Attachment I, Kige 10 
- conditions which impair the non-specific defenses against infection 
(chronic skin, respiratory tract, and bowel disease); 
- impaired immune competence; 
- immunosuppression (caused, for example, by steroids, radiation therapy, 
alkylating agents, or antimetabolites); 
- cancer; 
- other chronic illnesses, such as chronic kidney disease, diabetes 
mellitus, or the collagen diseases;. 
The collection and storage of frozen serum samples has become a widely 
accepted practice in the biotechnology industry. A serum sample is generally 
taken from each worker at the start of employment and, in some instances, 
1 6 
periodically thereafter. Serology programs will be most cost-effective 
when they either assess specifically the development of antigens associated 
with the organisms or products in a particular process or when they are simply 
stored in a bank and held at -70°C for future study or for reference in the 
event of illness. 
Periodic Follow-up Examinations - Comprehensive periodic medical 
examinations are generally of little value in the detection of occupational 
disease. Any periodic examinations incorporated into a surveillance program 
must be specifically targeted toward evaluation of the particular hazards 
which may confront a particular group of workers. For example, studies of 
endocrine function might be devised for workers engaged in the production of 
peptide or steroid hormones, or appropriate evaluations of immune function 
might be undertaken for workers producing interferon or other immunochemicals. 
[ 388 ] 
