H ARMONIZATION OF C ATEGORIZATION S YSTEMS FOR A GENTS - F IRST D ATA FROM G ERMAN P OISONS C ENTRES XXVII I NTERNATIONAL C ONGRESS OF THE EAPCCT A THENS 2 M AY 2007 A. S TRER 1, G. H LLER 2, HJ. R EINECKE 3, C. S EIDEL 4, U. S TEDTLER 5, R. W AGNER 6, M. G ANZERT 7, D. W URM 8, A. H AHN 9, H. D ESEL 6, PC S : 1) Z URICH 2) E RFURT 3) M AINZ 4) B ONN 5) F REIBURG 6) G TTINGEN 7) M UNICH 8) H OMBURG 9) B F R B ERLIN O BJECTIVE Categorization Systems for Agents => Central part in PC EAPCCT A THENS 2 M AY H ARMONIZATION OF CSA F IRST D ATA FROM PC S - A. S TRER O BJECTIVE O BJECTIVE M ETHODS M ETHODS R ESULTS R ESULTS C ONCLUSION C ONCLUSION F UTURE F UTURE L IMITATIONS L IMITATIONS Cate- gorization System for Agents (CSA) R OLE OF THE CSA Identification of Agents (consulting) Recording of Agents (case collection) Index (Names) of Agents EAPCCT P RAGUE 20. A PRIL C ATEGORIZATION S YSTEM FOR S UBSTANCES IN PCs - A. S TRER O BJECTIVE O BJECTIVE M ETHODS M ETHODS R ESULTS R ESULTS C ONCLUSION C ONCLUSION F UTURE F UTURE L IMITATIONS L IMITATIONS processing of new product information O BJECTIVE: U SE OF CSA categorization system names of agents recording of cases providing of substance / product info. retrieval of cases for scientific evaluations 1 st registration of agents annual reports EAPCCT P RAGUE 20. A PRIL C ATEGORIZATION S YSTEM FOR S UBSTANCES IN PCs - A. S TRER G ROUP IT OR L OSE IT A. S TRER O BJECTIVE O BJECTIVE M ETHODS M ETHODS R ESULTS R ESULTS C ONCLUSION C ONCLUSION F UTURE F UTURE L IMITATIONS L IMITATIONS O BJECTIVE O BJECTIVE M ETHODS M ETHODS R ESULTS R ESULTS C ONCLUSION C ONCLUSION F UTURE F UTURE L IMITATIONS L IMITATIONS O BJECTIVE: CSA A NNUAL R EP. EAPCCT A THENS 2 M AY H ARMONIZATION OF CSA F IRST D ATA FROM PC S - A. S TRER O BJECTIVE Categorization Systems for Agents => central part in PC TDI Project (1999 2006) => Electronic product data exchange => Harmonization of CSA in Germany TDI Project (2006) => Collection of harmonized data of Human Exposure 2005 in German PC EAPCCT A THENS 2 M AY H ARMONIZATION OF CSA F IRST D ATA FROM PC S - A. S TRER O BJECTIVE O BJECTIVE M ETHODS M ETHODS R ESULTS R ESULTS C ONCLUSION C ONCLUSION F UTURE F UTURE L IMITATIONS L IMITATIONS A IMS Steps of the harmonization process Situation before using the TDI-CSA Current state of TDI-CSA integration Make TDI-CSA more familiar Presentation of the first common data collection grouped by TDI-CSA Future steps of CSA harmonization EAPCCT A THENS 2 M AY H ARMONIZATION OF CSA F IRST D ATA FROM PC S - A. S TRER O BJECTIVE O BJECTIVE M ETHODS M ETHODS R ESULTS R ESULTS C ONCLUSION C ONCLUSION F UTURE F UTURE L IMITATIONS L IMITATIONS M ETHODS 1.Evaluation of the preceding situation in German PC => Ques. EAPCCT A THENS 2 M AY H ARMONIZATION OF CSA F IRST D ATA FROM PC S - A. S TRER O BJECTIVE O BJECTIVE M ETHODS M ETHODS R ESULTS R ESULTS C ONCLUSION C ONCLUSION F UTURE F UTURE L IMITATIONS L IMITATIONS M ETHODS 1.Evaluation of the preceding situation in German PC => Ques. 2.Developement of a harmon. CSA (1999 2006) => TDI-CSA EAPCCT A THENS 2 M AY H ARMONIZATION OF CSA F IRST D ATA FROM PC S - A. S TRER O BJECTIVE O BJECTIVE M ETHODS M ETHODS R ESULTS R ESULTS C ONCLUSION C ONCLUSION F UTURE F UTURE L IMITATIONS L IMITATIONS S TRUCTURE OF TDI-CSA L-1 L-2 L-3 L-4 L-5 L-6 L-7 L-8 L-9 Plants Cosmetics (COLIPA+ EAPCCT) Drugs (ATC-code) Pesticides SECTOR LEVEL EAPCCT P RAGUE 20. A PRIL C ATEGORIZATION S YSTEM FOR S UBSTANCES IN PCs - A. S TRER O BJECTIVE O BJECTIVE M ETHODS M ETHODS R ESULTS R ESULTS C ONCLUSION C ONCLUSION F UTURE F UTURE L IMITATIONS L IMITATIONS S TRUCTURE OF TDI-CSA technical link (non-ambiguous) retrieval (daily work) hierachcal structure (tree) EAPCCT P RAGUE 20. A PRIL C ATEGORIZATION S YSTEM FOR S UBSTANCES IN PCs - A. S TRER O BJECTIVE O BJECTIVE M ETHODS M ETHODS R ESULTS R ESULTS C ONCLUSION C ONCLUSION F UTURE F UTURE L IMITATIONS L IMITATIONS S TRUCTURE OF TDI-CSA TREE = products = remedies = human drugs = cardiovascular system hum. Drugs Metoprolol ATC-Code 2007 (n = 5410) (Vet-ATC; n=5900 ) WHO Collaborating Centre for Drug Statistics Methodology, Oslo EAPCCT P RAGUE 20. A PRIL C ATEGORIZATION S YSTEM FOR S UBSTANCES IN PCs - A. S TRER O BJECTIVE O BJECTIVE M ETHODS M ETHODS R ESULTS R ESULTS C ONCLUSION C ONCLUSION F UTURE F UTURE L IMITATIONS L IMITATIONS S TRUCTURE OF TDI-CSA TREE = natural environment = plants >>> taxonomical classification >>> Plants Golden Chain Tree Taxonomical classification according to: Zander, ed.: Dictionary of plant names, Kater pupl. 2000, 16th edition (n = 2700) EAPCCT P RAGUE 20. A PRIL C ATEGORIZATION S YSTEM FOR S UBSTANCES IN PCs - A. S TRER O BJECTIVE O BJECTIVE M ETHODS M ETHODS R ESULTS R ESULTS C ONCLUSION C ONCLUSION F UTURE F UTURE L IMITATIONS L IMITATIONS S TRUCTURE OF TDI-CSA TREE = products =products of daily demand = cosmetics = cosmetics for nails Cosmetics Nail Polish = nail polish and -remover = nail polish = nail polish remover Cosmetic Frame Formulations EAPCCT & COLIPA, 2000 completed by some own categories (n = 180) EAPCCT P RAGUE 20. A PRIL C ATEGORIZATION S YSTEM FOR S UBSTANCES IN PCs - A. S TRER O BJECTIVE O BJECTIVE M ETHODS M ETHODS R ESULTS R ESULTS C ONCLUSION C ONCLUSION F UTURE F UTURE L IMITATIONS L IMITATIONS M ETHODS 1.Evaluation of the preceding situation in German PC => Ques. 2.Developement of a harmon. CSA (1999 2006) => TDI-CSA 3.Test period in 2 PC (Erfurt+Mainz) (2001 2005), completion EAPCCT A THENS 2 M AY H ARMONIZATION OF CSA F IRST D ATA FROM PC S - A. S TRER O BJECTIVE O BJECTIVE M ETHODS M ETHODS R ESULTS R ESULTS C ONCLUSION C ONCLUSION F UTURE F UTURE L IMITATIONS L IMITATIONS M ETHODS 1.Evaluation of the preceding situation in German PC => Ques. 2.Developement of a harmon. CSA (1999 2006) => TDI-CSA 3.Test period in 2 PC (Erfurt+Mainz) (2001 2005), completion 4.Distribution 1 st version TDI-CSA (Sept. 2006) to German PC (n = 15029) EAPCCT A THENS 2 M AY H ARMONIZATION OF CSA F IRST D ATA FROM PC S - A. S TRER O BJECTIVE O BJECTIVE M ETHODS M ETHODS R ESULTS R ESULTS C ONCLUSION C ONCLUSION F UTURE F UTURE L IMITATIONS L IMITATIONS M ETHODS 5.Data Collection (2006) Inclusion criteria: Exposure of humans in 2005 Grouping criteria: First 3 levels of TDI-CSA Age groups (Children FORM EAPCCT A THENS 2 M AY H ARMONIZATION OF CSA F IRST D ATA FROM PC S - A. S TRER O BJECTIVE O BJECTIVE M ETHODS M ETHODS R ESULTS R ESULTS C ONCLUSION C ONCLUSION F UTURE F UTURE L IMITATIONS L IMITATIONS M ETHODS 40 Sectors x 3 Age Groups x 6 Severity Grading = 720 fields per PC x 7 PC = 5040 primary data EAPCCT A THENS 2 M AY H ARMONIZATION OF CSA F IRST D ATA FROM PC S - A. S TRER O BJECTIVE O BJECTIVE M ETHODS M ETHODS R ESULTS R ESULTS C ONCLUSION C ONCLUSION F UTURE F UTURE L IMITATIONS L IMITATIONS M ETHODS 6.Data collection and pooling in independent PC (9-11/2006) 7.Returning complete data set to participating PC (11/2006) 8.Common evaluation and quality control (since 11/2006) 9.Questionnaire: Depth of use (Jan. 2007) EAPCCT A THENS 2 M AY H ARMONIZATION OF CSA F IRST D ATA FROM PC S - A. S TRER O BJECTIVE O BJECTIVE M ETHODS M ETHODS R ESULTS R ESULTS C ONCLUSION C ONCLUSION F UTURE F UTURE L IMITATIONS L IMITATIONS Q UESTIONNAIRE- 1 : BEFORE TDI-CSA 7/10 participating PC 4 different CSA, regional extensions Existing CSA used since 6 27 y 6/7 maintain CSA, mostly infrequent 7/7 categorization of new agents 4/7 immediately with case recording, mostly 2 nd pass before annual report Maintenance of CSA: 1-5 person (1.5) Categorization of Agents: 1-20 p. (1.0) EAPCCT A THENS 2 M AY H ARMONIZATION OF CSA F IRST D ATA FROM PC S - A. S TRER O BJECTIVE O BJECTIVE M ETHODS M ETHODS R ESULTS R ESULTS C ONCLUSION C ONCLUSION F UTURE F UTURE L IMITATIONS L IMITATIONS I MPLEMENTATION OF TDI- CSA 7 of 10 PC integrated TDI-CSA at least up to first 3 levels, 2 month Parallel use of regional CSA and TDI-CSA First 3 levels cover 40 categories (Sectors: hum. drugs, cosmetics, ) 4/7 integrated complete TDI-CSA 2/7 complete categorization of the regional index of agents (cases) EAPCCT A THENS 2 M AY H ARMONIZATION OF CSA F IRST D ATA FROM PC S - A. S TRER O BJECTIVE O BJECTIVE M ETHODS M ETHODS R ESULTS R ESULTS C ONCLUSION C ONCLUSION F UTURE F UTURE L IMITATIONS L IMITATIONS D ATA C OLL.: H UM. E XPO 7/10 PCs 137689 cases 1270-27952 (Median 23220) cases/PC 78% of all Exposures in German PC EAPCCT A THENS 2 M AY H ARMONIZATION OF CSA F IRST D ATA FROM PC S - A. S TRER O BJECTIVE O BJECTIVE M ETHODS M ETHODS R ESULTS R ESULTS C ONCLUSION C ONCLUSION F UTURE F UTURE L IMITATIONS L IMITATIONS H UMAN E XPOSURE 2005 EAPCCT A THENS 2 M AY H ARMONIZATION OF CSA F IRST D ATA FROM PC S - A. S TRER AdultChildrenunknown Cases60'38671'3615'941 %44%52%4% Range % %1 - 13% O BJECTIVE O BJECTIVE M ETHODS M ETHODS R ESULTS R ESULTS C ONCLUSION C ONCLUSION F UTURE F UTURE L IMITATIONS L IMITATIONS H UMAN E XPOSURE 2005 DATA EAPCCT A THENS 2 M AY H ARMONIZATION OF CSA F IRST D ATA FROM PC S - A. S TRER O BJECTIVE O BJECTIVE M ETHODS M ETHODS R ESULTS R ESULTS C ONCLUSION C ONCLUSION F UTURE F UTURE L IMITATIONS L IMITATIONS L EVEL 1 C ATEGORIES EAPCCT A THENS 2 M AY H ARMONIZATION OF CSA F IRST D ATA FROM PC S - A. S TRER O BJECTIVE O BJECTIVE M ETHODS M ETHODS R ESULTS R ESULTS C ONCLUSION C ONCLUSION F UTURE F UTURE L IMITATIONS L IMITATIONS L EVEL 2-3 C ATEGORIES EAPCCT A THENS 2 M AY H ARMONIZATION OF CSA F IRST D ATA FROM PC S - A. S TRER O BJECTIVE O BJECTIVE M ETHODS M ETHODS R ESULTS R ESULTS C ONCLUSION C ONCLUSION F UTURE F UTURE L IMITATIONS L IMITATIONS SECTOR: T OP 10 C ATEGORIES EAPCCT A THENS 2 M AY H ARMONIZATION OF CSA F IRST D ATA FROM PC S - A. S TRER O BJECTIVE O BJECTIVE M ETHODS M ETHODS R ESULTS R ESULTS C ONCLUSION C ONCLUSION F UTURE F UTURE L IMITATIONS L IMITATIONS TOP 10 CATEGORIES (ADULT)% Human Drugs57.9 Cleaning Agents, Detergents and Care Products7.3 Foods and Food-Additives6.0 Products - unclassified3.7 Plants3.3 Chemicals for Technical Tools, Processes and Products2.9 Basic Materials2.9 Drugs of Abuse2.6 Pesticides and Exterminator2.2 Civilisation Remnants, Inherited Waste1.8 TOP 10 CATEGORIES (CHILDREN)% Human Drugs25.3 Plants20.3 Cleaning Agents, Detergents and Care Products14.4 Cosmetics7.2 Chemicals for Technical Tools, Processes and Products4.4 Foods and Food-Additives3.6 Products - unclassified3.0 Illuminant Fuels, Inflammable Matters, Scents, Decorations and similar Agents2.5 Paints, Varnish and Dyers2.4 Objects of daily Demand (except Cleaning and Room Air Conditioning Agents)2.1 GER = USA ? EAPCCT A THENS 2 M AY H ARMONIZATION OF CSA F IRST D ATA FROM PC S - A. S TRER O BJECTIVE O BJECTIVE M ETHODS M ETHODS R ESULTS R ESULTS C ONCLUSION C ONCLUSION F UTURE F UTURE L IMITATIONS L IMITATIONS NMOST FREQUENT CATEGORIES (ADULT >= 18y)) GER [%] ComparabilityComparison USA [%] MOST FREQUENT CAT. (ADULT > 19y) 1Human Drugs57.9==59.8several Groups of drugs 2Cleaning Agents, Detergents and Care Products7.3=4.2Food products/food poisoning 4Products - unclassified3.7-- 5Plants3.3?-? 6Chemicals for Technical Tools, Processes and Products2.9?-? 7Basic Materials2.9(=)=3.3Chemicals 8Drugs of Abuse2.6(=)=2.7Stimulants and street drugs 9Pesticides and Exterminator2.2=