How Are Disease-Agent Relationships Determined in Haz-Map?


  1. 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?
  2. Information was classified using a controlled vocabulary (indexes) for agents, adverse effects, industrial processes, non-occupational activities, diseases, signs & symptoms, hazardous job tasks, jobs, and industries. 

  3. 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.

  4. 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.

First Content

  1. 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].

  2. 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.

  3.  Also tagged on the basis of categories were "Organophosphate," 'Organochlorine," and "Carbamate" pesticides.

  4. 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.

  5. The Mullan and Murthy 1991 paper was used for the initial list of occupational diseases. 

Textbooks Used

  1. The early development of the content also relied on textbooks of occupational medicine (LaDou, Rom, Rosenstock, Sullivan & Krieger, APHA, and Zenz). 

  2. Other major sources were textbooks of pulmonary medicine (Harber, Hendrick, and Murray), occupational dermatology (Marks & DeLeo and Kanerva), toxicology (Hayes, Nordberg, Hawley's, Merck Index, and EPA Pesticides), and industrial hygiene (Burgess and Quick CPC).

  3. The list of Malo and Chan-Yeung was used for the agents causing occupational asthma. 

  4. Frazier and Hage [1998] and Luderer [2004] were the main sources for reproductive hazards. 

  5. Ionizing radiation as a cause of cancer is based on Boice [2006].

Disease-Agent Linkage

  1. 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.

  2. 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 studies. 

  3. Occupational cancer & carcinogen linkage, e.g., lung cancer & asbestos, occurs only when the International Agency for Research on Cancer (IARC) has determined that the agent is a known human carcinogen (Group 1). In some cases, IARC does not list the target organs, but Haz-Map follows the interpretation published in the "Occupation" chapter in Schottenfeld and Fraumeni's Cancer Epidemiology and Prevention. [Siemiatycki]

Recent Sources

  1. 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

  2. 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, RTECS (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).

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Revised: May 30, 2018

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