dormeint for long periods so that when they are finally expressed, 
the connection to the original cause might not be made. What is 
needed and should be mcuidated by NIH is a program for thorough 
constant medical surveillcuice of all personnel involved in 
recombinant research and work areas to detect small chcmges before 
they erupt into large problems. Under the present medical 
surveillance program, medically detectaOsle hints would be ignored 
until it is too late. A central bureau should be esteUblished by the 
NIH to manage the medical surveillance progreim. Blood serum should be 
obtained and stored from all individuals involved in recombinant 
researcy at 6 to 12 month intervals. A prospective cohort stu^ 
should be done by ascertaining the exposure of the individuals with 
a subsequent follow-up prograun recording their disease and mortality 
experience. The collected blood serum should be kept frozen for 
antibody determination in the future. All suspicious illness should 
be promptly reported to the central agency which would then conduct 
a thorough investigation and periodic medical exaims of personnel should 
be carried out to detect early indications of problems. To quote 
Michael Oxman at the Asilomar Conference, "The establishment of such 
am independent agency is essential because it is extremely difficult for 
an investigator to deal open-mindedly atnd unemotionally with illness 
in his own laboratory" ( Biohazards in Biological Research p. 349). 
The present system provides no adequate check on worker contamination 
and we strongly recommend that an NIH surveillance prograun be 
esta±»lished to carry out the activities described aibove. 
The existence of biohazard committees for each grantee 
institution provides a secondary check upon the activities of 
-27- 
Appendix K — 107 
