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.
The
question that Haz-Map tries to answer is, "How can we keep from getting lost in the
details?" It was designed to help users "zoom in" and "zoom
out" between the big picture and the details. What
information to include or exclude is based on the purpose of the map.
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, and simple asphyxiant). See
"Twenty-five Adverse Effects."
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.
II.
The Classification of Hazardous Chemicals and Occupational Diseases
Occupational Sentinel Health
Events or SHE(O)s were first published by Rutstein et al. in 1983 and
updated by Mullan and Murthy in 1991. This
effort to link 64 occupational diseases to causal agents and industries was a
precursor to the Haz-Map project. Haz-Map Diseases by Category shows the SHE(O)s in red font. This table also illustrates that for
most occupational diseases like lead poisoning and asbestosis, there is no
debate--they are caused by occupational exposures. Controversy does exist
for some chronic diseases like cancer and atherosclerotic heart disease.
"More Research Needed" diseases were added in 2011 after looking
at eight textbooks of occupational medicine and about 200 journal articles
retrieved from PubMed to find any other possible occupational diseases not
yet in Haz-Map. For more details, see More Research Needed Review in 2011.
All information is classified
using hierarchical categories. The 12 Major Agent Categories are subdivided
into 287 Categories.
The Major Agent Categories (# of categories)
follow. See this page for a complete list of the 287
minor categories of chemical and biological agents.
1. Metals
(24)
2.
Solvents
(16)
3. Pesticides
(31)
4. Mineral Dusts
(3)
5. Toxic Gases & Vapors
(14)
6. Plastics & Rubber
(18)
7.
Biological Agents
(28)
8. Nitrogen Compounds
(46)
9.
Other
Classes (74)
10. Other Uses (17)
11. Dyes (12)
12. Physical/Radiation (4)
Disease Categories are:
1.
Acute Poison (26)
2.
Airway Disease (7)
3.
Cancer, Occupational (17)
4.
Chronic Poison (13)
5.
Hypersensitivity Pneumonitis (30)
6.
Infection, Occupational (87)
7.
Infection, Travel (18)
8.
Metal
Poisoning, Occupational (6)
9.
More Research Needed (13)
10.
Pneumoconiosis
(Pulmonary Fibrosis) (12)
11. Reproduction
and Development (4)
12.
Skin Disease (7)
III. 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 https://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). ChemIDplus gives access to HSDB, IUCLID, EPA
HPVIS,
etc.
IV. 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 chemical and biological agents at work.
Revised: October 08, 2018
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