4 
people involved in the producticxi of menthol cold remedies. It is very clear 
that product exposure hazards exist in the pharmaceutical industry and that 
very strict containment of biologically active products has to be achieved at 
every stage of production. The third category of hazard is exposure to reagents 
used in the extraction and purification of the products. These hazards are 
not qualitatively or quantitatively different from hazards encountered in 
other sectors of the pharmaceutical or biotechnology industries. 
Dr. Landrigan said the CDC/NICSH report then outlines the components of a medi- 
cal surveillance program for workers in biotechnology industries: (1) pre- 
employment examinations, v*iich include collection of baseline serum samples, 
(2) periodic follcw-up examinations, (3) provision for active fbllow-up of any 
illness vhich causes inexplained absences from work of 48 hours duration, and 
(4) conduct of epidemiological or other long term follow-up studies. 
Dr. Landrigan said the report concludes with a statement on the limitations of 
medical surveillance: the likelihood is small that medical surveillance will 
detect any unexpected disease. Hopiefully, that disease will not occur at all; 
strict containment and good work practices should prevent its occurrence. The 
r^»rt argues, however, that uncertainty, both social and medical, as to the 
unknown hazards of this new industry are sufficient to justify the develc^xient 
of medical surveillance programs. 
Dr. Landrigan said the CDC/NIOSH r^xort had been revised following the February 
9, 1981 discussion of the document by the large Scale Review Working Group, and 
suggestions offered by the working group were incorpxorated in the document. 
Dr. Landrigan said the scope of the report has been broadened beyond recombinant 
[ 490 ] 
