BIRMINGHAM, Ala. — Health officials fear Alabama's tough new law against illegal immigration could increase the risk of illnesses across the state because many Hispanic immigrants worried about arrest and deportation already have stopped seeking medical care at government clinics.

Waiting rooms that once were full at some county health clinics just a few weeks ago now have empty seats because Hispanic patients stopped showing up, said Dr. Jim McVay, a spokesman for the Alabama Department of Public Health.

While most health programs administered through the clinics are federally funded and aren't affected by the law, he said, many immigrants apparently don't know that. That has some leaders worried about a possible increase in illnesses that can spread through communities.

"I don't want to spread fear, but any time people are afraid to get medical care there are potential complications," he said Friday.

Gov. Robert Bentley's office doubts the department's claims. But McVay said the drop off in patients has been particularly noticeable in north Alabama, where thousands of Hispanic immigrants work side-by-side with Alabama-born employees in the region's poultry and agriculture industry.

The head of the state health agency predicted just such a scenario four years ago in warning against clamping down on illegal immigrants living in Alabama. State Health Officer Donald Williamson, a physician, said tougher rules aimed at saving the state money by limiting services to immigrants might also cause sick people to be afraid of seeking medical treatment for conditions including tuberculosis.

"Avoid erecting barriers that would prevent people from seeking services," he advised the Joint Patriotic Immigration Commission.

Now, Williamson's worries apparently have come true among immigrants.

"There's a fear factor, that people are out to get them," said McVay.

State health officials, in stressing the importance of making health care readily available, in the past have linked rising numbers of immigrants to additional cases of communicable diseases like chicken pox and tuberculosis, and they have said Hispanic women need access to prenatal care to prevent infant mortality.

Bentley, who signed the illegal immigration law, is a physician. His press secretary, Jennifer Ardis, was skeptical that fewer numbers of Hispanics are going to county clinics.

"The Department of Public Health doesn't track the ethnicity of individuals seeking treatment at county health clinics," she said. "There are no facts to support any anecdotal story of a decrease or why it may have occurred. Anyone in need of health care should not hesitate to seek it in Alabama."

Supporters of the new law say it's designed to create jobs for Alabamians and drive down costs for services including health care. While studies have shown illegal immigrants are less likely to have health insurance than citizens and are more likely to rely on government clinics and hospital emergency rooms for care, federal regulations generally bar hospitals from reporting information on patients' citizenship status so the impact of illegal immigrants is difficult to gauge.

The Congressional Budget Office said the federal government provided states with $750 million over three years ending in 2008 to pay hospitals for emergency health care for illegal immigrants, but it couldn't come up with a total cost of providing medical services for people living in the country illegally. Alabama was among the states that received money through the program.

The law is affecting the public health community aside from concerns over the spread of illness.

Fearful that state workers could be prosecuted under part of the law that bars illegal immigrants from conducting business with the state, the Health Department imposed a two-week moratorium on permits for septic tanks, restaurants, food processors and temporary food operations after a federal judge cleared the way for sections of the law to take effect on Sept. 29, said Pres Allinder, director of environmental services for the state agency.

The department temporarily waived permitting regulations for dozens of companies and individuals during the shutdown rather than bring operations to a halt, he said.

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"If we give a permit to an illegal, knowing or unknowingly, we have committed a Class C felony," Allinder said. "It was an inconvenience for the citizens of Alabama and it was a problem for us, but it was a good thing to do. Our people could have faced felonies."

State permitting procedures are back to normal now, he said, but the agency is now requiring proof of citizenship for anyone seeking a health permit for a bakery, restaurant or store. While such proof wasn't previously required, Allinder said he isn't worried that the new regulation will create more work for inspectors by driving some operations underground.

"We fight that battle daily. We're constantly on the lookout for illegal operations," he said.