what sort of accomodation would a small business need to make for someone with a pacemaker (business is metal fab) where the employee’s job is to work around devices that affect the pacemaker?

There might not be any that are considered reasonable in that situation.

Here is an excerpt from an article that will give you some ideas.

HEART DISEASE/HEART CONDITION

WHAT IT IS

The heart is a simple but remarkable pump. It can be relied upon to beat about 60 times a minute for a lifetime without needing maintenance. Its purpose is to deliver blood to the tissues and organs of the body so that they are supplied with all the nutrition and oxygen they need.
Many things can happen to interfere with the normal functions of the heart, a most vital organ.
The most common heart problems that the average person is familiar with are heart attacks, congestive heart failure, coronary artery disease, wearing a pacemaker, and congenital heart disease.

CHARACTERISTICS

Heart conditions and heart diseases are so varied and complex that there is no one set of characteristics for persons with heart conditions. Each person must be dealt with on an individual basis and not compared to another person who has a heart condition.
A heart attack occurs when the blood supply to the heart is seriously reduced. Common symptoms are:
1. Uncomfortable pressure, fullness, squeezing or pain in the center of the chest lasting more than a few minutes.
2. Pain may spread to the shoulders neck or arm.
3. Chest discomfort with light-headedness, fainting, sweating, nausea or shortness of breath may occur.

HEART DISEASE/HEART CONDITION (continued)

Congestive heart failure occurs when the heart doesn’t pump as efficiently as it should; the blood flow is slowed down and the quantity of blood pumped is below normal. The result is that blood returning to the heart backs up in the veins. This causes fluid to be forced out of the blood vessels and into the tissues of the feet and legs. The swelling that results is called “edema” of the feet, ankles and legs. When the left side of the heart isn’t pumping as efficiently as it needs to, blood backs up in the vessels of the lungs. Sometimes fluid is forced out of the lung vessels into the breathing spaces themselves. When this happens, it is called “pulmonary edema” and shortness of breath and a consequent lack of stamina often result.
The ability of the kidneys to dispose of sodium and water also becomes impaired in cases of congestive heart failure and sodium that would normally be eliminated through the urine stays in the body and holds water. This aggravates the excess fluid problem that already exists in the body.
The body tries to compensate for congestive heart failure by:
* Enlarging

* Developing increased muscle mass

* Increased stimulation of the heart muscle so that the heart pumps more often to promote better circulation.

The best treatment of congestive heart failure is prevention.

Coronary artery disease affects the blood vessels (arteries) on the surface of the heart. Aging and other complex factors cause the ordinary soft and compliant blood vessels to harden. Fat, cholesterol and minerals from the blood are deposited on the inner surface of the coronary arteries. When these materials build up, they form what’s called plaque. Plaque may restrict blood flow through the artery and may stimulate the formation of a blood clot.
Many people have a (PTCA) percutaneous transluminal coronary angioplasty or a coronary artery bypass graft surgery to relieve or correct the problems from coronary artery disease.
Wearing a pacemaker – It works about the same way as your heart’s natural pacemaker. It is a small unit that uses batteries to produce the electrical impulses that make your heart pump. Pacemakers are used when your heart pumps too slowly, too fast or is irregular.
Today, thousands upon thousands of people have artificial pacemakers and lead full, productive lives.

HEART DISEASE/HEART CONDITION

Congenital heart disease – Many infants are born with anomalies of the heart, valves or arteries. Some of these deficiencies can be corrected with surgery; others develop into more serious heart problems.
With dramatic advances that have occurred in the surgical treatment for congenital heart disease, more patients are reaching adulthood.
WORKPLACE IMPLICATIONS
Having heart a condition or heart disease does not mean it is “the end of the world.” In many cases, treatment is effective. Getting good medical care, following the doctor’s advice and understanding the disease or condition and its treatment should allow an individual to lead a full, active life.
Doctors usually recommend some life style changes for individuals who have had heart attacks, coronary artery bypass surgery or congestive heart failure. Such things as not smoking, controlling high blood pressure, staying with a diet that is low in saturated fats, cholesterol and salt, having a sensible, regular exercise program and keeping one’s weight down will contribute to the maintenance of a feeling of well being.
POSSIBLE ACCOMMODATIONS see reasonable accommodations
Reassignment, modified work schedules, job modifications, smoke-free environment, reduced stressful situations, reduction in travel.