A new report from the Centers for Disease Control and Prevention (CDC) reveals that workers without paid sick days are at high risk of spreading illness. For food service workers, the consequences are dire. The report traces outbreaks of the Norovirus—an infectious stomach illness that causes severe vomiting and diarrhea— from 2009 to 2012 and found that restaurants were the most common sources of contamination through food preparation.

Norovirus is the number one cause of foodborne disease outbreaks and can spread through close contact or contaminated food or surfaces. As a result, infected food service workers, whose contact with food and consumers is unavoidable, can expose many to this illness when they report to work while sick. In fact, 70 percent of the outbreaks analyzed by the CDC were brought about by infected food service workers.

With the exception of a handful of cities and one state (Connecticut), employers in the U.S. are not required to guarantee their workers paid sick days. As a result, it is not uncommon for employees to go to work without fully recovering from an illness. A 2011 study examined the frequency of employee attendance while experiencing vomiting or diarrhea, finding that almost 12 percent of the workers who were interviewed reported going to work while suffering these symptoms. This same study found that about 20 percent of foodborne illnesses are directly related to the transmission of pathogens between food workers and the food with which they’re in contact.

Given these risks, the decision to report to work while sick may appear unreasonable. But for many employees, there is no other choice; without access to paid sick days, staying home could cost them their jobs or leave them without a crucial day’s pay.

Among low-wage workers, only 30 percent can earn paid sick days. At the same time, the median wage for restaurant workers across the nation is $8.59/hour, according to the Restaurant Opportunities Centers (ROC) United. Lack of sick days is also more common among workers of color, as only 62 percent of Black workers and 47 percent of Latino workers obtain paid sick days, in contrast to 64 percent of white workers. When ROC United surveyed 4,323 restaurant workers nationwide, it discovered that most of those in urban areas were workers of color or immigrant workers. The study additionally determined that of those surveyed, 88 percent reported not having access to paid sick days. The study found that 63 percent had attended work while sick.

When workers are denied the ability to recover from illnesses without risking their wages or their jobs, we’re effectively pretending that sickness is not inevitable. And this glaring oversight doesn’t just hurt the workers themselves—it has consequences for everyone they come in contact with, including consumers and coworkers.