Fears Aroused : AIDS in the Workplace: New Issues

For San Francisco mortician Joe Dezurik, it seemed like a routine hospital call. Even when he saw the red tag indicating that the elderly woman had died of a communicable disease, he was not concerned, having over the years encountered victims of tuberculosis and hepatitis.

However, when a hospital worker told him the woman had died of AIDS contracted through a blood transfusion, he panicked and rushed from the facility, refusing to transport the body to the funeral home.

“All I could think about was my young daughter; I wasn’t going to risk it no matter what,” he recalled.

The funeral home sent other workers to pick up the body, but even then no one at the facility would embalm the body. Instead, the remains were buried in a specially sealed casket.

Legal, Moral Questions

Today, funeral industry professionals, like many business people nationwide, are facing health, social, legal and moral questions posed by the epidemic of acquired immune deficiency syndrome.

California Funeral Directors, a trade association, is drafting guidelines expected to emphasize that morticians have a responsibility to take AIDS cases, and can do so safely with certain precautions. The group will also address whether there is justification for the extra charge of $100 to $400 that some morticians impose on the survivors of AIDS victims.

With the number of cases continuing to rise, no cure in sight and no vaccine on the horizon, the deadly disease is having an increased and often unexpected impact on the American workplace.

It has left employers wrestling with many issues, including: Can an employer fire an employee with AIDS? What if employees refuse to work with an AIDS victim? Can companies request that all employees take AIDS antibody blood screening tests? What financial effects can be incurred by serving or employing AIDS victims?

Medical Evidence

As of mid-December, 15,581 AIDS cases and 8,002 deaths from the disease had been reported nationally, the federal Centers for Disease Control reported. About 1.5 million people--mainly homosexuals and intravenous drug users--have been exposed to the syndrome, which attacks the immune system and leaves victims vulnerable to a variety of infections. Medical evidence indicates that the disease is transmitted in body fluids such as semen and blood during sexual contact and through contaminated hypodermic needles.

In the years since the epidemic began, ignorance of how the disease is transmitted has prompted scattered hysteria. AIDS victims have been evicted by landlords, refused services by hospital workers, fired from jobs, and barred from schools and ambulances.

City governments in Los Angeles, West Hollywood and San Francisco have tried to deal with some of those issues by enacting laws prohibiting discrimination against people with AIDS.

And last month, the federal Centers for Disease Control, attempting to ease fear and confusion, issued guidelines for the workplace. While not having the force of law, the recommendations are expected to carry considerable weight.

The report emphasizes that AIDS is not transmitted by casual contact, and says there is no need for restrictions on employees known to be ill.

But the government’s position is sometimes seemingly undermined by inconsistency. Shortly after the federal Department of Health and Human Services recommended against giving employees blood tests to detect AIDS antibodies on the grounds that they were unnecessary, the Pentagon announced that it would be giving the tests to all military recruits.

The Los Angeles County Fire Department has purchased 2,000 manual respirators, Capt. Al Bennett, paramedic coordinator, reported. The purchase was made after a paramedic administered mouth-to-mouth resuscitation to a man who was later found to have AIDS. There is no evidence that AIDS can be transmitted through saliva, and the firefighter, who undergoes periodic checkups, has not contracted AIDS. “Everyone was worrying after that incident, and although most doctors say you can’t contact AIDS that way, we did it for peace of mind,” Bennett said.

Faced with conflicting signals from the government, business executives are beginning to seek professional advice when faced with AIDS-related problems.

Requests for Help

Judy Spiegel, training director for AIDS Project Los Angeles, said the nonprofit social services agency is now getting requests from companies to conduct AIDS workshops for not only their medical staffs and management, but workers as well.

“You are dealing with fears that are not rational. By sitting down with people in their own work environment, you let them voice those fears. It’s much more effective than handing them a pamphlet,” Spiegel said.

More and more companies are requesting such programs, she said, but because of limited funds, AIDS Project has not been able to keep up with the demand. And there are other problems as well.

“Lets face it, we are dealing with three traditional taboos--sex, death, homosexuality. Any one of those subjects would preclude dinner conversation, any two, polite cocktail conversation,” said Bruce Decker, head of the California AIDS Task Force, appointed by the governor to coordinate the state’s AIDS education and prevention efforts.

Response to Seminar

It was standing room only when Bell Telephone conducted two AIDS seminars for employees in San Francisco recently. And in July, two full pages in the utility’s eight-page in-house newspaper were devoted to AIDS. The article noted that AIDS victims, who have weakened immune systems, had more cause to fear their fellow employees than vice versa. Dr. Michael Eriksen, director of preventive medicine for Pacific Bell, recalls that there was some concern initially about the project because they were dealing with topics not usually discussed in the workplace. “As it turned out, the response was very positive,” he said.

The company is also working with Levi Strauss and the San Francisco AIDS Foundation to develop films and booklets on how to deal with the problem in the workplace. These materials then would be made available to other companies and the public.

A number of other companies and trade groups have also held AIDS workshops, including Merchants and Manufacturers Assn., Hotel Personnel Managers Assn. and Crocker Bank.

Medical Advice

When two employees in the San Francisco offices of Crocker Bank contracted AIDS, “the questions began pouring in to management,” Wendi Temkin, a spokeswoman, said. Executives met with the bank’s medical staff, and with help from the San Francisco AIDS Foundation, organized a series of 11 seminars for employees.

Questionnaires filled out by workers before and after the programs showed that the programs helped decrease fear of contracting the disease, and also increased the employees’ general knowledge of AIDS, Temkin said.

Besides battling fear, companies are tackling many legal questions generated by the epidemic. Because the AIDS epidemic is only four years old, there are few laws speaking specifically to it.

Rep. Henry Waxman (D-Los Angeles), who chairs the House subcommittee on health and the environment, which deals with AIDS legislation, said that after ignoring the incipient epidemic for several years, employers are now in danger of overreacting.

Effect of Screening

“They want to screen workers for AIDS antibodies, even though 90% of those (carrying the antibodies) will never get AIDS, and even though its not possible to transmit the disease by causal contact,” he said. “What the tests will do is screen many (employees) out of jobs and out of insurance.”

In one of the first AIDS-related employment discrimination suits in the nation, the state Department of Fair Employment and Housing contends that Raytheon Co., an electronics manufacturer with a plant in Goleta, discriminated against an employee by not allowing him to work after he contracted AIDS.

The worker died several months ago. But the issue in the case, which will be heard in January, is whether employers have a right to bar AIDS victims from the workplace on the chance that the disease may be spread by casual contact.

Since Los Angeles became the first city in the nation to adopt an AIDS anti-discrimination law in August, 40 complaints have been registered, most related to housing and jobs. All have been resolved without litigation, said Mary House, deputy city attorney.

Gay Chef Is Fired

Typical of the cases, she said, was a gay chef who did not have AIDS but was fired because of his employer’s fear of the disease. “After educating the employer about AIDS, he rehired the man,” House said.

Of the nine housing complaints received, six were from landlords whose tenants feared they could contract AIDS from other renters by using the same trash cans and even from the building’s sewer system, House said. In one case brought by a renter, a landlord was attempting to charge a terminally ill tenant with AIDS an extra cleaning fee because he was going to fumigate the apartment when the man died.

Some companies providing services and goods relating to the AIDS epidemic have prospered, but in doing so have encountered sensitive public relations problems.

Mark King, a partner in a company that offers a pay-per-call erotic telephone conversation service patronized by homosexuals, says that some people have accused him of “cashing in” on the crisis, even though AIDS educators have applauded this type of business as an outlet for “safe sex.” The telephone sex business, along with X-rated videos and non-orgasmic sex and massage classes, have become trendy alternatives in the gay community.

King says that his business has grown considerably the past two years. Callers from as far away as France, England and Canada have been using the service, which costs $36.50 a call.

Teaching Techniques

The Body Electric, an Oakland massage school, has been flooded with requests from AIDS social service groups to train volunteer workers in massage. An associate at the school also teaches other non-orgasmic sexual techniques. The school has classes for health care workers and volunteers and for partners of AIDS patients and has offered seminars as far away as New York. “So many AIDS patients feel like lepers. To be touched is a very important part of the healing process,” said Joseph Kramer, owner of the school.

Medical experts also urge gays to use condoms as part of a “safe sex” campaign to contain the spread of AIDS. Sale of the items has grown 10% annually for the last four years. Last year, more than 400 million were sold, manufacturers say. Mark Klein, vice president of marketing for Schmid Laboratories, one of the two leading manufacturers, says that while fear of contracting sexually transmitted diseases such as AIDS has accounted for some sales gains, Schmid has not created any major advertising campaigns directed at the epidemic or in the gay community. The company has chosen to continue to focus on teen pregnancies because “it is such a mammoth problem,” Klein said.

One insurance company has begun selling a supplemental health policy specifically for AIDS coverage. Coastal Insurance Co. of Santa Monica has sold 1,200 of the policies in four states, including California, an official said. The policy will pay a maximum of $78,000 a year. The company says it is not sure how high the risk may be in offering such a policy, but has raised annual rates from $194 to $290 in the past year. Four claims have been made, but Coastal has made no payments, contending that the policy holders failed to note on applications that they had AIDS-related symptoms at the time they purchased the policies, the official said.

Watching Developments

Some industries have taken extra steps to make sure their professionals are kept up to date on AIDS-related developments. The California Restaurant Assn. newsletter recently conducted an AIDS interview with Dr. Shirley Fannin, associate director of communicable diseases for Los Angeles County. The interview, which emphasized that food handlers with AIDS pose no public health threat on the job, was sent to the owners of 8,000 restaurants. The group’s newsletter will continue to publish updates for members.

While some restaurateurs say their business has been adversely affected by the epidemic, the restaurant association does not keep statistics on sales. Jonathan Ahearn, treasurer of the city of West Hollywood, a city with a large homosexual population and where restaurant business accounts for 25% of the tax base, said that sales receipts are up this year.

Several months ago Robin Claire became manager of a West Hollywood restaurant and nightclub. “I don’t think I’m going to die from getting sneezed on. AIDS is much more involved than that,” she said.

However, she said that business is down in her restaurant and others in the area. “I was out to dinner at another restaurant the other night and heard a woman at the next table say that she would not eat at a certain restaurant anymore because it has a gay chef. There are a lot of uninformed people like that out there.”

Paper Plates

West Hollywood pizza parlor owner Shahram Vahdat has started serving food on paper plates and cups, rather than crockery, and is using stronger disinfectants to clean his restaurant.

While Vahdat is aware of the advice of federal medical experts that such steps are not necessary, he doesn’t plan to bring back dishes. “My customers like it. My employees like it. It gives them peace of mind,” he says.

But as the AIDS epidemic wears on, there are many who have cut through the fear.

Tom Simpson, a San Francisco funeral counselor, conducted services for more than 100 AIDS victims the past year.

One of his first clients was a gay man trying to find a funeral home that would hold an open casket service for his deceased lover. Simpson provided the service and was inundated with such requests.

Basis for Concern

“Being gay, my concern for my brothers helped me face the fear that many in my profession have. But it is also common sense. Medical reports say that if you take care, you can’t get AIDS during embalming,” he said.

While Simpson has dealt adequately with the technical problems the epidemic has visited upon his profession, he has not weathered so well another AIDS-related job stress.

“It’s an emotional strain to see so many young men dying in the prime of their life,” he said.