Haz-Map: A Relational Database of Occupational Toxicology
| Jay A. Brown, MD, MPH | |
9 Categories of Occupational Diseases
| Airway Diseases | |
| Pneumoconioses | |
| Hypersensitivity Pneumonitis | |
| Infections |
9 Categories of Occupational Diseases
| Acute Poisons | |
| Chronic Poisons | |
| Metals | |
| Skin Diseases | |
| Cancer |
Occupational Diseases Are Preventable
| By removing the worker from exposure | |
| By making changes in the workplace |
The Knowledge Coupling Problem
| The explosion of medical knowledge | ||
| The limits of human memory | ||
| The need for information | ||
| Situation specific | ||
| At the point of decision | ||
A Flat File Database Is Like an Electronic Filing Cabinet
| Gather information; | |
| Sift through information; | |
| Add file folders; | |
| File information; | |
| Revise file folders; | |
| Continue at step 1; |
An Intelligent Relational Database Is Like a Map
| A map begins with a broad outline. | |
| Details are added. | |
| Part-to-whole relationships are depicted. | |
| Intended use determines selection of content. |
| By health and safety professionals | ||
| Physicians | ||
| Nurses | ||
| Industrial Hygienists | ||
| To assist in diagnosis and prevention | ||
The Broad Outline of Haz-Map Is Eight Related Tables
Haz-Map Uses Standard Coding Classification Systems
Toxic Chemicals Can Damage One or More Organ Systems
| Lung Toxins | |
| Neurotoxins | |
| Skin Toxins | |
| Hematotoxins | |
| Hepatotoxins | |
| Liver/Kidney/Reproductive Toxins | |
| Carcinogens |
The Agents Form: Adverse Effects
The Agents Form: Agent Profile
The Agents Form: Exposure Assessment
Identification of Hazardous Job Tasks Is Crucial for Prevention
| It is not the mere presence of chemicals in the workplace that puts the workers at risk. | |
| Hazardous job tasks open one or more exposure routes, usually skin absorption or inhalation. | |
| What is the specific job task that puts the workers at risk for the disease? |
Examples of the 178 Hazardous Job Tasks
| Manufacture polyurethane products | |
| Remove insulation installed before 1975 | |
| Extract coal | |
| Inhale dust of moldy hay, silage, straw or grain |
Examples of the 178 Hazardous Job Tasks
| Handle medical needles or surgical instruments; | |
| Operate internal combustion engine with inadequate ventilation; | |
| Repair or maintain gasoline or jet fuel tanks; | |
| Remove lead coatings; | |
Finding Information at the Diseases Level: 3 Examples
| What are the hazardous job tasks in the shipyard industry, SIC 3731? | |
| What are the findings and hazardous job tasks associated with exposure to lead? | |
| Carpenters are at increased risk for what diseases? |
Job Tasks in the Shipyards, SIC 3731
Lead Poisoning: Findings & Job Tasks
Results of Query-by-Example for Diseases Linked to “carpenters”
Why Occupational Diseases Are Difficult to Recognize
| Look like non-occupational diseases | |
| Latency between exposure and disease | |
| Inadequate training of medical students | |
| Thousands of jobs, chemicals and diseases |
Chemicals Cause Disease If Three Conditions Are Met:
| The chemical is toxic—it can damage one or more organs; | |
| An exposure route exists for the chemical to enter the body; | |
| A sufficient dose is received; |
The Need for Toxicology Information in the Clinic
| To recognize diseases as occupational and prevent other cases in the workplace; | |
| To give accurate risk communication and prevent disease caused by the fear of chemicals; |
| Collection of data | |
| Analysis and interpretation | |
| Dissemination | |
| Action to control and prevent |
| If recognized, occupational diseases are preventable. | |
| To recognize them, health & safety professionals need quick access to comprehensive information. | |
| A relational database of occupational toxicology can store and display summarized information for clinical and preventive decision support. | |
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