2 
Er. Berns, co-chairman, called the fourth meeting of the Large-Scale Review 
Working Group to order at 9:00 a.m. on June 29, 1982. Dr. Bems said he and 
his co-chairman, Cr. McKinney, had reviewed the minutes of the February 9, 
1982 meeting. They had found the minutes to be complete and accurate. 
Dr. Mason moved ^proval of the minutes of the third meeting of the working 
group. The minutes were approved by a voice vote. 
Medical Surveillance of Biotechnology Workers 
Dr. Bems then introduced Dr. Landrigan of the National Institute for 
Occupational Safety and Health (NIOSH). Dr. Landrigan had presented to the 
working group, at the February 9, 1982 meetirg, the document "Medical 
Surveillance of Biotechnology Workers: Report of the CDC/^IOSH, Ad Hoc Working 
Group on Medical Surveillance for Industrial ^^lications of Biotechnology." 
Dr. landrigan reviewed the history of the report. He said the CDC/NIOSH 
(Centers for Disease Control/National Institute for Occupational Safety and 
Health) working group had been asked to consider the strengths, limitations 
and nature of ar^ medical surveillance program that might be develcped for the 
medical ncxiitorirg of industrial workers engaged in industrial applications of 
reconbinant ENA technologies. Dr. Landrigan said that as the CDC/NIOSH working 
group considered the issues, it became evident that medical surveillance had 
to be viewed as one of several layers of protection for industrial workers. 
Ihe principal protection for industrial workers is provided by strict physical 
containment of the processes. Almost as important as strict physical 
containment is the development of good work practices, the development of 
worker training programs, and to the extent possible, the use of biologically 
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