How Are Disease-Agent Relationships Determined in Haz-Map?
- What are the criteria for
determining causality? Is there
consensus in occupational medicine textbooks that this occupational
disease is caused by these hazardous agents? Can the disease be prevented
by good occupational hygiene practices?
was classified using a controlled vocabulary (indexes) for agents,
adverse effects, industrial processes, non-occupational activities,
diseases, signs & symptoms, hazardous job tasks, jobs, and
At the chemical level, the
concern is the potential toxic effects of the agents. Potential
adverse effects may be based on laboratory animal studies or human
cases of poisoning by ingestion.
At the disease level, the concern
is work-related diseases based on human case reports or epidemiological
studies. The exposure routes for
work-related diseases are usually inhalation or skin absorption.
The first content added was
information on about 700 chemicals from the NIOSH Pocket Guide to
Chemical Hazards [National Institute for Occupational Safety and
Health (NIOSH), 1997].
Next, using selected references
from the scientific literature, the author added to the database any
other chemical or biological agents linked to occupational asthma,
toxic pneumonitis, chronic bronchitis, neuropathy, Parkinson's
syndrome, acute solvent syndrome, methemoglobinemia, aplastic anemia,
hemolytic anemia, contact dermatitis, chloracne, liver injury, kidney
injury, and simple or chemical asphyxiation.
tagged on the basis of categories were "Organophosphate,"
'Organochlorine," and "Carbamate" pesticides.
Several databases were used
heavily in the early development of Haz-Map including Hazardous
Substances Data Bank (HSDB), ACGIH
Documentation of the TLVs and BEIs, ATSDR
ToxProfiles, Documentation for Immediately Dangerous to Life or
Health Concentrations (IDLH), and NIOSHTIC.
and Murthy 1991 paper was used for the initial list of
The early development of the
content also relied on textbooks of occupational medicine (LaDou,
Sullivan & Krieger, APHA,
Other major sources were
textbooks of pulmonary medicine (Harber,
Hendrick, and Murray),
occupational dermatology (Marks &
DeLeo and Kanerva),
toxicology (Hayes, Nordberg,
Index, and EPA Pesticides),
and industrial hygiene (Burgess and Quick
The list of Malo
and Chan-Yeung was used for the agents causing occupational
and Hage  and Luderer
 were the main sources for reproductive hazards.
Ionizing radiation as a cause of
cancer is based on Boice .
Linkage between an agent and a
disease indicates that sufficient exposure to the agent is associated
with an increased risk of developing the occupational disease.
For chronic diseases, linkage
between an agent and a disease means that a causal relationship has
been determined based on human case reports or epidemiological
Carcinogens are linked only if
they have been designated as known human carcinogens by the
International Agency for Research on Cancer (IARC).
In some cases, IARC does not list the target organs, but Haz-Map
follows the interpretation published in Schottenfeld and Fraumeni's Cancer
Epidemiology and Prevention. [Siemiatycki]
Other databases that have been
used extensively in recent years include ChemIDplus,
Occupational Health Guidelines
for Chemical Hazards, International
Chemical Safety Cards, CAMEO, CHEMINFO,
EXTOXNET, and the North
American Emergency Response Guidebook.
Databases accessible from EXPUB
include ESIS - Euopean chemical
substances information system, EPA OHM/TADS (Oil and Hazardous Materials Technical
Assistance Data System, EPA
ChAMP (Chemical Assessment and Management Program), REPROTOX,
(Registry of Toxic Effects of Chemical Substances), FDA
(US Food and Drug Administration), EFSA
(European Food Safety Authority), and OECD
SIDS (Organization for Economic Co-operation and
Development Screening Information Data Set).
Revised: April 26, 2015