Medical surveillance of exposed persons after exposure to PCBs, chlorinated dibenzodioxins and dibenzofurans after PCB transformer or capacitor incidents.

The panel discussion from the perspective of occupational medicine regarding appropriate medical surveillance after a PCB transformer or capacitor incident is reviewed. A thorough occupational medicine history and physical examination is stressed for any worker or other patient who may have been exposed. Appropriate laboratory tests, including complete blood count with differential, serum chemistries, serial blood PCB determinations, fat biopsy to estimate furan and dioxin levels, if indicated, pulmonary function tests, chest X-rays, urinalysis including porphyrin measurement, nerve conduction velocity testing and other tests are discussed. No consensus was reached on recommended length of medical followup. Because the field is rapidly changing, yearly updates of medical protocols are warranted. In addition, the need for surveillance to be conducted by specialists with training and experience in the fields of occupational medicine and nursing was emphasized. It was stressed that measuring the chemicals and their levels in soot and air and then comparing these with the patient's blood or fat levels, in the case of PCBs, furans and dioxins, is vital. It was noted that at present no modality of treatment is known to be clinically efficacious in removing PCBs, furans and dioxins from tissues or blood.