Section 1 (Sent to NLM in February and March 2008)

 

New Agent-Disease Links 2/23/08

 

These are Agent-Disease links for the 112 agents sent to NLM on February 3. The names of the agents are followed by the ID numbers of the linked diseases. See tables below for names of diseases.

 

No established human carcinogen (occupational): 141, 142, 144, 146, 147, 192, 200, 549;

Other biological toxins: 415, 431

Irritants:249, 285, 563

Hand-arm vibration: 279

Decompression:284

Mercury, inorganic compounds: 333, 18 (This is a new agent. Also, "Mercury" was changed to "Mercury, elemental."

Alizarin complexone: 18

Alizarin: 18

Azo violet: 18

Hydroxynaphthol blue: 18

Methyl purple: 18

Phenol blue: 18

Fungi: 23, 115, 390

Nickel II chloride hexahydrate: 23

Nickel II sulfate hexahydrate: 306, 23, 18

Hydrazine mononitrate: 306, 310, 18

Xenon: 310, 350

Lithium deuteride: 306

Manganese dioxide: 25

Deuterium: 350

Potassium iodide: 18

Urethane: 326

Diethylene glycol dibutyl ether: 326

Krypton: 350

Potassium ferricyanide: 351

1,1-Difluorethane: 326, 350

Quinuclidinyl benzilate: 310

Lanosol yellow 4G: 23

Ammonium bifluoride: 247

Calcium fluoride: 247

Sodium phosphate, tribasic: 306

FD&C blue no. 2: 23

 

New Agent-Disease Links 3/16/08

 

These are Agent-Disease links for the 120 agents sent to NLM on March 16. The names of the agents are followed by the ID numbers of the linked diseases. See tables below for names of diseases.

 

RARE EARTH METALS: 552; 235

Selenium oxychloride: 306; 18

Selenium dioxide: 306; 18

Dimethylmercury: 310

Aldicarb: 66

Acetophenone: 326

SULFITES: 23

Mercury II acetate: 333; 18; 

Lead II nitrate: 333; 223

Decahydronaphthalene: 326; 325

Ammonium phosphate, monobasic: 306

1,1,1,2-Tetrafluoroethane: 326; 350

Diseases in Haz-Map 2/23/08 Excluding Infectious Diseases

 

ID Disease Name

Acute Poison

656 Acute tubular necrosis
306 Pneumonitis, toxic
350 Asphyxiation, simple
155 Humidifier fever
326 Solvents, acute toxic effect
82 Hepatitis, chemical
363 Inhalation fever
310 Encephalopathy, acute toxic
351 Asphyxiation, chemical
159 Pontiac fever
158 Mill fever
226 Hemolytic anemia, acute
157 Organic dust inhalation fever
156 Grain fever
154 Polymer fume fever
318 Hydrofluoric acid, toxic effect
390 Hypersensitivity pneumonitis, acute
415 Tick paralysis
66 Organophosphate & carbamates, acute
160 Pentachlorophenol/Dinitrophenol, acute
431 Ciguatera fish poisoning
165 Organochlorine insecticides, acute
210 Methemoglobinemia, acute
389 Fumigants, acute toxic effect
69 Metal fume fever
550 Radiation sickness, acute

Airway

249 Asthma, irritant-induced
255 Byssinosis
551 Bronchiolitis obliterans
23 Asthma, occupational
236 Pulmonary disease, chronic obstructive
420 Vocal cord dysfunction, irritant-associated

Occupational Cancer

192 Kidney cancer
190 Bone cancer
189 Laryngeal cancer
200 Colorectal cancer
140 Nasal sinus cancer
2 Lung cancer
32 Skin cancer
549 Thyroid cancer
548 Melanoma
547 Liver cancer
3 Mesothelioma, pleural
136 Bladder cancer
147 Esophagus cancer
167 Leukemia
141 Nasopharynx cancer
142 Pancreatic cancer
144 Brain cancer
146 Stomach cancer
4 Mesothelioma, peritoneal

Chronic Poison

25 Parkinsonism
21 Sinusitis, chronic
282 Acro-osteolysis
655 Chronic renal failure
426 Carbon disulfide, chronic toxic effect
333 Neuropathy, toxic
325 Encephalopathy, chronic solvent
308 Cataract, chemical or radiation induced
9 Aplastic anemia
284 Osteonecrosis
281 Osteomalacia
279 Raynaud, phenomenon of
247 Skeletal fluorosis
307 Infertility, male

Interstitial 

1 Asbestosis
26 Chronic beryllium disease
552 Pneumoconioses, other
423 Asbestos-related pleural disease
235 Pneumoconioses, benign
117 Coal workers, pneumoconiosis of
118 Silicosis, simple
256 Hard metal disease
257 CWP, complicated
259 Silicosis, complicated
260 Silicosis, acute
115 Hypersensitivity pneumonitis, chronic

Metals

6 Cadmium, chronic toxic effect
13 Mercury, elemental, chronic toxic effect
17 Chromium, chronic toxic effect
36 Arsenic, chronic toxic effect
223 Lead, subacute toxic effect
239 Manganese, chronic toxic effect

Skin

18 Contact dermatitis, allergic
175 Oil acne
266 Contact urticaria
267 Contact dermatitis, photoallergic
285 Contact dermatitis, photoirritant
563 Contact dermatitis, irritant
215 Chloracne

Diseases Sorted by ID Number

ID Disease Name
1 Asbestosis
2 Lung cancer
3 Mesothelioma, pleural
4 Mesothelioma, peritoneal
6 Cadmium, chronic toxic effect
9 Aplastic anemia
13 Mercury, elemental, chronic toxic effect
17 Chromium, chronic toxic effect
18 Contact dermatitis, allergic
21 Sinusitis, chronic
23 Asthma, occupational
25 Parkinsonism
26 Chronic beryllium disease
32 Skin cancer
36 Arsenic, chronic toxic effect
66 Organophosphate & carbamates, acute
69 Metal fume fever
82 Hepatitis, chemical
115 Hypersensitivity pneumonitis, chronic
117 Coal workers, pneumoconiosis of
118 Silicosis, simple
136 Bladder cancer
140 Nasal sinus cancer
141 Nasopharynx cancer
142 Pancreatic cancer
144 Brain cancer
146 Stomach cancer
147 Esophagus cancer
154 Polymer fume fever
155 Humidifier fever
156 Grain fever
157 Organic dust inhalation fever
158 Mill fever
159 Pontiac fever
160 Pentachlorophenol/Dinitrophenol, acute
165 Organochlorine insecticides, acute
167 Leukemia
175 Oil acne
189 Laryngeal cancer
190 Bone cancer
192 Kidney cancer
200 Colorectal cancer
210 Methemoglobinemia, acute
215 Chloracne
223 Lead, subacute toxic effect
226 Hemolytic anemia, acute
235 Pneumoconioses, benign
236 Pulmonary disease, chronic obstructive
239 Manganese, chronic toxic effect
247 Skeletal fluorosis
249 Asthma, irritant-induced
255 Byssinosis
256 Hard metal disease
257 CWP, complicated
259 Silicosis, complicated
260 Silicosis, acute
266 Contact urticaria
267 Contact dermatitis, photoallergic
279 Raynaud, phenomenon of
281 Osteomalacia
282 Acro-osteolysis
284 Osteonecrosis
285 Contact dermatitis, photoirritant
306 Pneumonitis, toxic
307 Infertility, male
308 Cataract, chemical or radiation induced
310 Encephalopathy, acute toxic
318 Hydrofluoric acid, toxic effect
325 Encephalopathy, chronic solvent
326 Solvents, acute toxic effect
333 Neuropathy, toxic
350 Asphyxiation, simple
351 Asphyxiation, chemical
363 Inhalation fever
389 Fumigants, acute toxic effect
390 Hypersensitivity pneumonitis, acute
415 Tick paralysis
420 Vocal cord dysfunction, irritant-associated
423 Asbestos-related pleural disease
426 Carbon disulfide, chronic toxic effect
431 Ciguatera fish poisoning
547 Liver cancer
548 Melanoma
549 Thyroid cancer
550 Radiation sickness, acute
551 Bronchiolitis obliterans
552 Pneumoconioses, other
563 Contact dermatitis, irritant
655 Chronic renal failure
656 Acute tubular necrosis

 

 

Mapping Rules for Lead Compounds

 

All lead compound are linked to 223  (Lead Poisoning) and are also linked to a neurological disease, either 310 (Acute Toxic Encephalopathy) for organic lead compounds or 333 (Toxic Neuropathy) for other lead compounds. Organic lead compounds are also linked to 226 (Acute Hemolytic Anemia). All lead compounds are also linked to the Adverse Effects: Secondary Hepatotoxin, Reproductive Toxin, and Nephrotoxin.

 

Lead: 223, 226, 307, 333, 655, 656

Lead chromate: 223, 333

Lead arsenate: 223, 333

Lead IV oxide: 223, 333

Lead II sulfate: 223, 333

Lead II nitrate: 223, 333

Tetraethyl lead: 223, 226, 310 (Deleted 307)

Tetramethyl lead: 223, 226, 310 (Deleted 307)

Lead azide: 223, 333

Lead II thiocyanate: 223, 333

Lead nitroresorcinate: 223, 333

Lead styphate: 223, 333

Lead II acetate trihydrate: 223, 333

 

Changes Made in Review of "Health Hazard Summaries

 for Industrial and Occupational Chemicals" [Olson, Table IV-4]

 

Benzonitrile: 160, delete 351

Bromine pentafluoride: 247

p-Dichlorobenzene: 310

2-Diethylaminoethanol: 18

Dinitro-o-cresol: 160

Dinitrophenol: 160

4,6-Dinitro-o-sec-butyl phenol: 160

Dinocap: 160

2.4-Dinitrophenol:160

Diglycidyl ether: 18, 306

Epichlorohydrin: 306

Ethylene dichloride: delete 306

Ethyl silicate: 326

Furfural: 310

Glycidol: delete 18

Iodine: 306

Oxalic acid: 306

Oxygen difluoride: 247

Mercury, elemental: delete 18

Petroleum gas (liquified): 326

Propylene oxide: 306, 310

Methylamine: 306

Sodium azide: 306

Styrene: delete 18

Tellurium and compounds: 310

 

Additions Made in Review of Kidney Diseases

 

1,4-Dioxane: 656

Arsine: 656

Cadmium and compounds: 656, 655

Carbon tetrachloride: 656

Chromium and compounds: 656

Dinitro-o-cresol: 656

Dinitrophenol: 656

Diquat: 656

Lead: 656, 655

Mercury, elemental: 655

Paraquat dichloride: 656

Pentachlorophenol: 656

Stibine: 656

Uranium and compounds: 656

 

Review of 663 Chemicals Added to Haz-Map Sometime in the 1990s

Completed March 8, 2008

New Links Added to Group I (First 110 Chemicals)

Acrylic acid: 306

Hexachloroethane: 310

Nitric oxide: 306

New Links Added to Group II (Second 110 Chemicals)

Boron trifluoride: 247

Bromine pentafluoride: 247

n-Butane: 350

tert-Butyl chromate: 310

Camphor, synthetic: 310

Caprolactam: 310

Catechol: 310

alpha-Chloroacetophenone: 306

bis-Chloromethyl ether: 306

Chloromethyl methyl ether: 306

Chromyl chloride: 306

Vinyl bromide: 326

Vinyl fluoride: 326

Vinylidene chloride: 326

New Links Added to Group III (Third 110 Chemicals)

2-Nitropropane: 326

1,3-Dichloro-5,5-dimethylhydantoin: 306

Diethyl ketone: 325

o-Dichlorobenzene: 325

Ethyl butyl ketone: 325

Ethylidene norbornene: 326

Formamide: 326

Isobutyl acetate: 325

N-Isopropylaniline: 18

p-Toluidine: 18

Vinyl cyclohexene dioxide: 306

New Links Added to Group IV (Fourth 110 Chemicals)

Dimethylaminopropionitrile: 333

Methyl acetylene-propadiene mixture: 326; 325

Methylcyclohexanol: 325

Morpholine: 306

Nitroethane: 326

Nitrogen trifluoride: 247

1-Nitropropane: 326; 325

Nonane: 325

Oxygen difluoride: 247

Phenylphosphine: 226

Phosphoric acid: 306

Thioglycolic acid: 306

New Links Added to Group V (Fifth 110 Chemicals)

N,N-Dimethyl-1,3-propanediamine: 306

Hexachlorophene: 18; 310

p-Nitrochlorobenzene: 18

4-Nitrophenol: 18

Sodium fluoride: 247

Sulfur tetrafluoride: 247

Triethylene tetramine: 306

New Links Added to Group VI (Last 113 Chemicals)

Benzotriazole: 18

Benzylamine: 306

Bithionol: 18; 267

Boron trifluoride etherate: Delete 326

1-Bromo-2-propanol: 326

Butylated hydroxyanisole: 23

Chloramide: Delete 23

Dichlorophen: 18

Ethyl lactate: 326; 325

Ethyl-3-ethoxypropionate: 326

Fentichlor: 267

Tetramethyl ammonium hydroxide: 306

Triclosan: 18; 267

 

Change of Links to Chronic Solvent Encephalopathy (ID 325)

 

Instead of the previous rule of linking to all agents tagged with the adverse effect "Solvent Syndrome," this disease is now linked with all chemicals that are so tagged AND they are also linked to the Process "Painting (Solvents)." Any other chemicals, such as Styrene, with strong epidemiologic evidence of association with chronic solvent syndrome will also be linked to this disease. The following table shows all chemicals linked to Acute Solvent Syndrome. Chemicals that are also linked to Chronic Solvent Encephalopathy are shown in bold.

 

1,1,1,2-Tetrachloro-2,2-difluoroethane

1,1,1,2-Tetrachloroethane

1,1,1,2-Tetrafluoroethane

1,1,1-Trichloroethane

1,1,2,2-Tetrabromoethane

1,1,2,2-Tetrachloro-1,2-difluoroethane

1,1,2,2-Tetrachloroethane

1,1,2-Trichloro-1,2,2-trifluoroethane

1,1,2-Trichloroethane

1,1-Dichloroethane

1,1-Difluoroethane

1,2,3,4-Tetrahydronaphthalene

1,2,3-Trichloropropane

1,2,4,5-Tetrachlorobenzene

1,2,4-Trichlorobenzene

1,2-Dichloroethylene, all isomers

1,3-Dichloropropene

1,3-Dioxolane

1,4-Dioxane

1-Bromo-2-propanol

1-Bromopropane

1-Hexanol

1-Hexene

1-Nitropropane

2,2-Dimethylbutane

2-Butanone

2-Butoxyethanol

2-Butoxyethyl acetate

2-Ethoxyethanol

2-Ethoxyethyl acetate

2-Isopropoxyethanol

2-Methoxyethanol

2-Nitropropane

4-Vinyl cyclohexene

Acetone

Acetophenone

Acetyl acetone

Acetylene

alpha-Methyl styrene

Benzene

Benzyl acetate

Bromobenzene

Bromoform

Butyrolactone

Carbon tetrabromide

Carbon tetrachloride

CHLORINATED SOLVENTS

Chlorobenzene

Chlorobromomethane

Chlorodifluoromethane

CHLOROFLUOROCARBONS

Chloroform

Chloropentafluoroethane

Chloropropanol

Chlorotrifluoromethane

Collodion

Cumene

Cycloheptane

Cyclohexane

Cyclohexanol

Cyclohexanone

Cyclohexene

Cyclopentadiene

Cyclopentane

Decahydronaphthalene

Decanol

Diacetone alcohol

Diacetyl

Dibromomethane

Dichlorodifluoromethane

Dichloroethyl ether

Dichloromonofluoromethane

Dichlorotetrafluoroethane

Diesel fuel

Diethyl ketone

Diethylene glycol dibutyl ether

Diethylene glycol dimethyl ether

Diethylene glycol monobutyl ether

Diethylene glycol monoethyl ether

Diethylene glycol monohexyl ether

Diethylene glycol monophenyl ether

Difluorodibromomethane

Diisobutyl ketone

Dimethyl acetamide

Dimethyl ether

Dimethyl sulfoxide

Dimethylformamide

Dipropyl ketone

Dipropylene glycol methyl ether

Divinyl benzene

Dodecane

Enflurane

Ethane

Ethyl acetate

Ethyl alcohol

Ethyl amyl ketone

Ethyl benzene

Ethyl bromide

Ethyl butyl ketone

Ethyl chloride

Ethyl ether

Ethyl formate

Ethyl lactate

Ethyl nitrite

Ethyl silicate

Ethyl tert-butyl ether

Ethyl-3-ethoxypropionate

Ethylene

Ethylene chlorohydrin

Ethylene dibromide

Ethylene dichloride

Ethylene glycol monophenyl ether

Ethylidene norbornene

Fluorotrichloromethane

Fluroxene

Formamide

Furan

Furfuryl alcohol

Gasoline

GLYCOL ETHERS

Hexadecane

Hexylene glycol

Isoamyl acetate

Isoamyl alcohol

Isobutane

Isobutyl acetate

Isobutyl alcohol

Isooctyl alcohol

Isopentane

Isophorone

Isoprene

Isopropyl acetate

Isopropyl alcohol

Isopropyl ether

Jet fuel

Kerosene

Mesityl oxide

Methoxyflurane

Methyl (n-amyl) ketone

Methyl acetate

Methyl acetylene

Methyl acetylene-propadiene mixture

Methyl cellosolve acetate

Methyl chloride

Methyl formate

Methyl isoamyl ketone

Methyl isobutyl carbinol

Methyl isobutyl ketone

Methyl n-butyrate

Methyl propyl ketone

Methyl tert-butyl ether

Methyl vinyl ketone

Methylal

Methylcyclohexane

Methylcyclohexanol

Methylene chloride

n-Amyl acetate

Naphtha (coal tar)

n-Butane

n-Butyl acetate

n-Butyl alcohol

n-Butyl lactate

Neopentane

n-Heptane

Nitroethane

N-Methyl-2-pyrrolidone

Nonadecane

Nonane

n-Pentane

n-Propyl acetate

n-Propyl alcohol

n-Propylbenzene

o-Chlorostyrene

o-Chlorotoluene

Octadecane

Octane

o-Dichlorobenzene

o-Methylcyclohexanone

ORGANIC SOLVENTS

Pentachlorobenzene

Pentachloroethane

Pentadecane

Petroleum distillates

Petroleum gas (liquefied)

Petroleum mid-distillate

Propadiene

Propane

Propargyl alcohol

Propyl ether

Propylene dichloride

Propylene glycol monomethyl ether

p-tert-Butyltoluene

sec-Amyl acetate

sec-Butyl acetate

sec-Butyl alcohol

sec-Hexyl acetate

Stoddard solvent

Styrene

tert-Amyl methyl ether

tert-Butyl acetate

tert-Butyl alcohol

Tetrachloroethylene

Tetradecane

Tetrahydrofuran

Toluene

Trichloroethylene

Tridecane

Trifluorobromomethane

Trifluorochloroethylene

Trifluoromethane

Trimethyl benzene isomers

Turpentine

Undecane

Urethane

Vinyl acetate

Vinyl bromide

Vinyl fluoride

Vinyl methyl ether

Vinyl toluene

Vinylidene chloride

Vinylidene fluoride

VM & P Naphtha

Xylene isomers

 

Chlorofluorocarbons Now Classified as Simple Asphyxiants

 

"In general, anesthetic or CNS-depressant doses require fairly large air concentrations, which can also displace oxygen, leading to asphyxia." [Freons and Halons, Olson, p. 208] "Inhalation of concentrated gas will cause suffocation." [CAMEO profile on 1,1-Difluoroethane] "On loss of containment this liquid evaporates very quickly displacing the air and causing a serious risk of suffocation when in confined areas." [ICSC profile on Dichlorodifluoromethane] The following CFCs are gases at room temperature and are now linked to "Asphyxiation, simple" (ID 350) in addition to "Solvents, acute toxic effect" (ID 326):

 
Chloropentafluoroethane 76-15-3
Dichlorodifluoromethane 75-71-8
Dichloromonofluoromethane 75-43-4
Dichlorotetrafluoroethane 76-14-2
Difluorodibromomethane 75-61-6
Trifluorobromomethane 75-63-8
1,1,1,2-Tetrafluoroethane 811-97-2
Chlorodifluoromethane 75-45-6
CHLOROFLUOROCARBONS
Trifluoromethane 75-46-7
Chlorotrifluoromethane 75-72-9
1,1-Difluoroethane 75-37-6

Delinking Two Occupational Diseases from Adverse Effects

 

The disease "Asphyxiation, chemical" is no longer linked to the Adverse Effect with the same name. This means that a chemical can be tagged as a chemical asphyxiant on the basis of ingestion poisoning, but if will not be automatically linked to the occupational disease. At this time the only chemicals linked to the occupational disease after inhalation exposure are:

Carbon monoxide

Cyanogen bromide

Cyanogen

Hydrogen sulfide

CYANIDES

Sodium cyanide

Hydrogen cyanide

Cyanogen iodide

Acetone cyanohydrin

Potassium cyanide

Cyanogen chloride

The other chemicals that were previously linked to the occupational disease are still tagged with chemical asphyxiation as a potential adverse effect. The adverse effects of chemicals refers to both occupational and non-occupational exposures. Delinked from "Asphyxiation, chemical" the disease are the following:

 

1-Butanethiol

1-Decanethiol

1-Dodecanethiol

1-Heptanethiol

1-Hexadecanethiol

1-Hexanethiol

1-Nonanethiol

1-Octadecanethiol

1-Octanethiol

1-Pentanethiol

1-Propanethiol

1-Undecanethiol

2-Methyl-2-heptanethiol

Acetonitrile

Acrylonitrile

Adiponitrile

Ammonium thiocyanate

AZIDES

Calcium hydrosulfite

Carbonyl sulfide

Copper II azide

Cyclohexanethiol

Decanenitrile

Ethanethiol

Glycolonitrile

Isobutyronitrile

Lead azide

Lead II thiocyanate

Malononitrile

Mercury azide

Mercury II azide

Methyl mercaptan

Methylacrylonitrile

n-Butyronitrile

NITRILES

Potassium ferricyanide

Propionitrile

Silver azide

Sodium azide

Sodium hydrogen sulfide

Sodium hydrosulfite

Sodium sulfide

Succinonitrile

tert-Octyl mercaptan

Tetramethyl succinonitrile

THIOLS

Zinc hydrosulfite

 

Similarly, the disease Parkinsonism is now linked to only Carbon monoxide and Manganese. Other chemicals, e.g., MPTP, are tagged with the adverse effect but are not linked to the occupational disease. Delinked from Parkinsonism are MPTP and all other manganese compounds.

 

Section 2 (Sent to NLM July 21, 2008)

 

Change of Links to Chronic Solvent Encephalopathy (ID 325)

 

The agent-disease links were further refined after doing more research on the Sources/Uses of each chemical. The following chemicals are linked to the disease because they have been used as paint solvents or otherwise linked to chronic solvent encephalopathy (e.g., styrene).

 

1,1,1,2-Tetrachloroethane

1,1,1-Trichloroethane

1,1,2,2-Tetrachloroethane

1,1,2-Trichloroethane

1,2,3,4-Tetrahydronaphthalene

1,2,3-Trichloropropane

1,2-Dichloroethylene, all isomers

1,3-Dioxolane

1,4-Dioxane

1-Bromopropane

1-Hexanol

1-Nitropropane

2-Butanone

2-Butoxyethanol

2-Butoxyethyl acetate

2-Ethoxyethanol

2-Ethoxyethyl acetate

2-Ethylhexanoic acid

2-Isopropoxyethanol

2-Methoxyethanol

2-Nitropropane

Acetone

Acetyl acetone

Benzonitrile

Benzyl acetate

Carbon tetrachloride

Chlorobenzene

Cumene

Cyclohexane

Cyclohexanol

Cyclohexanone

Cyclopentane

Decahydronaphthalene

Diacetone alcohol

Diethyl ketone

Diethylene glycol dibutyl ether

Diethylene glycol monobuty l ether

Diethylene glycol monoethyl ether

Diethylene glycol monohexyl ether

Diisobutyl ketone

Dimethylformamide

Dipropyl ketone

Dipropylene glycol methyl ether

Ethyl acetate

Ethyl alcohol

Ethyl benzene

Ethyl butyl ketone

Ethyl lactate

Ethylene glycol

GLYCOL ETHERS

Isoamyl acetate

Isoamyl alcohol

Isobutyl acetate

Isobutyl alcohol

Isophorone

Isopropyl acetate

Isopropyl alcohol

Isopropyl ether

Kerosene

Mesityl oxide

Methyl (n-amyl) ketone

Methyl acetate

Methyl alcohol

Methyl isoamyl ketone

Methyl isobutyl carbinol

Methyl isobutyl ketone

Methyl n-butyrate

Methyl propyl ketone

Methylal

Methylcyclohexanol

Methylene chloride

n-Amyl acetate

Naphtha (coal tar)

n-Butyl acetate

n-Butyl alcohol

n-Butyl lactate

N-Methyl-2-pyrrolidone

Nonane

n-Propyl acetate

n-Propyl alcohol

o-Chlorotoluene

o-Dichlorobenzene

o-Methylcyclohexanone

ORGANIC SOLVENTS

Petroleum distillates

Propylene glycol

Propylene glycol monomethyl ether

Pyridine

sec-Amyl acetate

sec-Butyl acetate

sec-Butyl alcohol

sec-Hexyl acetate

Stoddard solvent

Styrene

tert-Butyl acetate

tert-Butyl alcohol

Tetrahydrofuran

Toluene

Trichloroethylene

Turpentine

VM & P Naphtha

Xylene isomers

 

 

The following chemicals were delinked from the disease Chronic Solvent Encephalopathy:

1,1,1,2-Tetrachloro-2,2-difluoroethane

1,1,1,2-Tetrafluoroethane

1,1,2,2-Tetrabromoethane

1,1,2,2-Tetrachloro-1,2-difluoroethane

1,1,2-Trichloro-1,2,2-trifluoroethane

1,1-Dichloroethane

1,1-Difluoroethane

1,2,4,5-Tetrachlorobenzene

1,2,4-Trichlorobenzene

1,3-Dichloropropene

1-Bromo-2-propanol

1-Hexene

2,2-Dimethylbutane

4-Vinyl cyclohexene

Acetophenone

Acetylene

alpha-Methyl styrene

Bromobenzene

Bromoform

Butyrolactone

Carbon tetrabromide

Chlorobromomethane

Chlorodifluoromethane

CHLOROFLUOROCARBONS

Chloroform

Chloropentafluoroethane

Chloropropanol

Chlorotrifluoromethane

Collodion

Cycloheptane

Cyclohexene

Cyclopentadiene

Decanol

Diacetyl

Dibromomethane

Dichlorodifluoromethane

Dichloroethyl ether

Dichloromonofluoromethane

Dichlorotetrafluoroethane

Diesel fuel

Diethylene glycol dimethyl ether

Diethylene glycol monophenyl ether

Difluorodibromomethane

Dimethyl acetamide

Dimethyl ether

Dimethyl sulfoxide

Divinyl benzene

Dodecane

Enflurane

Ethane

Ethyl amyl ketone

Ethyl bromide

Ethyl butyl ketone

Ethyl chloride

Ethyl ether

Ethyl formate

Ethyl nitrite

Ethyl silicate

Ethyl tert-butyl ether

Ethyl-3-ethoxypropionate

Ethylene

Ethylene chlorohydrin

Ethylene dibromide

Ethylene dichloride

Ethylene glycol monophenyl ether

Ethylidene norbornene

Fluorotrichloromethane

Fluroxene

Formamide

Furan

Furfuryl alcohol

Gasoline

Hexadecane

Hexylene glycol

Isobutane

Isobutyl acetate

Isobutyl alcohol

Isooctyl alcohol

Isopentane

Isoprene

Jet fuel

Methoxyflurane

Methyl acetylene

Methyl acetylene-propadiene mixture

Methyl cellosolve acetate

Methyl chloride

Methyl formate

Methyl tert-butyl ether

Methyl vinyl ketone

Methylcyclohexane

n-Butane

Neopentane

n-Heptane

Nitroethane

Nonadecane

n-Pentane

n-Propylbenzene

o-Chlorostyrene

Octadecane

Octane

Pentachlorobenzene

Pentachloroethane

Pentadecane

Petroleum gas (liquefied)

Petroleum mid-distillate

Propadiene

Propane

Propargyl alcohol

Propyl ether

Propylene dichloride

p-tert-Butyltoluene

tert-Amyl methyl ether

Tetrachloroethylene

Tetradecane

Tridecane

Trifluorobromomethane

Trifluorochloroethylene

Trifluoromethane

Trimethyl benzene isomers

Undecane

Urethane

Vinyl acetate

Vinyl bromide

Vinyl fluoride

Vinyl methyl ether

Vinyl toluene

Vinylidene chloride

Vinylidene fluoride

 

Changes in the Links to Acute Toxic Encephalopathy (ID 310)

 

Acute toxic encephalopathy was delinked from the adverse effect "Other CNS Neurotoxin." In the following list, all of these chemicals will continue to be linked to that adverse effect, but only the ones in bold will be linked to the occupational disease Acute Toxic Encephalopathy. The underlined chemicals are linked to the disease "Fumigants, acute toxic effect."

1,1-Dimethylhydrazine

1,2-Dimethylhydrazine

1,3-Butadiene

2-Aminopyridine

4-Aminopyridine

Allethrin

Aluminum phosphide

Benzotrichloride

Benzyl chloride

beta-Chloroprene

Biphenyl

Bismuth

Boric acid

Calcium phosphide

Camphor, synthetic

Caprolactam

Catechol

Cyclonite

Cypermethrin

Decaborane

DEET

Dimethyl disulfide

Dimethyl sulfide

Dimethylmercury

Fenvalerate

Fipronil

 

Furfural

Hexachloroethane

Hexachlorophene

Hydrazine

Hydrazine mononitrate

Imiprothrin

Iron pentacarbonyl

Manganese cyclopentadienyl tricarbonyl

Mercury, alkyl compounds

Mercury, aryl compounds

Methanesulfonic acid

Methyl alcohol

Methyl bromide

Methyl iodide

Methyl isothiocyanate

Methylcyclopentadienyl manganese tricarbonyl

Methylhydrazine

Nickel carbonyl

Nicotine

Nitrogen mustard (HN-1)

Nitrogen mustard (HN-2)

Nitrogen mustard (HN-3)

Nitromethane

p-Dichlorobenzene

Pentaborane

Phenol

 

Phenothrin

Phenylmercuric acetate

PHOSPHIDES

Phosphine

Propylene oxide

Pyrethrum

Pyridine

Pyrrolidine

Quinuclidinyl benzilate

Radiation, ionizing

Rotenone

Sodium borohydride

Sodium fluoroacetate

Strychnine

Sulfuryl fluoride

Tellurium and compounds

tert-Butyl chromate

Tetraethyl lead

Tetramethrin

Tetramethyl lead

Tin, organic compounds

Triallylamine

Triisobutylaluminum

Xenon

Zinc phosphide

 

The name of Alizarin yellow (584-42-9) was changed to Alizarine yellow G. This chemical will be published with the next batch of 184 chemicals, ie, not yet sent to NLM.

The name of Acid alizarin violet N (2092-55-9) was changed to Alizarine violet N. This chemical was sent to NLM in the last batch and is due to be published in June.

Difluorodibromomethane (75-61-6) was linked to the disease Pneurmonitis, toxic.

Mapping Rules for Pb, Mn, Hg, and Cr Compounds

The rule for lead compounds has been changed. Except for "Lead" itself, Inorganic lead compounds are no longer linked to Toxic neuropathy (333). The following list, copied from above, shows the linked diseases that have been removed (red font:

Lead: 223, 226, 307, 333, 655, 656

Lead chromate: 223, 333

Lead arsenate: 223, 333

Lead IV oxide: 223, 333

Lead II sulfate: 223, 333

Lead II nitrate: 223, 333

Tetraethyl lead: 223, 310, 226

Tetramethyl lead: 223, 310, 226

Lead azide: 223, 333

Lead II thiocyanate: 223, 333

Lead nitroresorcinate: 223, 333

Lead styphate: 223, 333

Lead II acetate trihydrate: 223, 333

 

All lead compound are linked to 223  (Lead Poisoning). All lead compounds are also linked to the Adverse Effects:  Motor Neuropathy, Reproductive Toxin, Nephrotoxin, and Hemolytic Anemia..

All inorganic manganese compounds are linked to the Adverse Effect Parkinsonism and to the Disease Manganese, chronic toxic effect (239).

All inorganic mercury compounds are linked to the Adverse Effects Nephrotoxin.and Sensorimotor Neuropathy.

All inorganic chromium compounds are linked to the Disease Chromium, chronic toxic effect (17).

 

Delinking Adverse Effects from Disease Toxic Neuropathy

The following list of chemicals are linked to one of the Adverse Effects, either motor neuropathy or sensorimotor neuropathy:

Motor Neuropathy Sensorimotor Neuropathy

Chlorpyrifos

Dichlorvos

EPN

1. n-Hexane

2-Hexanone

2. Lead

Lead azide

Lead chromate

Lead II acetate trihydrate

Lead II nitrate

Lead II sulfate

Lead II thiocyanate

Lead IV oxide

Lead nitroresorcinate

Lead styphnate

Leptophos

Mercury II fulminate

Methamidophos

Mipafox

Omethoate

3. ORGANOPHOSPHATES

Parathion

Trichlorfon

Trichloronate

Triorthocresyl phosphate

4. Acrylamide

Allyl chloride

5. Arsenic and compounds

Arsenic trichloride

Calcium arsenate

6. Carbon disulfide

Dichloroacetylene

Dimethylaminopropionitrile

7. Ethylene oxide

Gallium arsenide

Lead arsenate

Mercuric chloride

Mercuric nitrate

Mercurous nitrate

8. Mercury, elemental

Mercury II acetate

9. Mercury, inorganic compounds

Nitrous oxide

Phenyl arsine oxide

10. Thallium and soluble compounds

Thallous nitrate

 

 The agents that are not numbered have been delinked from the occupational disease Neuropathy, toxic. The numbered chemicals continue to be linked to that disease.

Delinking Adverse Effects from Disease Lung Cancer

The following list of chemicals are linked to the Adverse Effect Lung cancer:

Arsenic and compounds

Arsenic trichloride

Asbestos

Beryllium and compounds

Bis(2-chloroethyl)sulfide

bis-Chloromethyl ether

Cadmium and compounds

Calcium arsenate

Calcium chromate

Chloromethyl methyl ether

Chromic acid and chromates

Chromium and compounds

Chromium trioxide

Chromyl chloride

Coke oven emissions

Lead arsenate

Lead chromate

Nickel and compounds

Nickel carbonyl

Phenyl arsine oxide

Plutonium

Potassium dichromate

Radiation, ionizing

Radon

Silica, crystalline

Soots

Strontium chromate

tert-Butyl chromate

Zinc chromates

The agents that are not underlined have been delinked from the occupational disease Lung cancer. The underlined chemicals continue to be linked to that disease.

Delinking Adverse Effects from Disease Aplastic Anemia

The following list of chemicals are linked to the Adverse Effect Aplastic Anemia:

Benzene

2-Methoxyethanol

Heptachlor

Lindane

2,4,5-Trinitrotoluene

Glycol ethers

Calcium arsenate

Arsenic and compounds

Diethylene glycol monobutyl ether

beta-Hexachlorocyclohexane

Nitrogen mustard (HN-2)

Nitrogen mustard (HN-3)

Arsenic trichloride

Lead arsenate

Nitrogen mustard (HN-1)

Radiation, ionizing

Phenyl arsine oxide

The agents that are not underlined have been delinked from the occupational disease Aplastic Anemia. The underlined chemicals continue to be linked to that disease.

Delinking Adverse Effects from Disease Hemolytic Anemia

The following list of chemicals are linked to the Adverse Effect Hemolytic Anemia.

Lead

Stibine

Arsine

Phenylhydrazine

Tetraethyl lead

Tetramethyl lead

Dieldrin

Germanium tetrahydride

Phenylphosphine

Trimellitic anhydride

CHLORATES

Lewisite

Potassium chlorate

The agents that are not underlined have been delinked from the occupational disease Hemolytic Anemia. The underlined chemicals continue to be linked to that disease.

Insufficient Data

In current batch of 183 chemicals, the following were moved to the "Insufficient Data" table: Nickel hypophosphite, Dirhodium octacarbonyl, Malachite green hydrochloride, and Coomassie blue. 

Name Changes

Of the remaining 179 chemicals, the following name changes were made: Food red No. 3 to Erythrosine sodium and D & C red no. 17 to Sudan III. Name changes were also made to four previously published chemicals. In all cases the "no." was removed from the name: FD&C blue 1, FD&C blue 2, FD&C red 40, and FD&C yellow 6. Propylene imine was changed to Propyleneimine.

Male Reproductive Toxins

Linked to Disease 307 (Infertility, Male) were the following chemicals:

 

1. Carbon disulfide

5. GLYCOL ETHERS

Lead II thiocyanate

2. Manganese

6. 1,2-Dibromo-3-chloropropane

Lead azide

3. Lead

7. Chlordecone

Manganese tetroxide

4. 2-Bromopropane

Manganese dioxide

beta-Chloroprene

The first seven chemicals continue to be linked to this disease. The remaining five chemicals are no longer linked to this disease.

New Agent-Disease Links 7/21/08

 

Molybdate orange

17, 223

Chromium hexacarbonyl

17

Dimanganese decacarbonyl

239

1,2,3,4-Tetramethylbenzene

326

2-Decanone

326

Chromium carbide

17

Chromium II chloride

17

Chromium II fluoride

17, 247

Chromium III perchlorate

17

Chromium II sulfate

17

Chromium III acetylacetonate

17

Chromium III bromide

17

Chromium III chloride hexahydrate

17

Chromium III chloride

17

Chromium III fluoride hydrate

17, 247

Chromium III nitrate nonahydrate

17

Chromium III oxide

17

Chromium III phosphate

17

Chromium III sulfate

17

Chromium III sulfide

17

Chromium potassium sulfate dodecahydrate

17

Chromium potassium sulfate

17

Chromium silicide

17

Chromium trihydroxide

17

Chromyl fluoride

17, 247

Lead bis(2-ethylhexanoate)

223

Lead fluoride

223

Lead fluoroborate

223

Lead II acetate

223

Lead II bromide

223

Lead II carbonate

223

Lead II chloride

223

Lead II citrate

223

Lead II hydroxide

223

Lead II iodide

223

Lead II oxalate

223

Lead II oxide

223

Lead II perchlorate

223

Lead II phosphate

223

Lead II selenate

223

Lead II selenide

223

Lead II stearate

223

Lead II sulfide

223

Lead II sulfite

223

Lead II telluride

223

Lead III oxide

223

Lead IV acetate

223

Lead metasilicate

223

Lead molybdate

223

Lead niobium oxide

223

Lead octoate

223

Lead orthosilicate

223

Lead subacetate

223

Lead tantalate

223

Lead tetraoxide

223

Lead titanate

223

Lead tungstate

223

Lead vanadate

223

Lead zirconate titanate

223

Lead zirconate

223

Manganese II acetate

239

Manganese II carbonate

239

Manganese II chloride

239

Manganese II fluoride

239

Manganese II molybdate

239

Manganese II oxide

239

Manganese II sulfate

239

Manganese II sulfide

239

Manganese III fluoride

239

Manganese III oxide

239

Manganese, bis(eta5-cyclopentadienyl)

239

Nickel bis(2-ethylhexanoate)

18

Nickel biscyclopentadiene

18

Nickel boride

18

Nickel II acetate

18, 23

Nickel II carbonate

18, 23

Nickel II chloride

18, 23

Nickel II hydroxide

18, 23

Nickel II oxide

18, 23

Nickel II perchlorate hexahydrate

18

Nickel II phthalocyanine

18

Nickel II stearate

18

Nickel II sulfamate

18

Nickel II sulfate heptahydrate

18

Nickel II sulfide

18, 23

Nickel III oxide

18, 23

Nickel IV oxide

18, 23

Nickel naphthenate

18

Nickel potassium cyanide

18

Nickel telluride

18

Trinickel disulfide

18, 23, 306

2-Bromopropane

326

ORGANOMETALS

306

 

Section 3 (Sent to NLM October 18, 2008)

 

Recent evidence shows that 1-Bromopropane and 2-Bromopropane cause toxic neuropathy in high-dose animal studies, and 1-Bromopropane causes occupational neuropathy. [Matsuoka M. Neurotoxicity of organic solvents--recent findings. Brain Nerve 2007 Jun;59(6):591-6] Both chemicals are being used as replacements for chlorofluorocarbons. 2-Bromopropane was found to be a reproductive toxin, so it was replaced with 1-Bromopropane. 1-Bromopropane is less toxic to the reproductive system but more toxic to peripheral nerves. [Ichihara G et al. Neurological Abnormalities in Workers of a 1-Bromopropane Factory. Environ Health Perspect. 2004 Sep;112(13):1319-25] 1-Bromopropane is now linked to Toxic neuropathy (333). Both chemicals are linked to acute solvent syndrome (326), and 1-Bromopropane is also linked to Chronic encephalopathy (325). 1-Bromopropane has an ACGIH TLV. 2-Bromopropane was sent to NLM in the last batch with the "z" chemicals. 2-Bromopropane is also linked to 307 (Infertility, Male). Like n-Hexane, 1-Bromopropane is a solvent that causes occupational neuropathy. n-Hexane is now linked to the same diseases as 1-Bromopropane: 333, 326, and 325. 

 

Linked to Occupational asthma: Sodium persulfate and Potassium persulfate;

The disease "Hypersensitivity pneumonitis, chronic" was renamed "Hypersensitivity pneumonitis."

The disease "Sinusitis" was renamed "Rhinitis, occupational."

 

Mapping Rules for Inorganic Fluoride Compounds

The following inorganic fluoride compounds are linked to the occupational disease, Skeletal fluorosis: 

Fluorides, inorganic;

Sodium aluminum fluoride; and

Calcium fluoride.

All solid inorganic fluoride compounds will be given the generic occupational exposure levels (OELs) for "Fluorides, inorganic": 

TLV: 2.5 mg/m3, as F;

PEL: 2.5 mg/m3, as F;

MAK: 1 mg/m3, as F (inhalable fraction);

IDLH 250 mg/m3, as F;

BEI: Fluorides in urine = 3 mg/g creatinine prior to shift or 10 mg/g creatinine at end of shift;

Exceptions are radioactive compounds and those with a TLV, PEL, or MAK value assigned for toxicity other than fluorosis.

The following chemicals are no longer linked to the occupational disease, Skeletal fluorosis:

Antimony pentafluoride

Boron trifluoride

Bromine pentafluoride

Carbonyl fluoride

Nitrogen trifluoride

Oxygen difluoride

Perchloryl fluoride

Sulfur tetrafluoride

Fluorosilicic acid

Nickel II fluoride

Silicon tetrafluoride

Ammonium bifluoride

Chromium II fluoride

Chromium III fluoride hydrate

Chromyl fluoride

Lead fluoride

Manganese II fluoride

Manganese III fluoride

Sodium fluoride

 

Addendum to Chemical Asphyxiants

The following agents which are currently linked to chemical asphyxiation as an Adverse Effect will also be linked to chemical asphyxiation as an Occupational Disease:

1-Butanethiol

Tetramethyl succinonitrile

Acetonitrile

Acrylonitrile

NITRILES

THIOLS

 

Section 4 (Published by NLM January 15, 2009)

 

Tetrakis (hydroxymethyl) phosphonium salts was deleted and replaced with Tetrakis (hydroxymethyl) phosphonium chloride and Tetrakis (hydroxymethyl) phosphonium sulfate.

 

"Pneumonitis, toxic" was linked to the agent "Indium and compounds."

 

Section 5 (Published by NLM 06/29/09)

Delinking Adverse Effects from the Disease Toxic Pneumonitis

There are now 417 chemicals tagged with the adverse effect Pneumonitis. This includes chemicals that have not yet been published on the NLM website. In the past, all chemicals with the adverse effect were automatically linked to the disease "Pneumonitis, toxic." With this revision, only 116 chemicals are linked to the occupational disease. The main criteria for selecting those chemicals to link to the disease was whether or not the chemical is designated as a toxic inhalation hazard (TIH) in ERG 2008. The following was added to the comments field for the disease "Pneumonitis, toxic."

In this database, agents linked to toxic pneumonitis are divided into two categories: primary and secondary. The primary chemicals are listed as toxic inhalation hazards (TIH) in the 2008 Emergency Response Guidebook. These chemicals are linked to the occupational disease "Pneumonitis, toxic." The secondary chemicals are not linked to the occupational disease, but they are tagged with "Pneumonitis" as an adverse effect. Because of their importance in work-related exposures, chlorine dioxide, cadmium fume, ozone, and elemental mercury vapor are also linked to the occupational disease even though they are not designated TIH.

Section 6 (Published by NLM September 14, 2009)

Deleted Agent-Disease links for the following:

Ethylphenyldichlorosilane (ID #1482) is no longer linked to Pneumonitis, toxic;

Ethyl benzoate (ID # 8255) is no longer linked to Encephalopathy, chronic toxic;

Methyl carbamate (ID# 6075) is no longer linked to Solvents, acute toxic effect;

 

1,1,1-Trifluoro-2,2-dichloroethane (ID# 7876) was linked to Hepatitis, toxic.

Propylene glycol (ID# 685) was linked to Solvents, acute toxic effect;

Benzyl alcohol (ID# 1267) was linked to Solvents, acute toxic effect;

p-Aminobenzoic acid (ID# 3473) was linked to Contact dermatitis, allergic and Contact dermatitis, photoallergic;

2,4-Dichlorophenol (ID# 3006) was linked to Pentachlorophenol/Dinitrophenol, acute;

 

Deleted the Agent: "DYES."

Added "Octene" to the M Chemicals.

 

Deleted from Haz-Map and Added to Insufficient Data Table:

Zirconium tritide (ID 8499)

Zirconium titanate (ID 8498)

Zirconium tetraborohydride (ID 8497)

Zirconium octaethylporphine (ID 8489)

Zirconium III chloride (ID8476)

Zirconium cyanonitride (ID 8468)

Cadmium tungstoborate (ID 8441)

 

Moved from Insufficient Data Table to the New M Group in Haz-Map

Curium oxide (ID 1713)

Dicesium hexachloroplutonate (ID 1714)

Plutonium nitrate (ID 1720)

Thorium oxalate (ID 1737)

Tritium oxide (ID 1740)

Uranium trifluoride (ID 1751)

Neptunium oxide (ID 1803)

Plutonium difluoride (ID 1804)

Polonium tetranitrate (ID 1812)

Thorium carbide (ID 1817)

Coumarin 445 (ID 2174)

 

Added to 1-Nitronaphthalene (ID 2909) a link to "Methemoglobinemia, acute";

Changed name of 1,1"-Oxybisoctane (ID 8507) to Dioctyl ether;

Added to 2-Hexanone (ID 145) a link to "Neuropathy, toxic";

Deleted links to the disease "Raynaud, phenomenon of" for the following:

Calcium arsenate (ID 757), Arsenic trichloride (ID 1565), and Lead arsenate (ID 1656);

Changed "Raynaud, phenomenon of" to "Raynaud's phenomenon";

Changed "Coal workers, pneumoconiosis of" to "Coal workers' pneumoconiosis";

 

21 May 09 Review of Chromium Compounds: Diseases Added or Deleted

Added to Chromium dioxide (2029): Chromium, chronic toxic effect (17); asthma (23); and allergic contact dermatitis (18);

Deleted Chromium, chronic toxic effect (17) for the following: 

Chromium hexacarbonyl (2453)

Chromium carbide (2493)

Chromium II chloride (2495)

Chromium II fluoride (2496)

Chromium III perchlorate (2497)

Chromium II sulfate (2498)

Chromium III actylacetonate (2499)

Chromium III bromide (2500)

Chromium III chloride hexahydrate (2501)

Chromium III chloride (2502)

Chromium III fluoride tetrahydrate (2503)

Chromium III nitrate nonahydrate (2504)

Chromium III oxide (2505)

Chromium III phosphate (2506)

Chromium III sulfate (2507)

Chromium III sulfide (2508)

Chromium potassium sulfate dodecahydrate (2509)

Chromium potassium sulfate (2510)

Chromium silicide (2511)

Chromium trihydroxide (2512)

 

Deleted "Contact dermatitis, allergic" as a link to "Arsenic and compounds."

Added "Manganism" as a synonym of "Parkinsonism."

 

Beryllium and compounds linked to the disease "Contact dermatitis, allergic";

"Arsenic and compounds" changed to "Arsenic and inorganic compounds";

Dibutyl phenylphosphate (ID 2623) changed to Dibutyl phenyl phosphate;

Deleted CAS # 26249-20-7 for 1,2-Epoxybutane (ID 6481);

Deleted CAS # 961-11-5 of Tetrachlorvinphos (ID 7341)

Deleted CAS # 12655-93-5 for Nobium hydride (ID 3295)

Deleted CAS # 12648-43-0 for Palladium sulfide (ID 8304)

Changed CAS # to 123333-98-2 for Chromium III fluoride tetrahydrate (ID 2503);

 

Section 7 (Published by NLM September 14, 2009)

Deleted Agent-Disease link for Phenyl arsine oxide and Raynaud's phenomenon;

Deleted Agent-Disease link for Diepoxybutane and Pneumonitis, toxic;

Sodium arsenate linked to the disease "Contact dermatitis, allergic";

"Mercury, aryl compounds" linked to "Neuropathy, toxic"; 

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Revised: June 27, 2019

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