inuA- i a 
-7- 
3. The pertinent procedures listed under Facii.^ ^ciqliuid in the 
P4 Safety and Operations Manual will be adhered to. These include, 
but are not limited to, change of clothing, showering, out, etc. 
C. P2 
1. According to practices listed under P2 on Page 27913 of the above 
issue of the Federal Register. 
2. Rooms 218 and 220, Building 5, were previously certified as P1-EK1 
under IMUA-10. 
D. EK2 Plasmid-Vector System 
1. E. coli x! 776 bearing the polyoma-plasmid recombinant should be 
Tnvesti gated periodically to ensure that its genotypic and phenotypic 
properties have not been altered during the course of the experiment. 
E. Training 
1. The personnel listed on Page One have experience in handling 
microbial agents equivalent to P2-P3 levels of containment. They 
will be instructed in the procedures required for the P4 level of 
.containment prior to the commencement of this research. Training 
and certification of the training will be carried out under the 
direction of the Project Officer. 
VII. MEDICAL SURVEILLANCE PROGRAM 
A. Prior to initiation of work each employee shall have: 
1. A review of their medical history which should include recent or 
current antacid or antibiotic therapy. 
2. A physical examination. 
3. Serum, stool and urine samples taken for storage. 
B. Item A3 will be repeated every six months. Stool samples or anal swabs 
and urine samples will be collected at the discretion of OMS. 
C. Medical Coverage 
1. The Occupational Medical Service (OMS) will establish a file of all 
employees participating in this study. 
2. Any employee illness must be reported to the OMS. If the employee 
is unable to report to the OMS directly, he will contact the 
principal investigator who will notify the OMS. 
3. All injuries sustained by employees while working under P4 conditions 
must be reported to the OMS. These include sel f- i nocul ati on , aerosol 
exposures, cuts, abrasions, etc. Appropriate clinical specimens will 
be collected; serum, urine, stool, throbt washing. 
[Appendix C — 237] 
