. 13 - 
ej^osed workers end the long induction-latency periods which nay need to 
elapse between beginning of exposure and appearance of disease. In the longer 
tern, however, epidetniologlc studies nay be extremely useful as a health 
surveillance tool. Specific follow-up studies Intended to evaluate specific 
outcomes will be the most cost-effective form of epidemiologic follow-up. 
Among the outcomes to be considered for long-term surveillance might be 
Increases in cancer Incidence or mortality rates. Increased rates of endocrine 
disorders, and elevated rates of Immunologic diseases. Surveillance might 
also be directed to the detection of adverse reproductive outcomes in the 
offspring of male or female workers. Many such studies might require the 
concommitant evaluation of appropriate control groups. 
The necessary foundation for any long-term studies of biotechnology workers 
will be the Indefinite maintenance of careful records on each worker by each 
Institution or firm engaged In biotechnology. At a minimum, such records must 
Include the name of each worker, personal identifying information including 
Social Security number, results of all physical examinations and special 
medical tests, a complete history of work experience (including information on 
areas of work, specific jobs, and specific organisms, processes, and products 
encountered), and a record of any illnesses or of any accidents in which the 
worker was Involved. 
LIMITATIONS OF MEDICAL SURVEILLANCE 
The likelihood Is small that a medical surveillance program for biotechnology 
workers will detect any Illness caused by recombined organisms or by their 
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