Public Health Law Map - Beta 5 - Medical and Public Health Law Site

eporting duties that apply to the company physician or laboratory, sanitation rules
that govern the company cafeteria, or OSHA regulations. OSHA has already issued
regulations with detailed specifications on the management of bloodborne infections
in the workplace. There are also specific requirements for TB control in medical care
organizations. Any relevant CDC recommendations should be incorporated in the
plan, as should standard- setting documents from private professional groups and
accrediting agencies.
7. 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.
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.
8. The Special Problems of Immunosuppression
Immunosuppressed workers pose a double- edged problem: they are more
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