What Is It?

 

I. Purpose and Description of Haz-Map

Haz-Map began in 1991 with about 700 chemicals from the NIOSH Pocket Guide. Next were added all agents, both chemical and biological, known to cause adverse effects, e.g. work-related asthma, contact dermatitis, methemoglobinemia, toxic hepatitis, etc. The intention has always been to accurately represent or map the current state of scientific knowledge about hazardous agents in the workplace. 

Because of Haz-Map's design, users can "zoom in" and "zoom out" between the big picture and the details. Like a map, Haz-Map portrays relationships and scale between the parts and the whole. What information to include or exclude is based on the purpose of the map.

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Figure 1: Haz-Map was designed to assist safety and health professionals.

The purpose of Haz-Map is "decision support." It is meant to assist the expert by providing easy access to key information. The philosophy of decision-support software is to harness the computer as a tool for the natural intelligence of the human mind. The goal is not to replace the professional with "artificial intelligence."

The goal is to take advantage of the computer's infinite capacity to store information, and to make it as easy as possible for the health professional to access that information. There are no hidden algorithms operating in Haz-Map. A query results in a list or an intersection of lists. For example, searching for all occupational diseases that have cough as a symptom will give you one query result. Searching for all work-related diseases of carpenters will give you another result. One can then put the two criteria together in an AND search to find all diseases associated with carpenters AND cough. You could do the sorting by hand, but the computer does it instantaneously.

The purpose of Haz-Map is to assist in the identification and prevention of occupational diseases. All occupational diseases are preventable by reducing exposure in the workplace. Early recognition of an occupational disease in one worker can lead to prevention of the disease in coworkers.

The author of Haz-Map is Jay A. Brown, MD, MPH, a graduate of Indiana University School of Medicine in 1978 and the University of Washington School of Public Health in 1996. Jay completed residency training in Family Practice (1981) and in Occupational Medicine (1996). He is Board Certified in Occupational Medicine by the American Board of Preventive Medicine. Dr. Brown has over ten years of experience working in occupational medicine clinics. He is a member of the American College of Occupational and Environmental Medicine and the American Conference of Governmental Industrial Hygienists. Haz-Map was produced and is maintained solely by the author. It is a scientific project in the fields of occupational toxicology, infectious diseases, epidemiology, medical informatics, and preventive medicine.

Haz-Map was built for queries, and it uses a controlled vocabulary to systematically index the knowledge it contains. To produce a controlled vocabulary for queries in a relational database, text-based information must be transformed into structured and unambiguous indexes. Names of chemicals, diseases, findings, jobs, industries, and processes are all indexes. Each chemical is flagged for the presence or absence of adverse effects including Lung Toxin (asthma, pneumonitis, chronic bronchitis, and fibrosis), Neurotoxin (neuropathy, Parkinson's syndrome, CNS solvent syndrome), Hematotoxin (methemoglobinemia and aplastic or hemolytic anemia), Dermatotoxin (contact dermatitis, chloracne, or skin burns), Carcinogen (IARC, ACGIH, and NTP designations), Other Tissue Toxin (hepatotoxin, nephrotoxin, and reproductive toxin), and Other Poison (organophosphate, carbamate, organochlorine, uncoupler, chemical asphyxiant, simple asphyxiant, and lachrymator).

In addition to adverse effects, the Agents table also has fields to show all available information about properties, thresholds, and exposure limits that are useful in distinguishing between harmless and significant exposures.

All information is classified using hierarchical categories. The Major Agent Categories are subdivided into 250 Categories. The Major Agent Categories (# of categories) are:

1.      Biological Agents (25)

2.      Dyes (11)

3.      Metals (23)

4.      Mineral Dusts (3)

5.      Nitrogen Compounds (28)

6.      Other Classes (65)

7.      Other Uses (14)

8.      Pesticides (30)

9.      Physical/Radiation (4)

10.    Plastics & Rubber (17)

11.    Solvents (16)

12.    Toxic Gases & Vapors (14)

Disease Categories are:

1.     Acute Poison

2.     Airway Disease

3.     Cancer, Occupational

4.     Chronic Poison

5.     Hypersensitivity Pneumonitis

6.     Infection, Occupational

7.  Infection, Travel

8.     Pneumoconiosis (Pulmonary Fibrosis)

9.     Metal Poisoning, Occupational

10. Skin Disease

II. Information Sources and Content of Haz-Map

Information from peer-reviewed textbooks, journal articles, and electronic databases was classified and summarized to create the database. A bibliography including online resources is regularly updated at http://www.haz-map.com/refernc.htm. This page also shows the reference tags that are used throughout Haz-Map to reference source material, e.g., ATSDR Case Studies. Several databases were used heavily in the early development of Haz-Map including HSDB, ACGIH Documentation of the TLVs and BEIs, ATSDR ToxProfiles, and NIOSHTIC. The early development of the content also relied on textbooks of occupational medicine: LaDou, Rom, Rosenstock, Sullivan, and Zenz. Mullan was used for the initial list of occupational diseases. Other important sources are Harber, ILO Encyclo, Marks, Kanerva, and Kanerva 2004. Malo was used for the agents causing occupational asthma. Frazier was the main source for reproductive hazards. Industrial processes were based on Burgess. Infectious disease reference books include CCDM, Guerrant, ID, and PPID. Cancers caused by ionizing radiation are based on Boice, and other occupational cancers are based on Siemiatycki.  Other databases that have been used extensively in recent years include NIOSH Guidelines for Chemical Hazards, International Chemical Safety Cards (ICSC), CAMEO from EPA, CHEMINFO from CCOHS, EXTOXNET, and the Emergency Response Guidebook (ERG 2012). 

III. Targeted Audience of Haz-Map

Haz-Map was designed to be a decision-support computer application for occupational safety and health professionals. Its aim is to assist physicians, physician assistants, occupational health nurses, and industrial hygienists in the recognition of diseases caused by toxic chemicals and infectious agents in the workplace. Since its publication on the website of the National Library of Medicine in 2002, Haz-Map has also served consumers seeking information about the health effects of exposure to chemicals and biologicals at work. 

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