United States
Environmental Protection Agency
Sentinel Environmental Disease
and
Injury Management
Information System
(SEDIMIS)
System Manual
Version 1.5
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United States Environmental Protection Agency
Region IV
December, 1995
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Executive Summary
Dynamic Resources, Incorporated, Atlanta, Georgia, developed the detailed design
of the SEDIMIS project for Region IV of the Environmental Protection Agency.
Computer Sciences Corporation, Atlanta, Georgia, implemented the design using
Clipper 5.0 and created this manual in tandem with Region IV personnel. The detailed
design developed by DRI was used extensively in developing this users' manual.
The Sentinel Environmental Disease and Injury Management Information System
(SEDIMIS) provides the information needed by EPA professional staff, public health
officials, health professionals and other citizens to address the four requirements of the
Emergency Planning and Community Right-to-Know Act:
• Emergency Planning
• Emergency Release Notification
• Hazardous Chemical Reporting
• Toxic Chemical Release Reporting
In response to the law's requirements, states, communities, industries, and
citizens' groups around the country have joined forces to:
• Write emergency plans to protect the public from chemical accidents;
• Set up procedures to warn and, if necessary, evacuate the public in case of
emergency;
• Provide citizens and local governments with information about hazardous
chemicals and accidental releases of chemicals in their communities;
• Prepare public reports on annual releases of toxic chemicals into the air,
water, and soil.
SEDIMIS also provides a comprehensive system for the determination and surveillance
of environmental disease and injury. SEDIMIS utilizes a new concept of
environmental disease surveillance termed: Sentinel Health Event (Environmental)
[SHE(E)]. A SHE(E) is an unnecessary disease, disability , or untimely death which is
environmentally related and whose occurrence may:
• Provide the impetus for epidemiologic or environmental health studies;
• Serve as a warning signal that material substitution, engineering control, public
health intervention, or medical care may be required;
• Impact the general direction of risk management decision-making.
In addition, SEDIMIS integrates all available information on the potential health
effects of Superfund Amendments and Reauthorization Act of 1986 (SARA) Title HI,
Section 313 chemicals and the discharge of these substances into the environment of
the surrounding community.
Executive Summary i
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Figure 1-1: SHE(E)s by Category of Environmental Disease
Category of Environmental Disease
Number of SHE(E) Profiles Identified per Category
Dust Diseases of the Lung
6
Poisonings (Systemic Toxic Reactions)
53
Respiratory Conditions due to Toxic Agents
12
Disorders due to Repeated Trauma
None Specified to Date
Disorders Due to Physical Agents (Noise, Heat/Cold,
Radiation, Vibration, etc.)
2
Skin Diseases or Disorders
3
All Other Diseases:
- Reproductive Disorders
- Environmental Cancers
- All Other Environmental Diseases
1
22
None Specified to Date
Total
99
The overall structure of SEDIMIS consists of the integration and interaction of the
contents of the following seven databases:
• Sentinel Health Events(Environmental) - SHE(E)s
• Symptoms
• Physical Signs
• Laboratory Results
• Radiologic Findings
• Chemicals
• Facilities
SEDIMIS also incorporates population and chemical impact data for further
calculations in assessing environmental health hazards.
Region IV Emergency Response and Community Right-to-Know Act (EPCRA)
staff have developed a technique for evaluating a Toxic Release Inventory (TRI)
chemical based on its human health effects, its environmental effects and the volume
of the TRI chemical release. This new method of qualitative ranking accounts for the
types and numbers of different potential adverse human and ecological health effects
and is known as Toxicity Index Profiling (TIP). This technique assists in establishing
qualitative rankings for chemicals reported in the TRI system based on an integration
of readily available information on emissions, environmental health effects and
population. Using the TIP technique, users can calculate Risk Screening Vector
Products (RSVPs). An RSVP is a relative quantity indicating the potential for
environmental and human damage caused by the release of TRI or other SHE(E)
ii Sentinel Environmental Disease and Injury Management Information System Manual
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causing chemicals. Broadly speaking, the RSVP is the product of the quantity (coded)
of a chemical released times the TIP score of that chemical times the size of the
potentially affected population (coded).
RSVP = Quan-Code * TIP * Pop-Code
Version 1.0 of SEDIMIS contains over 40,000 lines of program code. The system
programmers used Clipper to develop the single user system. Because of the large
program memory and the extensive size of the files needed to operate SEDIMIS, you
should operate this system from a stand-alone microcomputer with high clock speed
and low hard drive access time. The system requires at a minimum an 80386 processor
(25MHz) with 20MB of free space on the hard drive.
Current system features include an on-line, context specific help system; multiple
access levels and an independent user name/password combination. The System
Administrator maintains the list of authorized users, passwords and security (access)
levels. The user name/password combination limits use of the system data to users
authorized by the system administrator. The security level permits general users to
obtain and manipulate the information stored by the system but restricts them from
actually accessing the databases.
Executive Summary iii
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Figure 1-2: Overall SEDIMIS Structure
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Acknowledgment
This SEDIMIS Users Guide was compiled by Melissa K. Hayes, B.S.E. with
Computer Sciences Corporation and John R. Stockwell, M.D., M.P.H. who is a
commissioned medical officer (Captain) in the U.S. Public Health Service and serves
as Human Health Effects Officer for the Federal Facilities Branch within the Waste
Management Division of the U.S. Environmental Protection Agency Regional Office
in Atlanta, Georgia.
Many of the concepts and original work developed for this Users Guide were
completed by William H. Peltier, IV, B.S.I.C.S. with Computer Sciences Corporation
and Jerome W. Sorensen, Geographic Information Systems (GIS) Analyst with the
U.S. Environmental Protection Agency Regional Office.
The authors greatly appreciate the thorough peer review of this document by Jesse W.
Dooley, Chief, Systems Operation and Development Unit, Clifford R. Davis, Chief,
Automated Data Processing Management Section, and John P. Sweeney, Chief,
Information Management Branch, and Ronald L. Barrow, Chief, Office of Integrated
Environmental Analysis. All are with U.S. EPA Region IV in Atlanta.
Acknowledgments Vii
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Table of Contents
Executive Summary i
Acknowledgment vii
Preface xi
I.0 Introduction 1
2.0 Entering SEDIMIS 5
3.0 Requesting Information 7
3.1 Example Search Requests 11
4.0 How to Change Your Password 23
5.0 Updating the User Database 25
6.0 The Symptoms Database 28
6.1 Updating the Symptoms Database 31
7.0 The Physical Signs Database 33
7.1 Updating the Physical Signs Database 37
8.0 The Laboratory Results Database 39
8.1 Updating the Laboratory Results Database 43
9.0 The Radiologic Findings Database 45
9.1 Updating the Radiologic Findings Database 49
10.0 The Qualifier Database 51
II.0 The Sentinel Health Event (Environmental) [SHE(E)] Database 53
11.1 Adding a New SHE(E) to the Database 55
11.2 Deleting or Editing an Existing SHE(E) 58
11.3 Finding SHE(E) Records 60
12.0 The Chemical Database 64
12.1 Adding a New Chemical to the Database 66
12.2 Deleting or Editing an Existing Chemical 68
12.3 Finding Chemical Records 70
Table of Contents ix
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Preface
U.S. EPA Region IV has developed the Sentinel Environmental Disease and Injury
Management Information System (SEDIMIS). The aim of this pfoject is to provide a
computer-assisted system of environmental disease and injury surveillance based on
relative risk ranking of the Toxic Chemical Release Inventory (TRI) chemical releases.
SEDIMIS can be used to provide a broad picture of the actual relative toxicity of the
TRI releases into the environment. This will, in turn, provide a "real world" based risk
assessment targeting strategy and relative risk ranking of facilities within each
geographical area of an EPA region. This initial version of SEDIMIS is installed with
census and TRI data for EPA Region IV alone. However, with appropriate substitution
of another region's census and TRI data files, SEDIMIS could be used for analyses in
other parts of the country.
SEDIMIS extends EPA's commitment to risk communication and risk management by
providing rapid access to relevant environmental medicine information and associated
toxic chemical release information that can be valuable in public health research,
environmental decision making, priority setting, program evaluation, and resource
allocation. Specifically, SEDIMIS can be a centralized database of a region's
population potentially at-risk. It can provide environmental health information based
on TRI release information and can be useful in the preparation of risk management
reports and trend analyses for populations and sensitive subgroups. SEDIMIS can
utilize the TRI data and serve as a link between EPA and other federal, state, and
local agencies with public health concerns and can help strengthen a region's public
health system.
In an effort to continually improve our service to you, we are eager to hear your
comments about SEDIMIS and the users guide. Our main objective is to make
SEDIMIS serve your needs. After you have used SEDIMIS, please let us know what
you think and how we can best modify the system to meet your needs more fully. If
you have ideas for SEDIMIS, including new functions or adding data sets, please call
or write us:
John R. Stockwell, M.D., M.P.H.
Regional Human Health Effects Officer
U.S. Environmental Protection Agency
Mail Code: WMD/FFB
345 Courtland Street, NE
Atlanta, GA 30308-3420
(404) 347-3555 x6444
FAX: (404)347-5205
Email: stockwell.john@epamail.epa.gov
We believe that you will find SEDIMIS and other new environmental health tools will
help accelerate meeting our common environmental and public health objectives in the
coming years.
Preface Xi
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The environmental medicine information in SEDIMIS is not intended to replace
professional medical advice or service. Personal health problems should be brought
to the attention of physicians and/or appropriate health professionals.
Users are also advised that in many cases other sources of information such as the
Environmental Protection Agency's Integrated Risk Information System (IRIS), toxicity
data and exposure data should be consulted before prioritizing or making other
decisions regarding sources of pollution
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1.0 Introduction
The chemical release data used in SEDIMIS has been provided through a new federal
law, the Emergency Planning and Community Right-to-Know Act1 (EPCRA) of the
Superfund Amendments and Reauthorization Act of 1986 (Public Law 99-499). Under
Section 313 of EPCRA, certain businesses must submit annual reports to EPA and the
state in which they operate for specified toxic chemicals manufactured, processed, or
used at the facility. Facilities must account for total aggregate releases to the
environment for each chemical listed under Section 313 for the calendar year. These
aggregate data are referred to as the Toxic Chemical Release Inventory (TRI). There
are over 300 chemicals and 20 chemical categories on the Section 313 list.
The initial version of SEDIMIS uses information specific to the Southeast obtained
from STF1A files, TIGER (Topologically Integrated Geographic Encoding and
Referencing digital map files), and files from the U.S. Bureau of Census.
Additionally, the Toxic Release Inventory System (TRI System) data for the eight
southeastern states of EPA Region IV are installed in this version of SEDIMIS. The
Public Data Branch (Information Management Division, EPA Office of Pollution
Prevention and Toxics) administers and maintains the TRI System. To receive
assistance in obtaining the appropriate census and TRI System data for an EPA region
other than Region IV, contact:
Chief, Regional Risk Guidance Staff
Mail Code TS-778
401 "M" Street, SW
Washington, D.C. 20460
(202) 260-3931
The regional risk manager can use SEDIMIS to provide a computer-assisted system of
environmental disease and injury surveillance based on qualitative rankings for the
chemicals reported in the TRI system based on an integration of readily available
information on emissions, environmental health effects, and population. SEDIMIS will
allow the regional risk manager to view a broad picture of the relative public health
importance of the TRI releases in an EPA region. This, in turn, can provide a "real
world" based risk assessment targeting strategy and relative risk ranking of TRI
facilities within each geographical area of a specific EPA region. SEDIMIS can assist
in taking the first steps in defining the geographic distribution of environmental
releases of the TRI toxic chemicals and helps to lay the foundation for risk screening
efforts in EPA regions by identifying potential exposure zones from TRI releases.
SEDIMIS can allow the regional risk manager to focus on the relative magnitude of
these releases and their potential human and ecological health significance for
'The act is also known as Title III of SARA (the Superfund Amendments and Reauthorization Act).
Introduction 1
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individual counties in an EPA region. SEDIMIS can provide the risk assessor with
information to consider when determining the type and extent of follow-up activities
that may be required at a TRI facility or geographic area within a specific EPA region.
SEDIMIS uses three new concepts which have been developed in Region IV's
Emergency Planning and Community Right-to-Know (EPCRA) program. These key
concepts are:
• Sentinel Health Event (Environmental) [SHE(E)];
• Toxicity Index Profiling (I IP); and
• the calculation of Risk Screening Vector Products (RSVPs).
The first key concept of SEDIMIS is that of SHE(E). A Sentinel Health Event
(Environmental) is defined as an unnecessary disease, disability or untimely death
which can be environmentally related and whose occurrence may:
• Provide the impetus for epidemiologic studies; or
• Serve as a warning signal that environmental control may be required.
The Region IV EPCRA staff have identified ninety-nine SHE(E) clinical profiles
which may be associated with sufficient exposure to certain TRI chemicals. Each of
these clinical profiles has an International Classification of Disease (ICD) code
number. As an elemental surveillance tool this SHE(E) list can serve as a screening
mechanism for disease which is potentially environmentally related and may have
applications in the early detection of potential exposure zones in the Southeast where
geographic initiatives can be focused in order to prevent actual environmental disease.
The Region IV EPCRA staff terms this TRI-SHE(E) application: TOXICOLOGICAL
PATHOGEOGRAPHY (literally, the geographical distribution of diseases caused by
poisons). These TRI-SHE(E) analyses of the TRI data can lead to improved
environmental results by identifying potential exposure zones in the region where risk
managers may choose to provide additional regulatory focus.
The second key concept of SEDIMIS is that of Toxicity Index Profiling (TIP). Region
IV EPCRA staff have developed this technique which will assist in prioritizing limited
risk assessment resources and can promote the establishment of health based
compliance monitoring. Basically, TIP has been used in Region IV to develop relative
weights for TRI releases according to the frequency of adverse human health and
ecological effects which may be associated with those chemicals and the respective
volumes of those releases. The TIP concept is based on an EPA toxicity data matrix
which provides a summary presentation of information publicly available through a
number of accessible databases: HSDB (Hazardous Substance Data Bank), RTECS
(Registry of Toxic Effects of Chemicals), GENETOX (Genetic Toxicology), AQUIRE
(EPA ERL-Duluth's Aquatic Information Retrieval database), ENVIROFATE (on-line
database), LOG P and related Parameters Database (numeric database). Chemical
agents, for which publicly available data suggested sufficient evidence that exposure to
the chemical agent potentially results in one or more human health or ecological
2 Sentinel Environmental Disease and Injury Management Information System Manual
-------
effects, were tabulated in the appropriate fields on the matrix. Information about those
adverse human health and ecological effects have been computerized in SEDIMIS.
The Specific constellation of possible human health and ecological effects of each
chemical within the toxicity data matrix is referred to as its Toxicity Index Profile
(HP). There are seven adverse human health and three ecological effects of concern.
Based on the matrix tabulation of these seven categories of adverse human health and
three categories of ecological effects of concern, each TRI chemical was assigned a
score of 1-10. This score is known as the chemical's Toxicity Index Profile or "TIP"
score. This TIP score represents the number of potential adverse human health and
ecological effect categories into which a chemical agent falls.
Figure 1-3: Abstract of EPCRA Section 313 Toxicity Matrix
Potential
Adverse
Effects
Chemical
Abstract
Service
(CAS)
Human
Health
Ecological
Toxicity
Index
Profile
Registry
Number
Chemical
C
HG
CM
DT
RT
AT
CT N
ET B
p
(TIP)
score
50-00-0
Formaldehyde
X
X
X
X
X X
X
7
51-28-5
2,4-Dinitrophenol
X
X
X
X
X
5
51-75-2
Nitrogen mustard
X
X
X
X
X
5
51-79-6
Urethane
(ethyl carbamate)
X
1
52-68-6
Trichlorfon
X
X
X
X
X
X
6
53-96-3
2-Acetlaminofluorene
X
1
55-18-5
N-nitrosodiethylamine
X
X
X
X
X
5
5S-21-0
Benzamide
X
1
It should be noted that an "X" on Table 1-1 indicates that a chemical has an effect.
However, no information is given regarding the severity of the effect, the
appropriateness of the study method, or the presence of conflicting test results. The
absence of an "X" may indicate either that there is no concern, that effects were not
reported, or that the chemical has not been tested. It is probable that as more test
results become available, more "Xs" will appear on such a matrix. It is important to
emphasize, however, that an "X" for any given endpoint (i.e., any specific human or
ecological effect) may not so much indicate serious adverse effects as the existence of
data. For instance the Registry of Toxic Effects of Chemical Substances (RTECS) is
one of the data inputs to the OPPT toxicity data matrix. RTECS lists all available data
sources from "high" to "low" order of toxicity. This hierarchal type of toxicity
information is not transferable to this matrix. For the sake of illustration, botulinum
toxin has a very specific effect even at low doses. By comparison, water may have a
greater number of effects at much higher doses. Accordingly, water may have many
more adverse effects checked in such a matrix, giving the impression that water is
more hazardous. Although the TIP methodology can be useful as a risk screening
Introduction 3
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technique, this method must be used with due discretion and with full knowledge of its
technical limitations.
The third key concept used in SEDIMIS is the calculation of Risk Screening Vector
Products (RSVPs). Region IV EPCRA staff have used the TIP concept described
above to develop, in turn, an additional technique which can provide risk screening
targets by allowing relative risk ranking of TRI facilities within the Southeast
according to greatest potential concern from a public health or environmental
standpoint. This technique has adapted basic concepts of the EPA Office of
Management Systems and Evaluation for the relative ranking of major environmental
problems. We expect that the risk screening targets provided by the calculation of
RSVPs may help produce the greatest environmental results.
Collateral analyses in Region IV confirm that, overall, a very large number of
chemicals, many with long-term potential effects, have been introduced into the
environments of the eight states of the region and into areas with significant
population density within these states. However, it is not yet possible to determine if
exposure to these toxic chemicals actually exists. The environmental monitoring data
that are needed are not now available. In short, there presently is insufficient
information to describe these geographic patterns of toxic chemical releases and
transfers as "chemical epidemics." Clearly, we need a greater understanding of the
environmental fate of these releases and transfers and their pathophysiologic
mechanisms following environmental exposure. This additional information would
allow us to better evaluate any role that these toxic chemicals may actually play in the
etiology of environmental disease and injury in the nation.
It is very important to realize that the TRI database provides information about
releases and transfers to the environment and not actual human exposures to these
chemicals. Many things can happen to a chemical once it is released into the
environment, and these processes make it difficult and extremely complicated to
calculate the extent to which people are being exposed to chemicals as a result of any
particular release. The TRI data can best serve as an index to potential problems,
rather than as a definitive indicator of public exposure to chemicals.
4 Sentinel Environmental Disease and Injury Management Information System Manual
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2.0 Entering SEDIMIS
SEDIMIS (vU) isa single-user system. Please refer to the Executive Summary for
minimum hardware requirements. Later versions may upgrade the system for Local
Area Network use.
You enter SEDIMIS by typing SEDIMIS at the DOS prompt from within the
SEDIMIS sub-directory. When the command executes, the system displays the log-in
screen and prompts you to enter your User Name.
• Type your User Name in the space provided and press ENTER.
• Type your Password in the space and press ENTER. As an additional security
measure, the system displays an on the screen as you type each character.
The User Name/Password combination which you enter is the one which is registered
with the SEDIMIS User Database. They are not necessarily the same as your Region
IV LAN User ID and Password. A valid SEDIMIS user name may contain up to ten
characters and must begin with an alphabetic character. A valid SEDIMIS password
may contain up to eight characters and must begin with an alphabetic character.If you
are not sure of your SEDIMIS user name or password, please contact your SEDIMIS
system administrator.
If you have not entered a valid User Name and/or Password, the system displays an
error message box.
• Press ENTER to clear the box. SEDIMIS will return to the initial log-in screen
and prompt you for your User Name and Password again.
If, after three tries, you have not entered a valid User Name/Password, SEDIMIS
displays another error message box denying you access.
• Press ENTER to clear the box. SEDIMIS returns you to the DOS prompt.
You can access the Help function during the log-in procedure by pressing the F1 key.
If you wish to exit SEDIMIS from the log-in screen, press the ESC key. Then use the
arrow keys or type Q to highlight Quit and press the ENTER key.
Entering SEDIMIS 5
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Figure 2-1: SEDIMIS User Name Entry Screen
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This information is not intended to replace
professional medical advice or service.
Personal health problems should be brought
to the attention of physicians and/or
appropriate health professionals.
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Sentinel Environmental Disease and Injury Management Information System Manual
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3.0 Requesting Information
The Request option is the main tool for linking all the information managed by
SEDIMIS. The system links so much data in so many ways that the possible requests
you can make are quite numerous. This will require some advance planning to avoid
being mapped out on the screen.
First, you must decide what overall information you are seeking. This is your
output criteria. Then, determine how you wish this information to be qualified. The
qualifying information is your input criteria. The input and output criteria may be
further limited using the search construction screens and Boolean logic.
The red lines across the top and bottom of the screen list basic information about
the Request function. Press F1 for a more detailed HELP screen. DO NOT press the
ESC key to exit a screen unless it is noted on the top or bottom line. The F10 key is
the normal exit key. Unless the cursor is in a list, pressing ESC will end the Request
process, erase any previously entered information and return to the main menu.
Input Search Criteria
• Once you have mapped out your request, use the arrow keys to highlight Request
and press ENTER or type R to select Request from the main menu.
• Use the arrow keys to highlight the Input Search Criteria Category and press
ENTER to select it. SEDIMIS will load the Search Construction Screen and will
display the options available for the Criteria Category.
• Highlight the Category and press ENTER to select it. The system writes your
selection in the Category column and advances the cursor to the Operation
column.
• The system displays a list of
operations available. See Figure 3-2
for the operations and explanations
for each. Highlight the operation and
press ENTER to write it in the
Operations column. The cursor
automatically advances to the Value
column.
You may enter the Value from the
keyboard or press F2 for a list of
Values from the database. If you
type the Value, you may use the
Figure 3-2: Operation Options
=
Equivalent To
<>
Not Equal To
<
Less Than or Precedes in
Alphabet*
>
Greater Than or Follows in
Alphabet*
<=
Less Than or Equal To*
>=
Greater Than or Equal To*
Although you may use these operations with
alphabetic characters, they are most useful with
the numeric TIP and RSVP categories.
Requesting Information 7
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wildcard placeholders to broaden the Figure 3-3: Wildcard Placeholders
search Value. See Figure 3-3 for a
definition of the wildcards. If you
opt to use the lists, highlight the
appropriate Value and press ENTER
to write it to the Value category.
You can jump through the lists of
Values by typing the first letter of the desired Value. Press ENTER to advance the
cursor to the next column.
• This completes the steps needed for a simple, single category search. You may
press F10 to begin the Output Criteria definition. If you are using more than one
Category, at this time you would continue on to define the second Category. The
remaining three columns (Left Parenthesis, Right Parenthesis and Logic) are used
to link the multiple categories together to form the Input Criteria. You enter any
Logic values after defining the Category Value.
• To use the Left and Right Parentheses columns, simply type the appropriate
symbol ["(" or ")"] when the cursor is in each column.
• The Logic field displays a menu
which shows all Logic options
available. See Figure 3-4 for a
definition of the Logic values.
Highlight the appropriate function
and press ENTER to select it.
• When you have completed constructing your Input Criteria, press F10 to advance
to the Output Criteria definition.
* Any number of characters may occupy the
position.
? Any one character may occupy the position.
Figure 3-4: Logic Options
AND
A valid result must contain both
values.
OR
A valid result can contain one or both
values.
AND NOT
A valid result contains the first but not
the second value.
Output Criteria
• Once you have completed constructing the Input Criteria by pressing F10,
SEDIMIS displays a screen which allows you to create your Output Criteria.
SEDIMIS will only display the Categories which are valid Output options for the
Input Criteria you have already selected. This screen is similar to the initial Input
Criteria Screen with one important distinction. You may choose more than one
Output Criteria Category. Highlight the Categories you wish to use and press
ENTER to mark them. Once you have chosen all of them, highlight the last line
on the screen and press ENTER to call the Search Construction Screen.
• You define the Output Criteria using the same techniques as the Input Criteria.
Select the Categories, Operations, Values, Logic and Parentheses in the exact
same way.
8 Sentinel Environmental Disease and Injury Management Information System Manual
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NOTE: It is important that you make use of the "*" Wildcard Placeholder
when creating your output search. This option allows the system to list all
the possible variations. If you narrow your search by specifying the exact
output, SEDIMIS will return either the output that you specified or nothing.
If your search returns no results, it means that the specific output you
entered did not meet your input criteria.
When you have finished defining the Output Criteria, advance the cursor to the
Category column and choose the final option Begin.
Defining the Output Mode
• SEDIMIS offers three different output modes: Screen, Printer or File. Use the
TAB or the arrow keys to select the desired mode and press ENTER to select it
and begin the search. If you choose Screen, the system writes the results of your
request to the screen. If you choose printer, the results are sent to your computer's
default printer. If you choose file, results are written to a file named
SEDIMIS.### on the default drive. The extension (###) will be replaced with the
lowest available number.
Requesting Information 9
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3.1 Example Search Requests
The following three sample searches focus on compounds of the chemical
manganese. They demonstrate the various searches you can perform using SEDIMIS
and show some of the combinations described in Section 3.0.
Search #1
This search looks for all the SHE(E)s (by Name) caused by Manganese.
Input Criteria
Output Criteria
Chemical Name limited to manganese.
All SHE(E)s by name. .
Figure 3-5(a): Search #1 Input Search Criteria Construction Screen
„ F1 - Help
Logic
Category
Chemical Name
Operation
Value
MANGANESE
F10 - SAVE and EXIT "" ESC - Cancel Search and"RETURN"'to Request Menu
From the Main Menu, select Request and press ENTER.
Select the Input Search Criteria Category Chemical Name and press ENTER.
SEDIMIS displays the search construction screen and a menu box displaying
Chemical Name. Press ENTER to select Chemical Name and advance the cursor
to the Operations Field.
Press ENTER to accept the default Operation "=" and move the cursor to the
Value field.
Press F2 to call the Chemicals Database. Press "M" to jump through the listing
then scroll through the database using the UP/DOWN arrow keys until the bar
Example Search Requests 11
-------
highlights Manganese. Press ENTER to select it. You could also use the PAGE
UP/DOWN keys to move through the listings but using the first letter method is
quicker.
• Press ENTER again to move the cursor to the next field.
• Press F10 to advance to the Output Criteria Selection Screen.
Highlight SHE(E) Name(s) including on the Output Criteria Selection Screen and
press ENTER.
• Highlight SHE(E) Name(s) including again on the next screen and press ENTER
to select it.
Figure 3-5(b): Search #1 Output Search Criteria Construction Screen
r
F1 - HStt»
Logic
(
Category
Operat ion
Value
SHE(E) Name
•
I ESC ¦¦¦
Cancel Search ¦& Retucrv to- Main
fcfervu
Version
• Highlight Exit Menu and press ENTER. SEDIMIS draws the Output Search Criteria
Construction Screen.
• Press ENTER to accept SHE(E) Name as the default Category Name and move the
cursor to the Operations field.
• Press ENTER to accept the default Operation "=" and move the cursor to the
Category Value field.
• Enter an asterisk ("*") in the Value field and press ENTER. This tells the system to
look for all SHE(E) Names which fit the input criteria.
• Press ENTER until the cursor returns to the Category field. Highlight Begin and press
ENTER to continue.
12 Sentinel Environmental Disease and Injury Management Information System Manual
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SEDIMIS displays the Output Mode Selection Screen. Accept the default Screen
option and press ENTER to begin the search.
• SEDIMIS will display the search results on the screen. Figure 3-7 shows a partial
display of the search results. You may scroll through the results using the arrow keys
and the PAGE UP/DOWN keys.
~ When you have reviewed the search results, press ESC to exit. At this time, you have
the option to print or dispose of the file.
Figure 3-5(c): Search #1 Partial Printout
SHE(E) (s) WITH SHE(E) Name = * BY Chemical Name = MANGANESE
MANGANESE POISONING
SYMPTOMS:
Lassitude
Drowsiness: CNS
Dizziness: CNS
Headache
Cough
Weakness: Muscles
Cramps: Extremities
Pain: Legs
Nausea
Perspiration Increased
Swallowing Difficult
PHYSICAL SIGNS
Expressionless Face: CNS
Blinking Absent: Eyes
Disturbance: Gait
Tremor/Trembling: Extremities
Stuttering: CNS
Hoarseness
Monotonous Voice: CNS
Laughing: CNS (impulsive)
Weeping: CNS (impulsive)
Mental Deterioration
LABORATORY RESULTS:
Manganese Present: Urine (later, possibly)
Coproporphyrins Increased: Urine (possibly)
RADIOLOGIC FINDINGS:
SHE(E) Type:
Acute
Chronic
SHE(E) Degree
Severe
Mild
SHE(E) Route
Ingestion
Inhalation
ICD-9 Code: 332.1
PARKINSONIAN SYNDROME ...
Example Search Requests 13
-------
Search #2
This search looks for all the SHE(E)s (by Name) with a Route of Transmission by
ingestion/absorption or inhalation which are characterized by a Laboratory Result of
increased coproporphyrins in the urine; a Symptom of lassitude and a Physical Sign of
a central nervous disordencausing laughing.
Input Criteria Laboratory Results limited to increased coproporphyrins in
the urine; AND Symptoms limited to lassitude; AND
Physical Signs limited to laughing: CNS.
Output Criteria SHE(E)s (by name) limited to the route of transmission not
by contact.
Figure 3-6(a): Search #2 Input Search Criteria Construction Screen
:
Log ic
(
Category
Operat ion
Value
)
AND
AND
Lab Results
Symptom
Physical Sign
Coproporphyrins Increased:
Lassitude
Laughing: CNS
Urine
F10 -
E-x.it
ESC «¦ Cancel Search £
ftaturn to fctain
Veraiofl "I"»0
• From the Main Menu, select Request and press ENTER.
Select the Input Search Criteria Category Medical Signs and press ENTER. SEDIMIS
displays the search construction screen and a menu box displaying the four medical
sign fields: Symptoms, Physical Signs, Laboratory Results & Radiologic Findings.
Use the UP/DOWN arrows to highlight Laboratory Results and press ENTER to
select it and advance the cursor to the Operations Field.
• Press ENTER to accept the default Operation "=" and move the cursor to the Value
field.
• Press F2 to call the Laboratory Results database. Press "U" to jump through the
listing and scroll through the database using the UP/DOWN arrow keys until the bar
highlights Urinalysis. Press ENTER to select it.
• SEDIMIS displays another database which lists the possible findings from the
urinalysis test. Press "C" to jump through the listing and scroll through the listing
14 Sentinel Environmental Disease and Injury Management Information System Manual
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using the UP/DOWN arrow keys until the bar highlights coproporphyria increased.
Press ENTER to select it.
Press ENTER again to move the cursor through the fields to the Category field. The
system will display the Medical Signs Menu.
Highlight Symptoms and press ENTER to select it and advance the cursor to the
Operations Field.
Press ENTER to accept the default Operation "=" and move the cursor to the Value
field.
Press F2 to call the Symptoms database. Choose the alphabetical listing and press
ENTER. Press "L" to jump through the listing and scroll through the database using
the UP/DOWN arrow keys until the bar highlights Lassitude. Press ENTER to select
it.
Press ENTER to advance the cursor to the Logic field. Highlight AND and press
ENTER to select it. The cursor advances automatically to the Category field.
Highlight Physical Signs and press ENTER to select it and advance the cursor to the
Operations Field.
Press ENTER to accept the default Operation "=" and move the cursor to the Value
field.
Press F2 to call the Physical Signs database. Choose the CMIT Category listing and
press ENTER. Press "N" to jump through the database and scroll through the listing
using the UP/DOWN arrow keys until the bar highlights Nervous System. Press
ENTER to select it.
SEDIMIS displays a menu of physical signs affecting the nervous system. Press "L"
to jump through the database and scroll through the listing using the UP/DOWN
arrow keys until the bar highlights Laughing. Press ENTER to select it.
Press ENTER until the cursor advances to the Logic field. Highlight AND and press
ENTER to select it. The cursor advances automatically to the Category field.
Press ESCAPE to clear the Medical Signs Category Listings.
Press F10 to advance to the Output Criteria Selection Screen.
Example Search Requests 15
-------
Figure 3-6(b): Search #2 Output Search Criteria Construction Screen
• -
Logic
(
Category
Operat ion
Value
)
SHE(E) Name
=
*
AND
SHE(E) Route
<>
Contact
P1D - tet
• SSC - Csftw-i Search & ftaeurn to «a m Hwu
Varst-on I .<3
• Highlight SHE(E) Name on the Output Criteria Selection Screen and press ENTER.
Highlight SHE(E) Route and press ENTER.
• Highlight Exit Menu and press ENTER. SEDIMIS draws the Output Search Criteria
Construction Screen.
• Highlight SHE(E) Name and press ENTER. Press ENTER again to move the cursor
to the Operations field.
• Press ENTER to accept the default Operation "=" and move the cursor to the
Category Value field.
Enter an asterisk ("*") in the Value field and press ENTER. This tells the system to
look for all SHE(E) Names which fit the input criteria.
• Press ENTER until the cursor returns to the Category field. Highlight SHE(E) Route
and press ENTER. Press ENTER again to move the cursor to the Operations field.
• Press F2 to display the list of Operations. Highlight "<>" (Not Equal To) and press
ENTER to select it and move the cursor to the Value field.
• The system displays a menu of values. Highlight Contact and press ENTER to select
it.
Press ENTER until the cursor calls the Logic functions. Highlight AND and press
ENTER. This will automatically advance the cursor to the Category field.
• Highlight Begin and press ENTER to continue.
• SEDIMIS displays the Output Mode Selection Screen. Press the TAB key to choose
Printer and press ENTER to select. Press ENTER again to verify the selection and
begin the search.
16 Sentinel Environmental Disease and Injury Management Information System Manual
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• SED1MIS will print the search results to your default printer. Figure 3-6(c) shows a
portion of the search results.
Figure 3-6(c): Search #2 Printout
SHE (E) (s) WITH SHE (E) Name = * AND SHE (E) Route <>
Contact BY Lab.
Result = Coproporphyrins Increased: Urine AND Symptom
= Lassitude AND
Physical Sign = Laughing: CNS
MANGANESE POISONING
SYMPTOMS:
Lassitude
Drowsiness: CNS
Dizziness: CNS
Headache
Cough
Weakness: Muscles
Cramps: Extremities
Pain: Legs
Nausea
Perspiration Increased
Swallowing Difficult
PHYSICAL SIGNS
Expressionless Face: CNS
Blinking Absent: Eyes
Disturbance: Gait
Tremor/Trembling: Extremities
Stuttering: CNS
Hoarseness
Monotonous Voice: CNS
Laughing: CNS (impulsive)
Weeping: CNS (impulsive)
Mental Deterioration
LABORATORY RESULTS:
Manganese Present: Urine (later, possibly)
Coproporphyrins Increased: Urine (possibly)
RADIOLOGIC FINDINGS:
SHE(E) Type:
Acute
Chronic
SHE(E) Degree
Severe
Mild
SHE(E) Route
Ingestion
Inhalation
ICD-9 Code: 332.1
Example Search Requests 17
-------
Search #3
This search looks for all the Chemical(s) (by Name) which are released by a specific
facility. Because of the structure of the Chemicals Database, this search will also describe
any SHE(E) associated with the chemical(s) found.
Input Criteria Facility Name limited to U. S. Brick, Cline Plant (located
in Boyd County, Kentucky;
Output Criteria All Chemicals (by name)
Figure 3-7(a): Search #3 Input Search Criteria Construction Screen
¦ ••••• ••
Logic
(
Category
Operat ion
Value
)
Faci1ity
U.S. BRICK CLINE
FtQ ~ Exit . ESC - Cancel Searcb £ Return Co ttatn Menu • -- Versi-cm i.,0
• From the Main Menu, select Request and press ENTER.
• Select the Input Search Criteria Category Facility Names and press ENTER.
SEDIMIS displays the search construction screen and a menu box displaying the
selected field: Facility Names. Press ENTER to select it and advance the cursor to
the Operations Field.
• Press ENTER to accept the default Operation "=" and move the cursor to the Value
field and display a list of the states in Region IV.
• Scroll through the database using the UP/DOWN arrow keys or press "K" to jump
through the listing until the bar highlights KENTUCKY. Press ENTER to select it.
• SEDIMIS displays another list of all the counties in Kentucky. You must scroll
through the listing using the UP/DOWN arrow keys or PAGE UP/DOWN until the
bar highlights BOYD. Press ENTER to select it.
• SEDIMIS will load all the Facilities located in Boyd County, Kentucky which are
included in the Toxic Release Information System (TRIS) database. This procedure
may take up to five minutes. When the information has been loaded, the system
displays the list of all Facility Names for the specified county. Scroll through the
18 Sentinel Environmental Disease and Injury Management Information System Manual
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listing using the UP/DOWN arrow keys or PAGE UP/DOWN until the bar highlights
U. S. BRICK, CUNE PLANT. Press ENTER to select it
Press F10 to advance to the Output Criteria Selection Screen.
Figure 3-7(b): Search #3 Output Search Criteria Construction Screen
-v. - FI.^.-HELP
Logic
(
Category
Operation
Value
)
Chemical Name
*
ESC - Cancei Search &
aecutn co Menu
Version 1,.Q
Highlight Chemical Name on the Output Criteria Selection Screen and press ENTER.
Highlight Exit Menu and press ENTER. SEDIMIS draws the Output Search Criteria
Construction Screen.
Highlight Chemical Name and press ENTER to move the cursor to the Operations
field.
Press ENTER to accept the default Operation "=" and move the cursor to the
Category Value field.
Enter an asterisk ("*") in the Value field and press ENTER. This tells the system to
look for all Chemical Names which fit the input criteria.
Press ENTER until the cursor returns to the Category field. Highlight Begin and press
ENTER to continue.
SEDIMIS displays the Output Mode Selection Screen. Press the TAB key to choose
Printer and press ENTER to select. Press ENTER again to verify the selection and
begin the search.
SEDIMIS will print the search results to your default printer.
Example Search Requests 19
-------
Figure 3-7(c): Search #3 Partial Printout
CHEMICAL(s) WITH Chemical Name = * BY Facility Name = U. S. BRICK
CLINE PLANT
MANGANESE
CAS NUMBER: 7439-96-5
TIP SCORE: 5
MODIFIED TIP SCORE: 10
Human Health Effects:
Reproductively Toxic
Acutely Toxic
Neurotoxic
Environmental Effects:
Persistent
SENTINEL HEALTH EVENT (ENVIRONMENTAL)
PARKINSONIAN SYNDROME
SYMPTOMS:
Stiffness: Extremities
PHYSICAL SIGNS:
Tremor/Trembling: Extremities (one or both, possibly)
Pill-Rolling Motion: Fingers
Rigidity: Extremities
Posture Stooped: CNS
Kyphotic Deformity: Spine
Ulnar Deviation: Hand
Flexion Contractures: Extremities
Masklike Face: CNS
Blinking Absent: Eyes
Shuffling Gait: CNS (later)
Drooling
Slowness in Initiating Movement: CNS
Head Forward on Chest: CNS
Inaction: General/Whole Body: CNS
Dermatitis: Skin (seborrhetic)
LABORATORY RESULTS:
RADIOLOGIC FINDINGS:
SHE(E) Type:
Acute
Chronic
SHE(E) Route
Ingestion
Inhalation
ICD-9 Code: 332.1
SENTINEL HEALTH EVENT (ENVIRONMENTAL)
MANGANESE POISONING....
20
Sentinel Environmental Disease and Injury Management Information System Manual
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The next sample search further explores the functions of SEDIMIS in correlating
various types of data that a researcher may find.
Search #4
An epidemiologist is investigating an apparent cluster of cases with symptoms of impaired
vision in workers at the Union Camp Corporation, in Savannah (Chatam County),
Georgia.
Does this facility release any toxic chemical which could possibly produce this symptom?
Which environmental disease could these workers be experiencing?
If this epidemiologist were to subsequently examine the medical records of the affected
workers, what physical signs and clinical laboratory findings could he possibly
encounter?
One possible approach to finding this information would use the following input/output
criteria. This is an especially efficient search (even though the facility index is slow to
load) because the chemical listing includes all SHE(E)s with associated medical signs
linked to the chemicals.
Input Criteria Facility Name limited to Union Camp Corporation located
in Chatam County, Georgia.
Output Criteria All chemicals by name. This also lists the SHE(E)s (if any)
associated with each chemical.
Using the procedure outlined in Example #3 with the above input and output criteria, the
search results indicate that the facilty in question is known to release the following
thirteen toxic chemicals.
ACETONE
BIPHENYL
CATECHOL [1,2-DIHYDROXYBENZENE]
CHLORINE
ETHYLENE GLYCOL
FORMALDEHYDE
HYDROCHLORIC ACID
MALEIC ANHYDRIDE
METHANOL[METHYL
ALCOHOL]
PHOSPHORIC ACID
SULFURIC ACID
TOLUENE
XYLENE (MIXED ISOMERS)
The report also indicates any SHE(E)s (with associated medical signs) which can result
from exposure to these chemicals. Upon review, the chemical methanol causes methyl
alcohol poisoning which is indicated by the symptom of impaired vision. Additional
medical signs are also listed. See Figure 3-8 for the search results pertaining to methanol.
Example Search Requests 21
-------
Figure 3-8: Search #4 Partial Printout
CHEMICAL(s) WITH Chemical Name = * BY Facility Name = UNION CAMP CORP.
METHANOL [METHYL ALCOHOL]
CAS NUMBER: 67-56-1
TIP SCORE: 1
MODIFIED TIP SCORE: 2
Human Health Effects:
Neurotoxic
Environmental Effects:
SENTINEL HEALTH EVENT (ENVIRONMENTAL)
METHYL ALCOLHOL POISONING
SYMPTOMS:
Fatigue
Headache
Nausea
Vomiting
Disturbance: Vision
Dizziness: CNS
PHYSICAL SIGNS:
Cyanosis
Cold, Clammy Skin
Euphoria: CNS
Respiration Shallow: Lungs
Blood Pressure Low
Acidosis (features of)
CNS Depression
Convulsions: CNS
Coma
Pupils Dilated
Hyperemia: Optic Disk
Edema: Retina
Blind White Disks: Retina
Atrophy: Optic Disk
Attenuated Vessels: Optic Disk
Visual Fields Contracted
LABORATORY RESULTS:
Methyl Alcohol Present: Breath
Methyl Alcohol Present: Urine
Methyl Alcohol Present: Blood
Formic Acid Present: Urine
RADIOLOGIC FINDINGS:
N/A
SHE(E) Type:
Acute
SHE(E) Degree:
Mild
SHE(E) Route
Contact
Ingestion
Inhalation
ICD-9 Code: 980.1
SENTINEL HEALTH EVENT (ENVIRONMENTAL)
22
Sentinel Environmental Disease and Injury Management Information System Manual
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4.0 How to Change Your Password
You should change your password at regular intervals. This helps to prevent
unauthorized access to the system. People tend to choose the names of family members
as their password. Slightly misspelling a name, especially by duplicating a letter makes
it very difficult for someone to correctly observe your password as you type it. For
example, it is virtually impossible to distinguish between someone typing "thomas" and
"tthomas."
You must be logged on to SEDIMIS in order to change your password.
At the first screen, type M or use the arrow keys to highlight Maintenance and press
ENTER to select the option.
If you are a Level 1 Security (general) user, your only option on the main menu will
be to change your password. If you are a Level 2 Security (system administration) user,
you will have several options to choose from. In either case, use the arrow keys to
highlight Password and press ENTER.
You may press ESCAPE at any time during the process to return to the Menu Bar.
SEDIMIS will prompt you for your current password. If you make a mistake as you
type the password, simply press the BACKSPACE or DELETE key to erase the mistake
and then type the correct password. Press ENTER when you complete the Password.
SEDIMIS will next prompt you to enter your new password. Passwords are limited
to eight (8) characters in length and the first character must be a letter. Once again, if you
make a mistake, use the BACKSPACE or DELETE key to erase the mistake and retype
the password. Press ENTER when you complete the password.
Finally, the system asks you to retype your new Password. This makes certain the
first typed entry is what you intended it to be. Retype your new password and press
ENTER. If the two new password entries are the same, SEDIMIS acknowledges your new
Password. Press ENTER to clear the box and return to the Menu Bar.
There are two reasons why an attempt to change your password will fail:
• you incorrectly entered your current password; or,
• the retyped new password did not match the originally entered password.
SEDIMIS will display a dialogue box which tells you what happened.
How to Change Your Password 23
-------
If you did not enter your current password correctly, the system displays a dialogue
box immediately after this step. Press ENTER to clear the box and return to the password
entry box. SEDIMIS allows you three chances to enter your current password correctly
before locking you out.
If you did not retype your new password correctly, SEDIMIS shows a dialogue box
at that point in the entry process. Press ENTER to clear the box and return to the point
where your enter your new password. After you do this, SEDIMIS will ask you to retype
the new password. You have three chances to enter and confirm your new password
before the system returns you to the main menu.
Figure 4-1: Password Change Screens
SEDIMIS
' ' , 't *> t Y
' ¦" ' j
:.l Type your new Password
in the BOX below.
| NEWPASS_
•• I
• • * - i
!s-„ 1 i
'''
YSt ¦
.^y^yyyy^^\;\;/ " • ¦y'sy-yyyyyyy^
.':: ::: . y\ • V: *$*
"I
:l Type your new Password
in the BOX below.
I y?
i
!; ": ,
I
Esc - Exit Password Change
Version 1.5
24 Sentinel Environmental Disease and Injury Management Information System Manual
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5.0 Updating the User Database
The User Database contains the listing of all User Names and their associated Passwords
and Security Levels. You must be a Level 2 Security User in order to access the User
Database.
NOTE: When editing the User Database, all User Names and Passwords will
be visible on the screen. This is the only situation that the actual
passwords can be seen. At all other times SEDIMIS displays
asterisks (*) instead of the characters in a password.
At the first menu screen, type M or use the arrow keys to highlight Maintenance and
press ENTER to select the option.
If you are a Level 1 Security (general) user, your only option from the Maintenance menu
will be to change your password. If you are a Level 2 Security (system administration)
user, you will have several options to choose from. To access the User Database, type U
or use the arrow keys to highlight Users and press ENTER.
The User Maintenance Menu Bar includes three options:
• ADD Add a new user (User Name and Password) to the SEDIMIS
database.
• DELETE Delete an existing user from the database.
• EDIT Change information (User Name, Password or Security Level) of an
existing user.
Adding a New User
Type A or use the arrow keys to highlight Add and press ENTER.
• Enter the User Name at the system prompt. User Names are limited to ten (10)
characters in length and must begin with a letter. If you make a mistake, you may
use either the BACKSPACE or DEL key to erase the error. Press ENTER when
finished.
Enter the Password at the system prompt. Passwords are limited to eight (8)
characters in length and must begin with a letter. If you make a mistake, you may
use either the BACKSPACE or DEL key to erase the error. Press ENTER when
finished.
• Assign a Security Level for the new user by placing an X in the appropriate box. Use
the TAB and SHIFT-TAB keys to toggle between the two levels. If you make an
Updating the User Database 25
-------
error, use the DEL key to erase the mistake. Press ENTER to accept the displayed
Security Level and complete the Add process.
NOTE: SEDIMIS includes two security levels. Level 1 users are permitted to
access the system to search and review records. They may also change their
passwords. Level 2 users have full access to the system. They should be strictly
limited to those designated as system administrators and assistants in order to limit
the possibility of data corruption
Deleting an Existing User
• Type D or use the arrow keys to highlight Delete and press ENTER.
• SEDIMIS displays an alphabetical list of authorized users. You move the highlight
bar through the list with the arrow keys. The PAGE UP/DOWN keys move the
highlight bar one screen (17 lines) up or down. You may also type the first letter of
the User Name you are seeking. The highlight bar will move to the first User Name
beginning with that letter.
• When the correct User Name is highlighted, press ENTER to select the name.
• You must confirm your selection by pressing ENTER at the Confirmation Box. If
you wish to cancel your selection, press ESC or use the arrow keys to highlight
Cancel and press ENTER at the Confirmation Box.
Editing A User Record
• Type E or use the arrow keys to highlight Edit and press ENTER.
• SEDIMIS displays an alphabetical list of authorized users. You move the highlight
bar through the list with the arrow keys. The PAGE UP/DOWN keys move the
highlight bar one screen (17 lines) up or down. You may also type the first letter of
the User Name you are seeking. The highlight bar will move to the first User Name
beginning with that letter.
• When the correct User Name is highlighted, press ENTER to select the name.
• SEDIMIS displays a Decision Box allowing you to choose whether to edit the User
Name or skip to the Password. Press ENTER to edit the User Name and F2 to skip
to the Password. Also press F2 if you wish to edit the Security Level. Press ESC to
abort editing the record.
• If you pressed ENTER, type in the new User Name. Once you press ENTER you
cannot abort the edit process. You must enter a new name even if it is the same as
26 Sentinel Environmental Disease and Injury Management Information System Manual
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the current User Name. User Names are limited to ten (10) characters and must begin
with a letter. When you finish entering the new User Name, press ENTER.
If you initially pressed F2 or after you finish editing the User Name, the system
displays another Decision Box. Press ENTER to edit the Password or F2 to skip to
the Security Level. If you have completed editing the User record also press F2.
Press ESC to abort editing the record.
If you pressed ENTER, type in the new Password. Once you press ENTER you
cannot abort the edit process. You must enter a new Password even if it is the same
as the current Password. Passwords are limited to eight (8) characters and must begin
with a letter. When you finish entering the new Password, press ENTER.
If you pressed F2 from the previous screen or after you finish editing the Password,
SEDIMIS displays another box. Press the TAB key to toggle to the other security
level and press ENTER. If you do not wish to change the Security Level, press F10
to save the edited record. Press ESC to abort the editing process.
Updating the User Database 27
-------
6.0 The Symptoms Database
The Symptoms Database contains the list of all possible patient reported symptoms.
Symptoms are referenced by the SHE(E) Database to generate a profile of any SHE(E).
You must be a Level 2 Security User in order to access the Symptoms Database.
The Symptoms Database contains the following information:
• a unique four-digit code number for each Symptom;
• a full description of the Symptom;
• one code number specifying the CMIT organ category into which a Symptom
falls;
• one code number specifying the Anatomical category into which a Symptom falls;
The Current Medical Information and Terminology (CMIT) Category Classification is
based on the affected organ system. The organ systems defined are:
Conditions related to the body as a whole including psyche;
Integumentary System
Musculoskeletal System
Respiratory System
Cardiovascular System
Hemic and Lymphatic System
Digestive System
Urogenital System
Endocrine System
Nervous System
Organs of Special Sense
The Anatomical Systems are defined as:
Abdomen/Lower Trunk
Back
Chest/Thorax
Ears
Extremities
Eyes
General/Systemic
Head (other than sense organs)
Mouth and Tongue
Nose
Psychological/Mental
Skin
Throat and Neck
28 Sentinel Environmental Disease and Injury Management Information System Manual
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You should enter Symptoms in general terms. SEDIMIS includes an extra database which
lists Qualifiers for all the medical signs. A Qualifier further describes the symptom but
do not limit a general search. For example, if you wish to list all SHE(E)s producing a
cough, all occurrences, with or without a qualifier would be listed.
You may access the Symptoms Database in one of three ways:
• all Symptoms listed in alphabetical order;
• Symptoms grouped by CMIT organ category then listed in alphabetical order;
• Symptoms grouped by anatomical region then listed in alphabetical order.
Accessing the Symptoms Database
At the first screen, type M or use the arrow keys to highlight Maintenance and press
ENTER to select the option.
If you are a Level 1 Security (general) user, your only option from the Maintenance menu
will be to change your password. If you are a Level 2 Security (system administration)
user, you will have several options to choose from. To access the Symptom Database,
type S or use the arrow keys to highlight Symptoms and press ENTER.
The Symptoms Maintenance Menu Bar includes four options:
• ADD Add a new Symptom to the SEDIMIS database.
• DELETE Delete an existing Symptom from the database.
• EDIT Change the information stored about an existing Symptom.
• QUIT Return to the Main Menu.
The Symptoms Database 29
-------
Figure 6-1: Database Relationships
User specifies
a Symptom, i
Diagnostic
Aid
t
What SHE(E)s have
this Symptom?
What chemicals produce
this Symptom?
User specifies a SHE(E)
or chemical.
Anticipation
of medical
problems
What Symptoms are
associated with the SHE(B
or produced by the chemical/
t
-------
6.1 Updating the Symptoms Database
Adding a New Symptom
• Type A or use the arrow keys to highlight Add and press ENTER.
• Type S or use the arrow keys to highlight Symptom and press ENTER.
• Enter the Symptom at the prompt. Symptoms are limited to fifty-five (55) characters
in length (including blanks). You should capitalize the first letter and leave the rest
of the letters in lower case.If you make a mistake, you may use either the
BACKSPACE or DEL key to erase the error. Press ENTER when finished. Press
ESC to cancel the operation.
• SEDIMIS will next display a scroll bar menu which allows you to assign the new
symptom to its proper CMIT category. Use the arrow keys to highlight the proper
category and press ENTER.
• SEDIMIS displays a scroll bar menu which lists the Anatomical categories. Use the
arrow keys to highlight the proper category and press ENTER.
• The system displays a confirmation screen which displays all the new information.
If all the information is correct, press ENTER to add the new Symptom to the
database. If there is an error, use the TAB key or the arrow keys to highlight NO and
press ENTER. You will have to re-enter all the information if this happens.
Deleting an Existing Symptom
SEDIMIS will not allow you to delete a Symptom which is used to describe a SHE(E).
• Use the arrow keys to highlight Delete or type D and press ENTER.
• SEDIMIS displays an alphabetical list of Symptoms. You move the highlight bar
through the list with the arrow keys. The PAGE UP/DOWN keys move the highlight
bar one screen (17 lines) up or down. You may also type the first letter of the
Symptom you are seeking. The highlight bar will move to the first Symptom
beginning with that letter.
• When the correct Symptom is highlighted, press ENTER.
• You must confirm your selection by pressing ENTER at the Confirmation Box. If
you wish to cancel your selection, press ESC or highlight Cancel and press ENTER
at the Confirmation Box. NOTE: You cannot delete a symptom which is linked to
another database.
Updating the Symptoms Database 31
-------
Editing A Symptom
• Type E or use the arrow keys to highlight Edit and press ENTER.
• Type S or use the arrow keys to highlight Symptom and press ENTER.
• SEDIMIS displays an alphabetical list of Symptoms. Move the highlight bar through
the list using the arrow keys. The PAGE UP/DOWN keys move the highlight bar one
screen (17 lines) up or down. You may also type the first letter of the Symptom you
are seeking. The highlight bar will move to the first Symptom beginning with that
letter.
• When the correct Symptom is highlighted, press ENTER.
• SEDIMIS displays a Decision Box allowing you to choose the field(s) you wish to
edit. You may edit the Description, CMIT category and/or the Anatomical category.
Place an X in the box next to the field(s) you wish to edit. If you wish to skip a
field, press the TAB key to skip that box. Press ENTER to confirm your choices and
begin editing or choose Cancel and press ENTER to abort the edit process.
• If you chose to edit the Symptom description, SEDIMIS displays a Dialogue Box
which prompts you to enter the new Symptom description. Press ENTER when you
are through or press ESC to cancel editing the description. Symptom descriptions are
limited to fifty-five (55) characters (including spaces.) The description should begin
with a capital letter and the other letters should be lower-case. After you press
ENTER, SEDIMIS displays each SHE(E) which includes the Symptom in its
description. The system asks if the newly edited Symptom will still accurately
describe the SHE(E)s. This feature provides a fail-safe check so that you do not
accidentally corrupt the SHE(E) database. If the edited Symptom will not describe
each SHE(E) listed, it will ABORT the editing process.
• Tf you chose to edit the CMIT category, the system displays a scroll bar menu listing
all CMIT categories. Use the arrow keys to highlight the proper category and press
ENTER.
• If you chose the edit the Anatomical category, SEDIMIS displays a scroll bar menu
which lists the Anatomical categories. Use the arrow keys to highlight the proper
category and press ENTER.
32 Sentinel Environmental Disease and Injury Management Information System Manual
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7.0 The Physical Signs Database
The Physical Signs Database contains the list of all possible physician-noted physical
manifestations. Physical Signs are referenced by the SHE(E) Database to generate a
profile of any SHE(E). The database differs from the others in that it contains only those
objective, quantifiable physical abnormalities noted by a physician which do not require
laboratory analysis or non-standard office equipment to ascertain.
You must be a Level 2 Security User in order to access the Physical Signs Database.
The Physical Signs Database contains the following information:
• a unique four-digit code number for each Physical Sign;
• a full description of the Physical Sign;
• one code number specifying the CMIT organ category into which a Physical Sign
falls;
• one code number specifying the Anatomical category into which a Physical Sign
falls;
The Current Medical Information and Terminology (CMIT) Category Classification is
based on the affected organ system. The organ systems defined are:
• Conditions related to the body as a whole including psyche
• Integumentary System
• Musculoskeletal System
• Respiratory System
• Cardiovascular System
• Hemic and Lymphatic System
• Digestive System
• Urogenital System
• Endocrine System
• Nervous System
• Organs of Special Sense
The Anatomical Systems are defined as:
• Abdomen/Lower Trunk
• Back
• Chest/Thorax
• Ears
• Extremities
• Eyes
• General/Systemic
• Head (other than sense organs)
• Mouth and Tongue
The Physical Signs Database 33
-------
• Nose
• Psychological/Mental
• Skin
• Throat and Neck
You should enter Physical Signs in general terms. SEDIMIS includes an extra database
which lists Qualifiers for all the medical signs. A Qualifier further describes the physical
sign but does not limit a general search. For example, if you wish to list all SHE(E)s
producing petechiae, all occurrences, with or without a qualifier would be listed.
You may access the Physical Signs Database in one of three ways:
• all Physical Signs listed in alphabetical order;
• Physical Signs grouped by CMIT organ category then listed in alphabetical order,
• Physical Signs grouped by anatomical region then listed in alphabetical order.
Accessing the Physical Signs Database
At the first screen, type M or use the arrow keys to highlight Maintenance and press
ENTER to select the option.
•If you are a Level 1 Security (general) user, your only option from the Maintenance menu
will be to change your password. If you are a Level 2 Security (system administration)
user, you will have several options to choose from. To access the Physical Sign Database,
type P or use the arrow keys to highlight Physical Signs and press ENTER.
The Physical Signs Maintenance Menu Bar includes three options:
• ADD Add a new Physical Sign to the SEDIMIS database.
• DELETE Delete an existing Physical Sign from the database.
• EDIT Change the information stored about an existing Physical Sign.
• QUIT Return to the Main Menu
34 Sentinel Environmental Disease and Injury Management Information System Manual
-------
Figure 7-1: Database Relationships
Diagnostic
Aid
User specifies
a Physical
Sign.
What SHE(E)s have
this Physical
Sign?
?What chemicals
' produce this
Physical Sign?
User specifies a SHE(E)
mm or chemical.
What
Physical Signs are
associated with the SHE(E| f j
produced by the chemical? ''
Anticipation
of medical
problems
-------
7.1 Updating the Physical Signs Database
Adding a New Physical Sign
• Type A or use the arrow keys to highlight Add and press ENTER.
• Type P or use the arrow keys to highlight Physical Sign and press ENTER.
Enter the Physical Sign at the prompt. Physical Signs are limited to fifty-five (55)
characters in length (including blanks). You should capitalize the first letter and leave
the rest of the letters in lower case.If you make a mistake, you may use either the
BACKSPACE or DEL key to erase the error. Press ENTER when finished. Press
ESC to cancel the operation.
• SEDIMIS will next display a scroll bar menu which allows you to assign the new
symptom to its proper CMIT category. Use the arrow keys to highlight the proper
category and press ENTER.
• SEDIMIS displays a scroll bar menu which lists the Anatomical categories. Use the
arrow keys to highlight the proper category and press ENTER.
• The system displays a confirmation screen which displays all the new information.
If all the information is correct, press ENTER to add the new Physical Sign to the
database. If there is an error, use the TAB key or the arrow keys to highlight NO and
press ENTER. You will have to re-enter all the information if this happens.
Deleting an Existing Physical Sign
SEDIMIS will not allow you to delete a Physical Sign which is used to describe a
SHE(E).
• Type D or use the arrow keys to highlight Delete and press ENTER.
• SEDIMIS displays an alphabetical list of Physical Signs. You move the highlight bar
through the list with the arrow keys. The PAGE UP/DOWN keys move the highlight
bar one screen (17 lines) up or down. You may also type the first letter of the
Physical Sign you are seeking. The highlight bar will move to the first Physical Sign
beginning with that letter.
• When the correct Physical Sign is highlighted, press ENTER.
• You must confirm your selection by pressing ENTER at the Confirmation Box. If
you wish to cancel your selection, press ESC or highlight Cancel and press ENTER
at the Confirmation Box. NOTE: You cannot delete a Physical Sign that is linked
to another database.
Updating the Physical Signs Database 37
-------
Editing A Physical Sign
• Type E or use the arrow keys to highlight Edit and press ENTER.
• Type P or use the arrow keys to highlight Physical Sign and press ENTER.
• SEDIMIS displays an alphabetical list of Physical Signs. Move the highlight bar
through the list using the arrow keys. The PAGE UP/DOWN keys move the highlight
bar one screen (17 lines) up or down. You may also type the first letter of the
Physical Sign you are seeking. The highlight bar will move to the first Physical Sign
beginning with that letter.
• When the correct Physical Sign is highlighted, press ENTER.
• SEDIMIS displays a Decision Box allowing you to choose the field(s) you wish to
edit. You may enter the Description, CMIT category and/or the Anatomical category.
Place an X in the box next to the field(s) you wish to edit. If you wish to skip a
field, press the TAB key to skip that box. Press ENTER to begin editing or choose
Cancel and press ENTER to abort the edit process.
• If you chose to edit the Physical Sign description, SEDIMIS displays a Dialogue Box
which prompts you to enter the new Physical Sign description. Press ENTER when
you are through or press ESC to cancel editing the description. Physical Sign
descriptions are limited to fifty-five (55) characters (including spaces.) The
description should begin with a capital letter and the other letters should be lower-
case. After you press ENTER, SEDIMIS displays each SHE(E) which includes the
Physical Sign in its description. The system asks if the newly edited Physical Sign
will still accurately describe the SHE(E)s. This feature provides a fail-safe check so
that you do not accidentally corrupt the SHE(E) database. If the edited Physical Sign
will not describe each SHE(E) listed, it will ABORT the editing process.
• If you chose to edit the CMIT category, the system displays a scroll bar menu listing
all CMIT categories. Use the arrow keys to highlight the proper category and press
ENTER.
• If you chose the edit the Anatomical category, SEDIMIS displays a scroll bar menu
which lists the Anatomical categories. Use the arrow keys to highlight the proper
category and press ENTER.
38 Sentinel Environmental Disease and Injury Management Information System Manual
-------
8.0 The Laboratory Results Database
The Laboratory Results Database contains the list of all possible results reported as the
result of a laboratory or other special test. Laboratory Results are referenced by the
SHE(E) Database to generate a profile of any SHE(E). This database differs from the
others in that it contains only results obtained from a standard laboratory test or a clinical
physical diagnostic test.
You must be a Level 2 Security User in order to access the Laboratory Results Database.
The Laboratory Results Database contains the following information:
• a unique four-digit code number for each Laboratory Result;
• a full description of the Laboratory Result;
• one code number specifying the specific test performed which indicated the
Laboratory Result specified in the database;
The tests which can be performed are defined as follows:
• Biopsy
• Blood Analysis, Serum
• Blood Analysis, Whole
• Bone Marrow Analysis
• Breath Analysis
• Electrocardiogram (ECG)
• Electroencephalogram (EEG)
• Electromyleogram (EMG)
• Fingernail Analysis
• Gastric Analysis
• Hair Analysis
• Pulmonary Function
• Semen Analysis
• Skin Test
• Sputum Analysis
• Stool Analysis
• Urinalysis
• Visual Field Test
You should enter Laboratory Results in general terms. SEDIMIS includes an extra
database which lists Qualifiers for all the medical signs. A Qualifier further describes the
Laboratory Result but does not limit a general search. For example, if you wish to list all
SHE(E)s which possess test results such as reticulocytes increased, all occurrences, with
or without a qualifier would be listed.
The Laboratory Results Database 39
-------
Accessing the Laboratory Results Database
At the first screen, type M or use the arrow keys to highlight Maintenance and press
ENTER to select the option.
If you are a Level 1 Security (general) user, your only option from the Maintenance menu
will be to change your password. If you are a Level 2 Security (system administration)
user, you will have several options to choose from. To access the Laboratory Result
Database, type L or use the arrow keys to highlight Laboratory Results and press ENTER.
The Laboratory Results Maintenance Menu Bar includes three options:
• ADD Add a new Laboratory Result to the SEDIMIS database.
• DELETE Delete an existing Laboratory Result from the database.
• EDIT Change the information stored about an existing Laboratory Result.
• QUIT Return to the Main Menu
40 Sentinel Environmental Disease and Injury Management Information System Manual
-------
Figure 8-1: Database Relationships
Diagnostic
Aid
User specifies
a Laboratory^
Result
What SHE(E)s have
this Laboratory
Result?
What chemicals
produce this
Laboratory Result?
User specifies a SHE(E)
or chemical.
I"™™
What Laboratory
Results are
associated with the SHE(E)
or produced by the chemical?
Anticipation
of medical
problems
-------
8.1 Updating the Laboratory Results Database
Adding a New Laboratory Result
• Type A or use the arrow keys to highlight Add and press ENTER.
• Type L or use the arrow keys to highlight Laboratory Result and press ENTER.
Enter the Laboratory Result at the prompt. Laboratory Results are limited to fifty-five
(55) characters in length (including blanks). You must capitalize the first letter of the
description; the rest of the characters may be either upper or lower case. SEDIMIS
will display the name on all subsequent menus exactly as you type it. If you make
a mistake, you may use either the BACKSPACE or DEL key to erase the error. Press
ENTER when finished. Press ESC to cancel the operation.
• SEDIMIS will next display a scroll bar menu which allows you to assign the new
symptom to its proper test category. Use the arrow keys to highlight the proper
category and press ENTER.
• The system displays a confirmation screen which displays all the new information.
If all the information is correct, press ENTER to add the new Laboratory Result to
the database. If there is an error, use the TAB key or the arrow keys to highlight NO
and press ENTER. You will have to re-enter all the information if this happens.
Deleting an Existing Laboratory Result
SEDIMIS will not allow you to delete a Laboratory Result which is used to describe a
SHE(E).
• Type D or use the arrow keys to highlight Delete and press ENTER.
• SEDIMIS displays an alphabetical list of Laboratory Results. You move the highlight
bar through the list with the arrow keys. The PAGE UP/DOWN keys move the
highlight bar one screen (17 lines) up or down. You may also type the first letter of
the Laboratory Result you are seeking. The highlight bar will move to the first
Laboratory Result beginning with that letter.
• When the correct Laboratory Result is highlighted, press ENTER.
• You must confirm your selection by pressing ENTER at the Confirmation Box. If
you wish to cancel your selection, press ESC or highlight Cancel and press ENTER
at the Confirmation Box. NOTE: You cannot delete a Laboratory Result that is
linked to another database.
Updating the Laboratory Results Database 43
-------
Editing A Laboratory Result
• Type E or use the arrow keys to highlight Edit and press ENTER.
• Type L or use the arrow keys to highlight Laboratory Result and press ENTER.
• SEDIMIS displays an alphabetical list of Laboratory Results. Move the highlight bar
through the list using the arrow keys. The PAGE UP/DOWN keys move the highlight
bar one screen (17 lines) up or down. You may also type the first letter of the
Laboratory Result you are seeking. The highlight bar will move to the first
Laboratory Result beginning with that letter.
• When the correct Laboratory Result is highlighted, press ENTER.
• SEDIMIS displays a Decision Box allowing you to choose the field(s) you wish to
edit. You may edit the Description and/or Test category. Place an X in the box next
to the field(s) you wish to edit. If you wish to skip a field, press the TAB key to skip
that box. Press ENTER to begin editing or choose Cancel and press ENTER to abort
the edit process.
• If you chose to edit the Laboratory Result description, SEDIMIS displays a Dialogue
Box which prompts you to enter the new Laboratory Result description. Press
ENTER when you are through or press ESC to cancel editing the description.
Laboratory Result descriptions are limited to fifty-five (55) characters (including
spaces.) The description should begin with a capital letter and the other letters should
be lower-case. After you press ENTER, SEDIMIS displays each SHE(E) which
includes the Laboratory Result in its description. The system asks if the newly edited
Laboratory Result will still accurately describe the SHE(E)s. This feature provides
a fail-safe check so that you do not accidentally corrupt the SHE(E) database. If the
edited Laboratory Result will not describe each SHE(E) listed, it will ABORT the
editing process.
• If you chose to edit the Test category, the system displays a scroll bar menu listing
all Test categories. Use the arrow keys to highlight the proper category and press
ENTER.
44 Sentinel Environmental Disease and Injury Management Information System Manual
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9.0 The Radiologic Findings Database
The Radiologic Findings Database contains the list of all possible results reported from
non-invasive viewing technologies. Radiologic Findings are referenced by the SHE(E)
Database to generate a profile of any SHE(E). At present, this database is limited to
findings resulting from traditional Xrays. As SHE(E)s are described using other
technologies (CAT Scans, PET Scans, MRI and/or Sonograms) these findings will also
be included.
You must be a Level 2 Security User in order to access the Radiologic Findings Database.
The Radiologic Findings Database contains the following information:
• a unique four-digit code number for each Radiologic Finding;
• a full description of the Radiologic Finding;
• one code number specifying the type/location of the examination performed;
The tests which can be performed are defined as follows:
• Abdominal Series/Liver Scan
• Barium Swallow
• Bone Xray
• Bowel Study
• Celiac Angiography
• Chest Xray
• Cystogram
• Pyelogram/Retrograde Pyelography
• Sinus Series
You should enter Radiologic Findings in general terms. SEDIMIS includes an extra
database which lists Qualifiers for all the medical signs. A Qualifier further describes the
Radiologic Finding but does not limit a general search. For example, if you wish to list
all SHE(E)s which possess Radiologic Findings such as pulmonary infiltrations, all
occurrences, with or without a qualifier would be listed.
Accessing the Radiologic Findings Database
At the first screen, type M or use the arrow keys to highlight Maintenance and press
ENTER to select the option.
If you are a Level 1 Security (general) user, your only option from the Maintenance menu
will be to change your password. If you are a Level 2 Security (system administration)
user, you will have several options to choose from. To access the Radiologic Finding
The Radiologic Findings Database 45
-------
Database, type R or use the arrow keys to highlight Radiologic Findings and press
ENTER.
The Radiologic Findings Maintenance Menu Bar includes three options:
• ADD Add a new Radiologic Finding to the SEDIMIS database.
• DELETE Delete an existing Radiologic Finding from the database.
• EDIT Change the information stored about an existing Radiologic Finding.
• QUIT Return to the Main Menu.
46 Sentinel Environmental Disease and Injury Management Information System Manual
-------
Figure 9-1: Database Relationships
Diagnostic
Aid
User specifies
a Radiologic,
Finding
What SHE(E)s have
this Radiologic
Finding?
What chemicals
produce this
Radiologic Finding?
User specifies a SHE(E)
or chemical.
What Radiologic
Findings are
associated with the SHE(E)
produced by the chemical?
Anticipation
of medical
problems
t
-------
9.1 Updating the Radiologic Findings Database
Adding a New Radiologic Finding
• Type A or use the arrow keys to highlight Add and press ENTER.
• Type R or use the arrow keys to highlight Radiologic Finding and press ENTER.
Enter the Radiologic Finding at the prompt. Radiologic Findings are limited to fifty-
five (55) characters in length (including blanks). You must capitalize the first letter
of the description; the rest of the characters may be either upper or lower case.
SEDIMIS will display the name on all subsequent menus exactly as you type it. If
you make a mistake, you may use either the BACKSPACE or DEL key to erase the
error. Press ENTER when finished. Press ESC to cancel the operation.
• SEDIMIS will next display a scroll bar menu which allows you to assign the new
symptom to its proper Test category. Use the arrow keys to highlight the proper
category and press ENTER.
• The system displays a confirmation screen which displays all the new information.
If all the information is correct, press ENTER to add the new Radiologic Finding to
the database. If there is an error, use the arrow keys to highlight NO and press
ENTER. You will have to re-enter all the information if this happens.
Deleting an Existing Radiologic Finding
SEDIMIS will not allow you to delete a Radiologic Finding which is used to describe a
SHE(E).
• Type D or use the arrow keys to highlight Delete and press ENTER.
SEDIMIS displays an alphabetical list of Radiologic Findings. You move the
highlight bar through the list with the arrow keys. The PAGE UP/DOWN keys move
the highlight bar one screen (17 lines) up or down. You may also type the first letter
of the Radiologic Finding you are seeking. The highlight bar will move to the first
Radiologic Finding beginning with that letter.
• When the correct Radiologic Finding is highlighted, press ENTER.
• You must confirm your selection by pressing ENTER at the Confirmation Box. If
you wish to cancel your selection, press ESC or highlight Cancel and press ENTER
at the Confirmation Box. NOTE: You cannot delete a Radiologic Finding which is
linked to another database.
Updating the Radiologic Findings Database 49
-------
Editing A Radiologic Finding
• Type E or use the arrow keys to highlight Edit and press ENTER.
• Type L or use the arrow keys to highlight Radiologic Finding and press ENTER.
• SEDIMIS displays an alphabetical list of Radiologic Findings. Move the highlight bar
through the list using the arrow keys. The PAGE UP/DOWN keys move the highlight
bar one screen (17 lines) up or down. You may also type the first letter of the
Radiologic Finding you are seeking. The highlight bar will move to the first
Radiologic Finding beginning with that letter.
• When the correct Radiologic Finding is highlighted, press ENTER.
SEDIMIS displays a Decision Box allowing you to choose the field(s) you wish to
edit. You may edit the Description and/or Test category. Place an X in the box next
to the field(s) you wish to edit. If you wish to skip a field, press the TAB key to skip
that box. Press ENTER to begin editing or choose Cancel and press ENTER to abort
the edit process.
If you chose to edit the Radiologic Finding description, SEDIMIS displays a
Dialogue Box which prompts you to enter the new Radiologic Finding description.
Press ENTER when you are through or press ESC to cancel editing the description.
Radiologic Finding descriptions are limited to fifty-five (55) characters (including
spaces.) The description should begin with a capital letter; the rest of the characters
may be either upper or lower case. SEDIMIS will display the name on all subsequent
menus exactly as you type it. After you press ENTER, SEDIMIS displays each
SHE(E) which includes the Radiologic Finding in its description. The system asks
if the newly edited Radiologic Finding will still accurately describe the SHE(E)s.
This feature provides a fail-safe check so that you do not accidentally corrupt the
SHE(E) database. If the edited Radiologic Finding will not describe each SHE(E)
listed, it will ABORT the editing process.
• If you chose to edit the Test category, the system displays a scroll bar menu listing
all Test categories. Use the arrow keys to highlight the proper category and press
ENTER.
50 Sentinel Environmental Disease and Injury Management Information System Manual
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10.0 The Qualifier Database
The Qualifier Database contains adjectives which further describe the different
Medical Signs. The system uses only one Qualifier Database for all four Medical Signs
(Symptoms, Physical Signs, Laboratory Results and Radiologic Findings.) Medical Signs
do not possess Qualifiers all the time. Different SHE(E)s may be described using the
same Medical Sign and different Qualifiers. The presence or absence of a Qualifier does
not affect a search for a SHE(E) described by a Medical Sign. All instances of the
Medical Sign will be reported.
You must be a Level 2 Security User in order to access the Qualifier Database.
Adding a New Qualifier
• Type A or use the arrow keys to highlight Add and press ENTER.
• Type Q or use the arrow keys to highlight Qualifier and press ENTER.
• Enter the Qualifier description at the prompt. Qualifier descriptions are limited to
thirty (30) characters in length (including blanks). You should type all letters in lower
case. If you make a mistake, you may use either the BACKSPACE or DEL key to
erase the error. Press ENTER when finished. Press ESC to cancel adding a qualifier.
• The system displays a confirmation screen which displays all the new information.
If all the information is correct, press ENTER to add the new Qualifier to the
database. If there is an error, press ESC to cancel adding the Qualifier to the
database.
Deleting an Existing Qualifier
• A Qualifier cannot be deleted. A well-chosen Qualifier is applicable to many
Symptoms and may be applicable to others in the future.
Editing A Qualifier
• Type E or use the arrow keys to highlight Edit and press ENTER.
• Type Q or use the arrow keys to highlight Qualifier and press ENTER.
• SEDIMIS displays an alphabetical list of Qualifiers. Move the highlight bar through
the list using the arrow keys. The PAGE UP/DOWN keys move the highlight bar one
screen (17 lines) up or down. You may also type the first letter of the Qualifier you
The Qualifier Database 51
-------
are seeking. The highlight bar will move to the first Qualifier beginning with that
letter.
• When the correct Qualifier is highlighted, press ENTER.
• SEDIMIS displays a Dialogue Box which prompts you to enter the new Qualifier
description. Press ENTER when you are through or press ESC to cancel editing the
description. Qualifier descriptions are limited to thirty (30) characters (including
spaces.) The description should be entered in lower-case letters.
• The system displays a confirmation screen which displays all the new information.
If all the information is correct, press ENTER to add the new Qualifier to the
database. If there is an error, press ESC to cancel adding the Qualifier to the
database.
52 Sentinel Environmental Disease and Injury Management Information System Manual
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11.0 The Sentinel Health Event (Environmental)
[SHE(E)] Database
A Sentinel Health Event (Environmental) [SHE(E)] is defined as an unnecessary disease,
disability, injury or untimely death which is environmentally related and which may:
• Provide the impetus for epidemiologic or environmental health studies;
• Serve as a warning signal that material substitution, engineering control, public
health intervention or medical care may be required;
• Impact the general direction of risk management decision-making.
The SHE(E) database contains the list of all Sentinel Health Events (Environmental)
[SHE(E)], as well as each SHE(E)'s Symptomological, Physical, Laboratory-determined
and Radiologic manifestations. The SHE(E) database incorporates the contents of the four
Medical databases described earlier in this document. SEDIMIS uses the Medical
databases to describe unique, specific Sentinel Health Events.
You must be a Level 2 Security User in order to access the SHE(E) Database.
The SHE(E) Database contains the following information:
• a unique code number for each SHE(E) (either the CMIT code number or a
created code number)
• the full name of each SHE(E);
• the type of exposure causing the SHE(E) (acute and/or chronic);
• the degree of exposure for the SHE(E) (severe and/or mild);
• the route of exposure causing the SHE(E) (contact/absorption, ingestion, and/or
inhalation);
• the International Classification of Disease: Volume 9 (ICD-9) code number for
each SHE(E);
• the Environmental Disease Category Classification of each SHE(E);
• the Medical Findings (with Qualifiers) for each SHE(E).
Accessing the SHE(E) Database
At the first screen, type M or use the arrow keys to highlight Maintenance and press
ENTER to select the option.
If you are a Level 1 Security (general) user, your only option from the Maintenance menu
will be to change your password. If you are a Level 2 Security (system administration)
user, you will have several options to choose from. To access the SHE(E) Database, use
the arrow keys to highlight SHE(E) and press ENTER.
The Sentinel Health Event (Environmental) [SHE(E)] Database 53
-------
The SHE(E) Maintenance Menu Bar includes five options:
• ADD Add a new SHE(E) to the SEDIMIS database.
• DELETE Delete an existing SHE(E) from the database.
• EDIT Change the information stored about an existing SHE(E).
• FIND Create a subset of the SHE(E) database using one or more fields of
interest
• QUIT Return to the SEDIMIS Main Menu
54 Sentinel Environmental Disease and Injury Management Information System Manual
-------
11.1 Adding a New SHE(E) to the Database
• See Figure 11-1 for the list of keys available for editing and navigating while adding
a record.
• Type A or use the arrow keys to highlight Add and press ENTER. SEDIMIS will
display a blank entry screen similar to Figure 11-2.
• Enter a unique SHE(E) Code in the first field. You should enter the Code in either
of the customary formats: ## IIIIIIII or ##-## IIIIIIII. The system accepts either format.
If the Code includes an alphabetic designator at the end, enter it now. SHE(E) Codes
are limited to twelve (12) characters, including any blanks or hyphens. Press ENTER
when finished.
• Enter the complete, unique SHE(E) Name. The Name is limited to fifty-five (55)
characters including blanks. You may enter the data using upper or lower case; the
system will convert it to upper case. Press ENTER when finished.
• Enter the Medical Data by pressing a Y or N in the appropriate fields. If you pass
over an empty field, SEDIMIS defaults to a Y in that field. At least one choice in
each category (Type, Degree, Route) must show a Y.
Enter the ICD-9 Code in the next field. The Code is limited to six (6) characters and
cannot contain any blanks. You may leave this field blank.
• SEDIMIS displays a scroll bar menu listing the Environmental Disease Categories.
Use the UP/DOWN ARROW keys to scroll through the list and press ENTER to
select a Category. If you reenter the field, press F2 to call the scrollbar menu.
Figure 11-1: Editing and Navigating Keys Available
TAB or DOWN ARROW
Move the cursor forward to the beginning of the next field.
SHIFT-TAB or UP ARROW
Move the cursor backward to the beginning of the previous field.
ENTER
Move the cursor forward to the beginning of the next field.
HOME
Move the cursor to the beginning of the current field.
END
Move the cursor to the space following the last character of the current field.
INSERT
Toggle between insert mode and typeover mode.
BACKSPACE
Deletes the character to the left of the cursor & moves the remaining characters left.
LEFT ARROW
Move the cursor one character to the left within the current field.
RIGHT ARROW
Move the cursor one character to the right within the current field.
PAGE DOWN
Saves the information added to the current record, clears the information and moves
the cursor to the first field in the next record to be added.
F1
Calls a help screen.
F6
Toggles the screen display between Screen 1 and Screen 2.
F10
Saves the information added to the current record, clears the screen and ends the
ADD function.
ESCAPE
Ends the ADD function but DOES NOT save the information added to the current
record. SEDIMIS displays a confirmation box before deleting any information.
Adding a New SHE(E) to the Database 55
-------
• You enter the data for the four Medical Signs fields (Symptoms, Physical Signs,
Laboratory Results and Radiologic Findings) in exactly the same way. Press F2 to
access the Medical Signs Database. The system can display Symptoms and Physical
signs in several different orders. Select the order by highlighting it and pressing
ENTER. Highlight the first Medical Sign on the scrollbar menu and press ENTER
to select it. If you wish to add Qualifiers to the Medical Sign description, press F2
for a list of Qualifiers. Select the first Qualifier in the same manner. If you wish to
add another Qualifier, press F2 and select the next Qualifier. You may add up to five
(5) Qualifiers to the Medical Sign description. After you have added the last Qualifier
press ENTER to move to the next Medical Sign field. Add the second Medical Sign
and its Qualifiers (if any) in the same manner. When you have added all the Medical
Signs in one area, press ENTER to move the cursor through the blank fields to the
first field of the next Medical Sign. When you have added all the Medical Signs,
press PAGE DOWN to save the record and move to the next blank record.
56 Sentinel Environmental Disease and Injury Management Information System Manual
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Figure 11-2: SHE(E) Data Entry Screens
Add Delete Edit.. Find puit
SHE(E) Code and Designator:
SHE(E) Name:
TYPE: Acute? Chronic? |
ROUTE: Contact? | Ingestion? |i
DEGREE: Severe? I Mild? §
Inhalation?
RECORD tttt of ###
PgDn - NEXT
PgUp - Previous
,^d,.:J|:lete Edit Find ..puit
SHE(E) Code and Designator:
SHE(E) Name: :
.Laboratory.. Results.:^.
ay
mi
is,
13
IS
•'Si
; •••••••••%
1
F»|
: Radiologic Findings:.
I
._...
''"'record'"''# # "6f"'Tfti""'
Adding a New SHE(E) to the Database 57
-------
11.2 Deleting or Editing an Existing SHE(E)
Deleting an Existing SHE(E)
• You may only delete one record at a time. You cannot delete SHE(E)s which are
caused by a chemical listed in the Chemicals database.
• You must find and display the record you wish to delete before proceeding with the
deleting process.
• Once you have displayed the appropriate record on the screen, use the arrow keys to
highlight Delete or type D and press ENTER.
• SEDIMIS displays a message box which asks you to confirm the deletion. The
default response is NO. Press ENTER or type N to accept the default and cancel the
deletion. Type Y or use the arrow keys to highlight YES and press ENTER to
confirm and proceed with the deletion.
Editing an Existing SHE(E)
• You must find and display the record you wish to edit before proceeding with
editing.
• Once you have displayed the appropriate record op the screen, use the arrow keys to
highlight Edit or type E and press ENTER. You may begin editing from either the
first or second screen of the record.
Figure 11-3: Editing and Navigating Keys Available
TAB or DOWN ARROW
Move the cursor forward to the beginning of the next field.
SHIFT-TAB or UP ARROW Move the cursor backward to the beginning of the previous field.
ENTER
Move the cursor forward to the beginning of the next field.
HOME
Move the cursor to the beginning of the current field.
END
Move the cursor to the space following the last character of the current field.
INSERT
Toggle between insert mode and typeover mode.
BACKSPACE
Deletes the character to the left of the cursor & moves the remaining characters left.
LEFT ARROW
Move the cursor one character to the left within the current field.
RIGHT ARROW
Move the cursor one character to the right within the current field.
PAGE DOWN
Saves the information added to the current record, clears the information and moves
the cursor to the first field in the next record to be added.
F1
Calls a help screen.
F6
Toggles the screen display between Screen 1 and Screen 2.
F10
Saves the information added to the current record, clears the screen and ends the
ADD function.
ESCAPE
Ends the ADD function but DOES NOT save the information added to the current
record. SEDIMIS displays a confirmation box before deleting any information.
58 Sentinel Environmental Disease and Injury Management Information System Manual
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• SEDIMIS moves the cursor to the first field on the screen. Use the keys listed in
Figure 11-3 to move the cursor through the fields to the ones you wish to change.
• When you change the data in a field, you must follow the proper format when you
enter the new information.
• When editing the Environmental Disease Category, you cannot enter the code from
the keyboard. You must press F2 to display the list of categories and selecting the
category from the list.
• To change a Medical Code (Symptom, Physical Sign, Laboratory Result or
Radiologic Finding) or any Qualifier associated with the Code, you must first erase
the existing data and then enter the new information.
Deleting or Editing a SHE(E) 59
-------
11.3 Finding SHE(E) Records
The Find function allows you to search the SHE(E) database for records which meet
specific criteria. You choose the data you wish to look for by selecting a specific Find
By function from the menu. The Find By options are:
• Code Number
• SHE(E) Name
• Type, Degree and/or Route of Exposure
• ICD-9 Code
• Environmental Disease Category
• Symptom
• Physical Sign
• Laboratory Result
• Radiologic Finding
• Defining Other Criteria
The final option allows you to design your own search by combining fields using Boolean
logic.
When selected, each of these options searches the SHE(E) database and places any
record(s) which meet the search criteria in a separate file. When the search is complete,
SEDIMIS displays this file for your review and editing. This function allows the system
administrator to quickly and easily locate records for updating and editing.
Searching on a Single Field
Each of the first nine options allows you to search for all SHE(E) records which share
a common description of some sort. These options allow you to search only on the
contents of a single field. They each operate in the same manner:
• Highlight Find on the SHE(E) Record Menu Bar and press ENTER to select it.
• Highlight the Find By option you wish use and press ENTER to select it
• SEDIMIS displays a blank SHE(E) record screen with the cursor in the appropriate
field. Enter the data you wish to search the database for. Some fields require you to
use the lists to enter data. Others give you the option of accessing the database lists
or typing the information. You may use the wildcard placeholders in some fields.
(See Figure 11-5 for definitions of the wildcards.) Specific information for entering
data in different fields follows.
60 Sentinel Environmental Disease and Injury Management Information System Manual
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Figure 11-4: Field Requirments
Code Number
Enter the Code Number and Designator. Press F2 to
access SHE(E) database. Wildcard placeholders may be
used.
SHE(E) Name
Enter the SHE(E) Name. Press F2 to access SHE(E)
database. Wildcard placeholders may be used.
Type, Degree and/or Route of Exposure
Type X in each box or press TAB to skip to the next box.
ICD-9 Code
Type the code in the entry box. Wildcard placeholders may
be used.
Environmental Disease Category
Choose the Environmental Disease Category from the
scrollbar menu.
Any of the Medical Codes
Press F2 to access the medical databases. You MUST
select the Medical Code from the list
• Press F10 to begin the search.
• SEDIMIS assembles and displays all records which meet the specified criteria. A
further option allows you to review and edit the displayed records.
Searching on Multiple Fields
The Other Criteria option allows you to define your own search using multiple fields and
Boolean logic. If you select this option, SEDIMIS displays a menu screen which includes
the following options:
CLEAR
GO
SCREEN
BOOLEAN
Clears any data from a previous search from the memory.
Begins a search.
Allows you to use the standard SHE(E) entry screen to
construct a search using any number of fields but only AND
logic.
Displays a special screen which allows you to construct a
search using any field and either AND, OR or AND NOT
logic.
To use the SCREEN option:
• Highlight CLEAR and press ENTER. This clears any data from a previous search
which may still be in memory.
Highlight SCREEN and press ENTER. SEDIMIS displays a blank SHE(E) entry
screen.
Finding SHE(E) Records 61
-------
Enter the data you wish to search for in the appropriate fields. You may use the
wildcard placeholders to broaden the search. (See Figure 11-4 for definitions of the
wildcards.) The SHE(E) database is available from certain fields. The top line on the
screen will display a message when you can access it. Press F2 for a listing. The
system searches for the data you enter using AND logic.
Press ESC to abort the entry process and return to the menu screen.
When you have entered all the search criteria, press F10 to return to the menu screen.
Highlight GO and press ENTER to begin the search.
use the BOOLEAN option:
Highlight CLEAR and press ENTER. This clears any data from a previous search
which may still be in memory.
Highlight BOOLEAN and press ENTER. SEDIMIS displays a blank search
construction screen.
The system displays a list of all the fields used in the SHE(E) database. Scroll
through the list to highlight the first field of your search and press ENTER to select
it. SEDIMIS writes its code in the FIELD column. Press ENTER to advance the
cursor to the VALUE column.
The system displays a list of all Figure 11-5: Wildcard Placeholders
database entries for that field.
Highlight the value you wish to search
for and press ENTER to select it; or,
press ESC and enter the value from
the keyboard. If you type the value,
you may use the wildcard placeholders to broaden the search. (See Figure 11-5 for
definitions of the wildcards.) After the value is written to the column, press ENTER
to advance the cursor to the OPERATION column.
The system displays a list of the operations available. (See Figure 11-6 for definitions
of the operators.) Highlight the appropriate symbol and press ENTER to select it.
Press ENTER to advance the cursor to the LOGIC field or press F10 to return to the
menu screen to begin the search.
Any number of characters may occupy the
position.
? Any one character may occupy the position.
Sentinel Environmental Disease and Injury Management Information System Manual
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Figure 11-6: Operation Options
Figure 11-7: Logic Options
AND A valid result must contain both
values.
OR A valid result can contain one or
both values.
AND NOT A valid result contains the first but
not the second value.
• Highlight the logic operator you wish
to use and press ENTER to select it.
See Figure 11-7 for available logic
operators. Press ENTER to advance to
• If you do not need to use the parentheses, press ENTER at each column to advance
the cursor. If you need them, enter the appropriate character ["(" or ")"] in its column
and press ENTER to advance the cursor.
• Repeat the preceding steps until you have entered the complete search and press F10
to return to the menu screen and press GO to begin the search.
=
Equivalent To
<>
Not Equal To
<
Less Than or Precedes in the Alphabet*
>
Greater Than or Follows in the
Alphabet*
<=
Less Than or Equal To*
>=
Greater Than or Equal To*
Although you may use these operations with
alphabetic characters, they are most useful with
the numeric TIP and RSVP categories.
the left parenthesis column.
Finding SHE(E) Records 63
-------
12.0 The Chemical Database
The Chemicals Database stores information on the health effects of SARA (Superfund
Amendments and Reauthorization Act of 1986) Title HI, Section 313 chemicals.
The Chemicals Database was assembled through searching the following resources:
• Hawley's Condensed Chemical Dictionary (N. Irving Sax and Richard J. Lewis);
• Dangerous Properties of Industrial Materials (N. Irving Sax and Richard J. Lewis);
• the National Library of Medicine's (NLM's) TOXNET Hazardous Substance Data
Bank (HSDB);
• the NLM's TOXNET Registry of Toxic effects of Chemicals (RTECS) Data Bank;
• the EPA's Toxic Release Inventory System (TRIS) Database of all chemicals released
by reporting facilities.
These resources were searched to locate as many compounds of the following chemicals:
Arsenic Compounds
Barium Compounds
Beryllium Compounds
Cadmium Compounds
Chlorophenols
Chromium Compounds
Cobalt Compounds
Copper Compounds
Cyanide Compounds
Glycol Ethers
Manganese Compounds
Nickel Compounds
Polybrominated Biphenyls (PBPs)
Selenium Compounds
Silver Compounds
Thallium Compounds
Zinc Compounds
You must be a Level 2 Security User in order to access the Chemicals Database.
The Chemicals Database contains the following information:
• each Section 313 Chemical's name;
• each Chemical's CAS identification number;
• the Human Health Effects of each Chemical;
• the Environmental Effects of each Chemical;
• the Sentinel Health Events (Environmental) [SHE(E)] caused by each Chemical.
Accessing the Chemicals Database
At the first screen, type M or use the arrow keys to highlight Maintenance and press
ENTER to select the option.
If you are a Level 1 Security (general) user, your only option from the Maintenance menu
will be to change your password. If you are a Level 2 Security (system administration)
64 Sentinel Environmental Disease and Injury Management Information System Manual
-------
user, you will have several options to choose from. To access the SHE(E) Database,
the arrow keys to highlight Chemical or type C and press ENTER.
The Chemicals Maintenance Menu Bar includes four options:
• ADD Add a new chemical to the SEDIMIS database.
• DELETE Delete an existing chemical from the database.
• EDIT Change the information stored about an existing chemical.
• FIND Create a subset of the database using one or more fields of interest
The Chemicals Database
-------
12.1 Adding a New Chemical to the Database
• See Figure 12-1 for the list of keys available for editing and navigating while adding
a record.
• Type A or use the arrow keys to highlight Add and press ENTER. SEDIMIS will
display a blank entry screen similar to Figure 12-2.
• Enter a unique Chemical Name in the first field. Chemical Names are limited to two
hundred and fifty-five (255) characters, including any blanks or hyphens. You may
enter the Name in either upper or lower case or a combination of the two. The
system will convert the Name to upper case except for the following reserved words:
aci-, alpha-, beta-, cis-, dl-, sec-, tert-, and trans-. Press ENTER when finished.
• Enter the unique CAS Number. The Number is limited to eleven (11) characters
including hyphens. The system will not accept blanks. You should enter the data in
the customary CAS format of IIIIIIIIIIII-ft#-#. Press ENTER when finished.
• Enter the Human Health Effect and Environmental Effect Data by pressing a Y or
N in the appropriate fields. If you pass over an empty field, SEDIMIS defaults to a
N in that field.
• Enter the SHE(E) Code(s). Press F2 to access the SHE(E) Database. Use the
UP/DOWN arrows or the PAGE UP/DOWN keys to scroll through the list. Highlight
the SHE(E) Name and Code and press ENTER to select it You may also type the
Code in directly. SHE(E) Codes are limited to eleven (11) characters (including
hyphens and blanks) and must be entered in the one of the following formats: ##
Figure 12-1: Editing and Navigating Keys Available
TAB or DOWN ARROW
Move the cursor forward to the beginning of the next field.
SHIFT-TAB or UP ARROW
Move the cursor backward to the beginning of the previous field.
ENTER
Move the cursor forward to the beginning of the next field.
HOME
Move the cursor to the beginning of the current field.
END
Move the cursor to the space following the last character of the current field.
INSERT
Toggle between insert mode and typeover mode.
BACKSPACE
Deletes the character to the left of the cursor & moves the remaining characters left.
LEFT ARROW
Move the cursor one character to the left within the current field.
RIGHT ARROW
Move the cursor one character to the right within the current field.
PAGE DOWN
Saves the information added to the current record, clears the information and moves
the cursor to the first field in the next record to be added.
F1
Calls a help screen.
F6
Toggles the screen display between Screen 1 and Screen 2.
F10
Saves the information added to the current record, clears the screen and ends the
ADD function.
ESCAPE
Ends the ADD function but DOES NOT save the information added to the current
record. SEDIMIS displays a confirmation box before deleting any information.
66 Sentinel Environmental Disease and Injury Management Information System Manual
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#### or ##-## IIIIIIIt. After the system writes the Code to the entry field, press
ENTER to move to the next field.
Figure 12-2: Chemical Data Entry Screen
Add Delete Edit, Find Quit .... . ...
|S ' ' CHEMICALS MANUFACTURED/USED/RELEASED'"
Chemical Name: , „ „
! CAS: >
!:¦; HUMAN HEALTH and ENVIRONMENTAL EFFECTS:
^ Carcinogenic: Human Genetic and Chromosomal Mutagen: gj
I
Developmentally Toxic: Reproductively Toxic:
£1
I
SENTINEL HEALTH EVENT (ENVIRONMENTAL) [SHE(E)] CODE NUMBER(S):
|i: Acutely Toxic: & Chronically Toxic: Neurotoxic: jp
# y. g; ;:
Environmentally Toxic: £; Bioaccumulative: y Persistent: &
E
^ is ^ a o cs m ml
: p-:
RECORD S78 of iSl'l PgDn - NEXT ' PgUp" - Previous"
Adding a New Chemical to the Database 67
-------
12.2 Deleting or Editing an Existing Chemical
Deleting an Existing Chemical
• You may only delete one record at a time. You cannot delete Chemicals which are
manufactured, used or discharged by reporting facilities.
• You must find and display the record you wish to delete before proceeding with the
deleting process.
• Once you have displayed the appropriate record on the screen, type D or use the
arrow keys to highlight Delete and press ENTER.
• SEDIMIS displays a message box which asks you to confirm the deletion. The
default response is NO. Press ENTER or type N to accept the default and cancel the
deletion. Type Y or use the arrow keys to highlight YES and press ENTER to
confirm and proceed with the deletion.
Editing an Existing Chemical
• You must find and display the record you wish to edit before proceeding with
editing.
• Once you have displayed the appropriate record on the screen, type E or use the
arrow keys to highlight Edit and press ENTER. You may begin editing from either
the first or second screen of the record.
Figure 12-3: Editing and Navigating Keys Available
TAB or DOWN ARROW
Move the cursor forward to the beginning of the next field.
SHIFT-TAB or UP ARROW
Move the cursor backward to the beginning of the previous field.
ENTER
Move the cursor forward to the beginning of the next field.
HOME
Move the cursor to the beginning of the current field.
END
Move the cursor to the space following the last character of the current field.
INSERT
Toggle between insert mode and typeover mode.
BACKSPACE
Deletes the character to the left of the cursor & moves the remaining characters left.
LEFT ARROW
Move the cursor one character to the left within the current field.
RIGHT ARROW
Move the cursor one character to the right within the current field.
PAGE DOWN
Saves the information added to the current record, clears the information and moves
the cursor to the first field in the next record to be added.
F1
Calls a help screen.
F6
Toggles the screen display between Screen 1 and Screen 2.
F10
Saves the information added to the current record, clears the screen and ends the
ADD function.
ESCAPE
Ends the ADD function but DOES NOT save the information added to the current
record. SEDIMIS displays a confirmation box before deleting any information.
68 Sentinel Environmental Disease and Injury Management Information System Manual
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• SEDIMIS moves the cursor to the first field on the screen. Use the keys listed in
Figure 12-3 to move the cursor through the fields to the ones you wish to change.
• When you change the data in a field, you must follow the proper format when you
enter the new information.
Deleting or Editing a Chemical 69
-------
12.3 Finding Chemical Records
The Find function allows you to search the Chemical database for records which meet
specific criteria. You choose the data you wish to look for by selecting a specific Find
By function from the menu. The Find By options are:
• Name
• CAS Number
• Human Health Effect(s)
• Environmental Effect(s)
• Sentinel Health Event(s)
• Defining Other Criteria
The final option allows you to design your own search by combining fields using Boolean
logic.
When selected, each of these options searches the Chemical database and places any
record(s) which meet the search criteria in a separate file. When the search is complete,
SEDIMIS displays this file for your review and editing. This function allows the system
administrator to quickly and easily locate records for updating and editing.
Searching on a Single Field
Each of the first five options allows you to search for all Chemical records which share
a common description of some sort. These options allow you to search only on the
contents of a single field. They each operate in the same manner:
Highlight Find on the SHE(E) Record Menu Bar and press ENTER to select it.
• Highlight the Find By option you wish use and press ENTER to select it
• SEDIMIS displays a blank Chemical record screen with the cursor in the appropriate
field. Enter the data you wish to search the database for. Some fields require you to
use the lists to enter data. Others give you the option of accessing the database lists
or typing the information. You may use the wildcard placeholders in some fields.
(See Figure 12-5 for definitions of the wildcards.) Specific information for entering
data in different fields follows.
70 Sentinel Environmental Disease and Injury Management Information System Manual
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Figure 12-4: Field Requirements
Chemical Name
Enter the Name. Press F2 to access Chemical database. Wildcard
placeholders may be used.
CAS Number
Enter the CAS Number. Press F2 to access the Chemical database.
Wildcard placeholders may be used.
Human Health Effect(s)
Type X in each box or press TAB to skip to the next box.
Environmental Effect(s)
Type X in each box or press TAB to skip to the next box.
Sentinel Health Effect(s)
Type the SHE(E) Code or press F2 to access the SHE(E) database.
Wildcard placeholders may be used.
Press F10 to begin the search.
SEDIMIS assembles and displays all records which meet the specified criteria. A
further option allows you to review and edit the displayed records.
Searching on Multiple Fields
The Other Criteria option allows you to define your own search using multiple fields and
Boolean logic. If you select this option, SEDIMIS displays a menu screen which includes
the following options:
CLEAR
GO
SCREEN
BOOLEAN
Clears any data from a previous search from the memory.
Begins a search.
Allows you to use the standard Chemical database entry
screen to construct a search using any number of fields but
only AND logic.
Displays a special screen which allows you to construct a
search using any field and either AND, OR or AND NOT
logic.
To use the SCREEN option:
• Highlight CLEAR and press ENTER. This clears any data from a previous search
which may still be in memory.
• Highlight SCREEN and press ENTER. SEDIMIS displays a blank Chemical entry
screen.
• Enter the data you wish to search for in the appropriate fields. You may use the
wildcard placeholders to broaden the search. (See Figure 12-4 for definitions of the
wildcards.) The Chemical or SHE(E) databases are available from certain fields. The
top line on the screen will display a message when you can access either one. Press
F2 for a listing. The system searches for the data you enter using AND logic.
Finding Chemical Records 71
-------
Press ESC to abort the entry process and return to the menu screen.
When you have entered all the search criteria, press F10 to return to the menu screen.
Highlight GO and press ENTER to begin the search.
use the BOOLEAN option:
Highlight CLEAR and press ENTER. This clears any data from a previous search
which may still be in memory.
Highlight BOOLEAN and press ENTER. SEDIMIS displays a blank search
construction screen.
The system displays a list of all the fields used in the Chemical database. Scroll
through the list to highlight the first field of your search and press ENTER to select
it. SEDIMIS writes its code in the FIELD column. Press ENTER to advance the
cursor to the VALUE column.
The system displays a list of all
database entries for that field.
Highlight the value you wish to search
for and press ENTER to select it; or,
press ESC and enter'the value from
the keyboard. If you type the value, you may use the wildcard placeholders to
broaden the search. (See Figure 12-5 for definitions of the wildcards.) After the value
is written to the column, press ENTER to advance the cursor to the OPERATION
column.
Figure 12-5: Wildcard Placeholders
Any number of characters may occupy the
position.
? Any one character may occupy the position.
The system displays a list of the
operations available. (See Figure 12-6
for definitions of the operators.)
Highlight the appropriate symbol and
press ENTER to select it. Press
ENTER to advance the cursor to the
LOGIC field or press F10 to return to
the menu screen to begin the search.
Figure 12-6: Operation Options
Equivalent To
<> Not Equal To
< Less Than or Precedes in the Alphabet*
> Greater Than or Follows in the
Alphabet*
<= Less Than or Equal To*
>= Greater Than or Equal To*
Although you may use these operations with
alphabetic characters, they are most useful with
the numeric TIP and RSVP categories.
Highlight the logic operator you wish to use and press ENTER to select it. See
Figure 12-7 for available logic operators. Press ENTER to advance to the left
parenthesis column.
Sentinel Environmental Disease and Injury Management Information System Manual
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• If you do not need to use the
parentheses, press ENTER at each
column to advance the cursor. If you
need them, enter the appropriate
character ["(" or ")"] in its column and
press ENTER to advance the cursor.
• Repeat the preceding steps until you ha
to return to the menu screen and press
Figure 12-7: Logic Options
AND A valid result must contain both
values.
OR A valid result can contain one or both
values.
AND NOT A valid result may contain one but not
both values.
entered the complete search and press F10
0 to begin the search.
Finding Chemical Records 73
-------
SEDEMIS v.1.5
Disk 1 of 2
Sentinel Environmental Disease
and
Injury Management Information System
For installation instructions insert Disk 1
and type:
A: TYPE SEDIMIS.NTO
and press
U.S. Environmental Protection Agency
Region IV
EPA ?2./l0( A
-------
rzmm
SEDIMIS v.1.5
Disk 2 of 2
Sentinel Environmental Disease
and
Injury Management Information System
For installation instructions insert Disk 1
and type:
A: TYPE SEDEVHS.NFO
and press
U.S. Environmental Protection Agency
Region IV
70YA-U/iOi A
wa woe g^UtfWjd.oa *-
6S>s/o//f&aQ3a;Ouo/»y-
niMimtirfA
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