AOEC - Asthmagens
AOEC Exposure Codes - Asthmagen List
The AOEC is a non-profit organization dedicated to “[facilitating] the prevention and treatment of occupational and environmental illnesses and injuries through collaborative reporting and investigation of health problems.”
The AOEC Exposure Code List was developed to help identify emerging occupational and environmental health concerns, including but not limited to asthma.
The AOEC Exposure Code List includes a wide range of exposures including not only chemicals but exposures to metals, dusts, plants, animals etc. as well as physical hazards e.g. falls, lifting, repetitive strains, etc.
The AOEC Exposure Code List includes asthmagens reported by occupational asthma experts and subsequently reviewed under AOEC criteria. Criteria for designation as an asthmagen include specificity and relevant exposure pathways. Additionally, to determine the type of asthmagen, the AOEC looks for these main clinical indicators in case studies published in scientific journals: specific inhalation challenges with immediate or delayed fall in expiratory flow and/or volume – sometimes called the “gold standard” for diagnosis – evidence of changing airway reactivity in response to exposure and control periods, airway hyperresponsiveness to non-specific stimuli, exposure related asthma symptoms, and presence of specific IgE antibodies (indicates allergic/sensitizer-induced asthma).
Formal criteria for the asthmagen designation have been established for sensitizer-induced asthma, and for irritant-induced asthma (Reactive Airways Dysfunction Syndrome (RADS). These criteria were developed in collaboration with experts in occupational and pulmonary medicine. Although not all of the substances reported to be asthmagens have yet been formally evaluated against the AOEC criteria, the AOEC has established an ongoing process to determine which exposures meet the criteria. Each year, several exposures are selected for review based on recommendations from AOEC members, asthma experts, industry representatives, or other stakeholders. These annual reports are available from the AOEC office by request.
Exposures designated with an “A” for asthmagen are further classified by which criteria they meet:
- Rs = Reviewed and meeting criteria for sensitizer-induced asthma
- Rr = Reviewed and meeting criteria for irritant-induced asthma (Reactive Airways Dysfunction Syndrome - RADS)
- Rrs = Reviewed and meeting both criteria for RADS and sensitizer-induced asthma
- R- =reviewed and not meeting either set of criteria.
- G = Substances that are generally accepted as asthmagens.
Pharos Exclusions: The Pharos listing for AOEC currently includes only those AOEC-listed substances that a) have a CAS number and b) have been given an "A" and/or "R"code by the AOEC. Substances without one of these codes in the AOEC database are references for other occupational exposure issues unrelated to asthma and not addressed in the CML at this time.
Some metals are reclassified as inhalable only - occupational exposures only.