Work placement and worker fitness: Implications of the Americans with disabilities act for pulmonary medicine

Pulmonary physicians have a significant role in assessing the ability of individuals with respiratory impairments to be placed in jobs or retain current jobs. The Americans with Disabilities Act mandates a high level of rational thought and justification for any recommendation against placement or work retention. This article reviews criteria for determining if an individual with a respiratory impairment or disability can currently and safely perform a job and if there is substantial direct threat of future risk. In addition, methods of modifying the workplace to accommodate individuals with respiratory disabilities are discussed.