OCCAM – How to proceed

HOW TO PROCEED

ASSESSMENT:

The assessment procedure starts with the drop down menus that first ask you to indicate the site of the neoplasia. Tumours whose site is unknown and/or metastatic tumours cannot be handled.
The tumour must be selected from a list prepared according to the International Classification of Disease (ICD IX – ICD X).
Not all tumours admit an occupational origin, therefore a window will appear after the selection has been confirmed with a preliminary indication.
For sites, which do not admit an occupational cause, the system provides a reply to this effect.
For sites, which may have an occupational cause, however, the system behaves as follows:

for mesotheliomias, hepatic angiosarcomas and tumours in the nasal cavity, it recommends reporting the case directly without further assessment;
for certain sites, it provides information on the scientific literature analysing occupational risks;
for other sites, the system requires the verification of the production sector.

In the latter case, by selecting the “verify” key in the window, a screen appears for selection of the sector where your patient worked.
Select the production sector where the worker was employed, select his / her job from the list at the bottom (e.g. production worker, etc.) and then click the “assess” key; the software will then provide a reply regarding the possibility of an occupational origin for the tumour.

SECTOR:

You must select the production sector where your patient worked from the list of sectors.
If he / she was employed in various sectors at different periods of time, you can make a new assessment at the end of the process by clicking the “Repeat assessment” key.
In addition to the sector, it is essential to specify the job the patient had, as he /she may have done exclusively administrative work conducted in an office within a given industry which could not have caused any exposure to carcinogens present on the shop floor.

BIBLIOGRAPHY:

It is possible to access the information in scientific literature by selecting the “industries” link.
For each sector, a brief reference shows the name of the author, the year of publication and the indicators of risk used in the study each time (RR, OR, SMR, MRR, PRR, PMR, r Coefficient of Pearson Correlation etc).
Click on “reference” to view the complete bibliography. A link is provided in addition to the authors, the title and the reference, enabling access to the abstract of the publication through the PubMed database of the U.S. National Library of Medicine.

PASSIVE SMOKING:

For workers suffering from pulmonary neoplasia who did not work on the shop floor, the software recommends assessment of the possibility of exposure to passive smoking, recently indicated by the IARC in volume n. 83 of 2002 as a certain carcinogen.