Preserving confidentiality in occupational medical practice.

The United States does not have a uniform law regarding medical confidentiality. However, codes of conduct from the American Medical Association, the American College of Occupational and Environmental Medicine and the International Commission of Occupational Health, as well as relevant parts of the Americans with Disabilities Act and the Occupational Safety and Health Act of 1970, can help physicians make informed decisions about requests for medical information. Such activities include preplacement and fitness-for-work evaluations medical surveillance examinations (including drug testing) and evaluation of symptoms and treatment of injuries that may be work-related. The patient should be the one to decide whether and when to release medical records to employers, unless overruled by public health risks or laws.