Evaluation of LOINC semantic coverage for coding clinical observations related to environmental influenced diseases

Terminology standards ensure semantic interoperability by allowing efficient exchange and pool of data coming from many idiosyncratic sources. This is especially true when operating among multiple domains that are connected to each other through different kinds of semantic relationships. Environment and health are strictly related domains, as the first one produces a variety of effects on the second one. While terminologies exist for coding and classifying almost all the aspects of the healthcare process (actors, products, observations, etc.), a specific one focused on environmental related or caused health problems has not yet been developed. Nonetheless, concepts related to the link between the two domains can be found in different standards. Among them, Logical Observation Identifiers Names and Codes (LOINC®) is the most widely used for identifying parameters connected to clinical conditions. Considering this, the work presented in this paper aims to: 1) identify a subset of existing LOINC codes of clinical observations influenced or related to environmental factors; 2) search for environmental concepts not covered by LOINC in the UMLS Metathesaurus to see if they are covered and how they are expressed in other medical terminologies; and consequently 3) detect LOINC concept gaps related to the link between environment and health to be filled by proposing new LOINC terms for standardizing identified clinical parameters.