Attachment I, Page 8 
packaging. Because of the biological activity of many products and 
by-products of organisms containing rDNA, prevention of any resultant health 
hazards will require extremely sophisticated engineering controls. 
In addition to the specific hazards which may result from occupational 
exposures to particular products, workers in rDNA applications may also be at 
risk of sensitization to proteins and peptides which are generated in the 
course of fermentation and extraction. A high frequency of sensitization to 
protein enzymes has, for example, been described among workers engaged in the 
14 
commercial production of enzyme detergents. Asthma is the most serious 
health consequence of such sensitization. Dermatitis and allergic rhinitis 
might also be expected to occur. 
PURPOSES OF MEDICAL SURVEILLANCE 
Uncertainty provides the strongest argument for maintaining medical 
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surveillance over workers engaged in industrial applications of rDNA. As 
in the case of any newly developed technology, there is a dearth of 
information concerning the nature or severity of any acute or chronic health 
hazards which might be associated with exposure to recombinant organisms or 
their products. Given that lack of knowledge, the CDC/NIOSH Working Group is 
of the opinion that medical surveillance of such workers constitutes prudent 
medical practice. Such surveillance should be aimed at the early detection of 
sentinel disease events.^® 
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