Health Monitoring - Occupational Health and Workplace Monitoring at Chemical Agent Disposal Facilities - page 23

CSDP occupational and environmental health program,
the committee believes that the program described in
the referenced documents has been fully implemented
and that medical records are being maintained as pre-
scribed. The committee noted that medical surveillance
for chemical agents and heat-stress prevention pro-
grams are carried out rigorously. The committee con-
cluded that the program is comprehensive, profes-
sional, and adequate to meet the known occupational
health needs of CSDP workers.

ing aromatic amines, polycyclic aromatic hydrocar-
bons, and a variety of alkylating agents (Skipper and
Groopman, 1991). These adducts, which are often
present in blood and urine and thus are easily acces-
sible, are formed even at very low exposure concentra-
tions. Therefore, they sometimes provide a more sensi-
tive measure of exposure than current methods.
However, they should not be used as screening tools
for predicting adverse health effects in humans until
the correlation between exposure and health effects is
better known. Preventing exposure is still the key to
avoiding adverse health effects.
The major chemical warfare agents include vesi-
cants, such as HD, and nerve agents, such as GB and
VX. All of the vesicants are alkylating agents and,
therefore, will yield adducts with both DNA and pro-
teins, which could serve as the basis for very sensitive
assays for exposure (nerve agents are alkylphosphonic
esters and are not especially reactive with macromol-
ecules like DNA and proteins). The PMCD should con-
tinue to follow and evaluate developments in medical
diagnostic techniques and incorporate them into the
CSDP medical monitoring program.

DEVELOPMENTS IN MEDICAL DIAGNOSTIC
TECHNIQUES

Advances in biotechnological diagnostic techniques
are likely to provide more sensitive methods of detect-
ing very low levels of exposure to some chemicals. As
these new techniques become commercially available,
the PMCD should consider adding them to the medical
surveillance program.
For example, recent research has shown that adducts
of deoxyribonucleic acid (DNA) and proteins are
formed on exposure to a number of chemicals, includ-