Confidentiality of personal medical information is a serious concern in occupational medicine. New regulations issued under the Health Insurance Portability and Accountablility Act (HIPAA) significantly alter procedures for protecting and managing confidential medical information. There are still questions about how much the new regulations will affect occupational medicine practices, but there will be significant changes in the collection, storage, and dissemination of personal medical information in the near future. The implications of increased confidentiality concerns on research are also considered.