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. Whereas 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 employees, clients, or both.
Screening has a bad reputation among medical 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. 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 to have 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, should screen coworkers 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.