3 
atteniiated organisms. After these protections are in plcK^e, the role of mediced 
surveillance can be considered. 
ft:. Landrigan said medic<d surveillance perfonns several functions. First, it 
serves as a check on the adequacy of other protection. Secondly, it is a 
defense against the unexpected; if unanticipated illness should occur, it 
facilitates the early detection and control of such illness. 
Dr. Landrigan said the CDC/NI06H vrorking group report discusses in sone detail 
the specific hazards medical surveillance might be directed against. These 
hazards may be classified in three categories. The first are microbied hazards; 
the hazards posed by colonization of the wrker by recombinant D^A organisms. 
The CDC/NIC6H working group concluded that the likelihood of such an event is 
quite snail, given that most organisms currently used are attenuated and that 
risk assessment information suggests an extremely snedl possibility of colon- 
ization by these organisms. The report cautions, however, that these assunptions 
should be reevaluated if more robust otgauiisns are employed in industrial 
processes. The second class of potential hazard is exposure to biologic^d 
products. Here, the CDC/NIOSH working group concluded, real risks exist. Risks 
frcm exposure to these products are probably not significantly different fron 
exposure risks elsevhere in the phamaceuticad industry. Adverse affec±s and 
illnesses are observed in pharmaceuticad manufacture workers exposed to bio- 
Icagicadly active prcaducts. As examples Dr. Landrigam mentioned the cxxur ranee 
of gyneexmastia in persons in\rolved in the producticsn of oral cxxitraceptives, 
frequent nose bleeds in workers using ferrous sulfate, toxic hepatitis in 
people working with isoprcapanol and carbon tetrachloride, and naisal polyps in 
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