Review of the Department of Labor's Site Exposure Matrix Database (2013) / Chapter Skim
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2 Haz-Map Database
2 Haz-Map Database
Pages 25-50
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From page 25... ...
The original concept for Haz-Map asked the question: "Why can't we have a relational database of toxic chemicals and occupational diseases to store and query information similar to ones used by companies to manage data about employees, products, and customers? " (Brown, 2008b)
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From page 26... ...
Pocket Guide to Chemical Hazards (available at http://www.cdc.gov/niosh/npg) and it has since been updated with additional chemical or biological agents associated with 235 occupational diseases, "using selected references from the scientific literature" (Brown, 2008b)
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From page 27... ...
Information is not always available for each field for every agent, particularly for the fields in the categories of Exposure Assessment and Adverse Effects. In part, this is because for many of the hazardous agents listed in Haz-Map, there is little or no industrial hygiene, toxicologic, or epidemiologic literature on the agent.
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From page 28... ...
NOTE: ACGIH = American Conference of Government Industrial Hygienists; BEI = biological exposure index; CAS = Chemical Abstracts Service; IARC = International Agency for Research on Cancer; IDLH = immediately dangerous to life or health concentrations; MAK = Maximale Arbeitsplatzkonzentrationen (German occupational exposure limit) ; NFPA = National Fire Protection Association; NLM = National Library of Medicine; OSHA = Occupational Safety and Health Administration; PEL = permissible exposure limit; RD50 = exposure concentration producing a 50% respiratory rate decrease; TIH = toxic inhalation hazard; TLV = threshold limit value; WEEL = workplace environmental exposure level.
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From page 29... ...
causes trivial liver injury in animal studies; No known injury in human cases; [Haddad, p.
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From page 30... ...
High ambient temperature required 2: Adverse Effects Neurotoxin CNS Solvent Syndrome Hepatotoxin Hepatotoxin, Secondary Links to Other NLM Databases Health Studies Human Health Effects from Hazardous Substances Data Bank: • EROSENE K Toxicity Information Search TOXNET Chemical Information Search ChemIDplus Biomedical References Search PubMed Related Information in HazMap Diseases Occupational diseases associated with exposure to this agent: • ncephalopathy, chronic solvent E • olvents, acute toxic effect S Processes I ndustrial Processes with risk of exposure: • etal Degreasing M • Painting (Solvents) • Petroleum Production and Refining Activities Activities with risk of exposure: • Intalagio printing NOTE: Only the "Diseases" field, in orange, is used in the Site Exposure Matrix database.
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From page 31... ...
. The DOL claims examiners use the "Specific Health Effects" field in SEM, imported from the Haz-Map "Diseases" field, for an initial assessment of whether a claimant's occupational exposure to a toxic substance at a DOE site is causally associated with the claimant's diagnosed disease.
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From page 32... ...
at higher exposure levels provides evidence that a toxic substance may cause the observed response. Types of health effects observed following exposure to a toxic substance can be broadly categorized as acute effects (i.e., the effects occur within 24 hours following exposure)
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From page 33... ...
Types of Evidence Many types of evidence can be considered when looking at the relationship between exposure to a toxic substance and health effects or disease. This evidence can include large, well-conducted clinical controlled trials such as those used for pharmaceutical agents; epidemiologic studies where groups of humans are evaluated to see if exposures have an impact on health; animal studies to determine the toxicity of an agent; and mechanistic studies, often conducted in vitro or at the subcellular level to determine the biological mechanisms by which an agent produces an outcome.
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From page 34... ...
This is because many exposure–disease associations have a long induction and latency period; that is, a protracted time interval between exposure to a toxic substance and the diagnosis of a resultant health outcome. For some exposure–disease associations, often involving chronic diseases that can occur at older ages (such as some cancers and cardiovascular disease)
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From page 35... ...
Because of these differences, results from animal studies alone are generally not sufficient to establish that exposure to a substance causes a specific health outcome in humans. Rather, animal studies can be used to support observations from human studies, to identify potential links between exposure and specific health outcomes in humans, or to provide hypotheses about what exposure and outcome relationships should be of concern.
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From page 36... ...
Because a causal association generally requires a strong evidence base, additional information from toxicological studies can be used to support or refute the available epidemiologic evidence. Thus, a weight-of-evidence approach that considers the strengths and weaknesses of all relevant studies, including toxicological and mechanistic studies, is most likely to provide a supportable conclusion about the link between a toxic substance and a disease.
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From page 37... ...
SOURCE: Hill, 1965. combination of human, animal, and mechanistic data (EPA, 2012)
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From page 38... ...
The breadth and depth of knowledge gained from using a number of experts gives additional support to conclusions and can help minimize bias and error. The committee discusses the approaches used by IARC, NTP, and the IOM as representative of organizations that have earned respect for high-quality reviews of scientific evidence regarding potential causal associations between substances and health effects.
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From page 39... ...
Evi dence i n A ni mal s Sufficient Limited Inadequate ESLC Sufficient Group 1 Group 2A Group 2B ↑1 if strong Limited ↑2A if belongs to a mechanistic class where other evidence in exposed members are classified in Groups 1 or 2A humans Evidence in Humans Group 2B ↑1 if strong Figure 2-2a Group 3 evidence in exposed Group 3 ↓4 if humans ↑2A if belongs to a mechanistic consistently and ↑2A if strong class where other members are strongly evidence that Inadequate classified in Groups 1 or 2A supported by a mechanism also ↑2B with strong evidence from broad range of operates in humans mechanistic and other relevant mechanistic and ↓3 if strong data other relevant evidence that data mechanism does not operate in humans ESLC Group 4 FIGURE 2-2 IARC approach to evaluating the evidence to determine the carcinogenicity of hazardous agents. NOTE: ESLC = evidence suggests lack of carcinogenicity.
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From page 40... ...
Establishing Hazardous Agent–Occupational Disease Links in Haz-Map The committee's understanding of the Haz-Map database approach to linking hazardous agents and occupational diseases is based on information provided by its developer and found at www.haz-map.com. The committee notes that this
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From page 41... ...
The developer told the committee that he tries to answer the following questions when determining whether exposure to a hazardous agent may cause an occupational disease: "Is there consensus in occupational medicine textbooks that this occupational disease is caused by these hazardous
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From page 42... ...
(Brown, 2012d) The www.haz-map.com website provides more information on some of the hazardous agent–occupational disease links in the database: The only exceptions to the rule that linkage indicates human disease known to be caused by the agent are the following diseases: Solvents, acute toxic effect (linked to all organic solvents)
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From page 43... ...
There are important concerns, however, that preclude its use as a comprehensive resource for assessing the causal relationship between toxic substances and occupational diseases. In this section, the committee comments on some of the problems in the hazardous agent-occupational disease links, that is the "Diseases" field.
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From page 44... ...
However, even before such criteria could be applied to the evidence selected by the developer, there is a lack of transparency about what information is reviewed, its sources, and how it is evaluated for each hazardous agent, with the exception of IARC classifications for carcinogens. For example, there are four noncancer diseases causally associated with formaldehyde -- asthma, occupational; contact dermatitis, allergic; contact urticaria; and fumigants, acute toxic effect.
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From page 45... ...
(Brown, 2012d) The stringent criteria for establishing hazardous agent and cancer links and the uninterpretable criteria for establishing noncancer disease links present substantial obstacles for the effective use of Haz-Map as the sole source of toxic substance–occupational disease links in SEM as discussed in detail in Chapter 3.
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From page 46... ...
. The current Haz-Map process for determining toxic substance–occupational disease links is based on the developer identifying "textbooks, journal articles, the Documentation of the Threshold Limit Values (published by ACGIH)
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From page 47... ...
Hazardous agents may also be added to the database at the instigation of DOL. The SEM contractor is required to "develop a list of toxic substances whose Haz-Map profiles are to be prioritized for updating by the DOL Project Medical Consultant," subject to approval by the DOL (see Chapter 3)
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From page 48... ...
. SUMMARY In this chapter the committee has reviewed the approach by which Haz-Map links exposure to toxic substances to occupational diseases.
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From page 49... ...
U.S. DOL Site Exposure Matrices, EEOICPA Part E
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