necessity of establishing uniform and consistent surveillance 
of R-DNA workers and their contacts for untoward effects 
associated with R-DNA laboratory activities. Again, the full 
detailing of (required?) monitoring procedures will apparently 
be left until later. For the same reasons as given under point 
(1) above, no relaxation of the guidelines should take place 
until this monitoring is instituted. Preferably, all work should 
stop until this frequently called for and necessary activity is 
begun, but I realize this is not feasible given the current 
situation. This shows once again how necessary it is to do these 
things right from the outset. 
Moreover, the lack of monitoring and surveillance almost 
guarantees that R-DNA research will appear safe, whether or not 
it is. This is because there will be virtually no way to detect 
an adverse event if it occurs. An historical example is available 
in the SV-40 contaminated adenovirus and polio vaccines that could, 
even now, be causing catastrophic illness beyond our ability to 
detect it because no means of follow-up of the exposed individuals 
was instituted. 
Recommendation : No relaxation or "increased flexibility" in the 
NIH guidelines be permitted until an adequate, consistent and 
uniform epidemiological monitoring and surveillance program is 
instituted and administered at the national level, and which includes, 
at the least, the following elements: 
(i) A definition of the monitored cohort which will include 
not only all R-DNA workers but also all ancillary workers, such as 
maintenance, glassware washqrs, etc. Immediate household members 
of these should also be included. There should be a mandatory 
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