated as a special case of the
general communicable disease plan.