Authors: Marijke W. de Kleijn de Vrankrijker and Stephanie A. Valk



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WORLD HEALTH ORGANIZATION WHO/HFS/CAS/C/03.33 Distr.: LIMITED ENGLISH ONLY MEETING OF WHO COLLABORATING CENTRES FOR THE FAMILY OF INTERNATIONAL CLASSIFICATIONS Cologne, Germany 19-25 October 2003 Title: ISO 9999 submission to the WHO-FIC Authors: Marijke W. de Kleijn de Vrankrijker and Stephanie A. Valk Purpose: for decision Recommendations: to accept ISO 9999 as a related member of the WHO Family of International Classifications Abstract During the Heads of centres meeting last October 2002 in Brisbane a paper has been presented concerning the International classification of technical aids for persons with disabilities, ISO 9999 (paper nr WHO/GPE/CAS/02.91). Aim of the presentation was to explore the usefulness of the classification as a related member of the family of international classifications. The meeting welcomed the information about the classification, concluded it has a place within the matrix for the WHO-FIC and agreed that its relations with the ICF are very clear. For those reasons it was agreed that report be presented to the meeting in 2003 together with a submission for membership according to the protocol and a clear description of the relationship to the ICF. In its meeting last November 2002 in Japan the responsible ISO committee (ISO/TC 173/SC2) agreed to prepare a report to the WHO HOC meeting 2003 including a description of the relationship between ISO 9999 and ICF (such as use of terms and definitions of ICF in the ISO 9999 introduction instead of ICIDH definitions). In its meeting last April 2003 in Leiden the FDC welcomed the reported developments of the classification and is keen to see the results of the survey concerning the use of the classification in countries with the WHO-FIC protocol. Aim of the presentation in Cologne is to provide the basic information for a decision upon the admission of ISO 9999 as a related member of the WHO-FIC. 1

Introduction The ISO 9999 Classification of technical aids for persons with disabilities is developed by the ISO (International Organization for Standardization). The International Standard establishes a classification of technical aids for persons with disabilities, especially produced or generally available. It is restricted to technical aids intended mainly for the use by an individual. Technical aids used by a person with a disability and which require the assistance of a helper for their operation, are included in the classification. Technical aids used by professionals only are excluded. Technical aids (including software) are being classified according to their function. The classification consists of three hierarchical levels and the codes consist of three groups of two digits each. Like other classifications, for each level codes, titles, explanatory notes inclusions, exclusions, cross-references are given. Besides the explanatory text and the classification itself, a conversion table between 2 nd and 3 rd editions of the standard and an alphabetical index are provided in order to facilitate the use and to improve the accessibility of the classification. Short summary of the history of ISO 9999 In 1983 a first meeting was arranged to set up an international classification system for technical aids by the ISO/TC173 SC2. Basis for the work was the Nordic classification System, which was already adopted as common classification system on technical aids for handicapped people in 1981. The first publication of ISO 9999 was in April 1992 with an integral approval by CEN of ISO 9999 as EN 29999:1994. The ISO/TC173 SC 2 had agreed that the ISO 9999 should be revised periodically. At the moment the latest (third) edition published is the ISO 9999:2002 and the ISO/TC173 SC2 is working on the revision of this document (fourth edition). Chapters The first level of classification consists of eleven chapters: Aids for personal medical treatment Aids for training in skills Orthoses and protheses Aids for personal care and protection Aids for personal mobility Aids for housekeeping Furnishing and adaptation to homes and other premises Aids for communication, information Aids handling products and goods Aids for equipment for environmental improvement, tools and machines Aids for recreation Use The ISO is accepted as national standard and in use in several countries. The classification is available in the formal languages of ISO and CEN being English, 2

German, and French. Being CEN standard means that EU countries have to apply the classification. The classification is besides the CEN languages also available in several other languages (such as Nordic, Dutch, Spanish and Japanese). The ISO 9999 classification is integrated in several information systems. The ISO 9999 is used in storing and distribution systems to keep the general view over the equipment in centres for technical aids. The standard is also used to classify technical aids in the process of evaluation to make contracts with the suppliers and for statistical purposes. The ISO secretariat is now producing a database of the ISO 9999 classification in Access-format. In this way, the classification can be managed better when changes have to be made. The database can also be implemented in information systems. ICF and WHO-FIC relationship The relationship between ISO 9999 and the ICF can be recognized in three areas: - In the introduction and the set of definitions use is made of ICF terminology. - On the decision level references to the ICF will be made in the new edition of the ISO 9999 with code and title. An ICF-reference will be made in those situations were the technical aid is enhancing the personal situations. An example is added to this paper in annex 1. - Technical aids are part of the environment, so ISO 9999 can be seen as a more specific and more detailed classification in addition to the E-list of ICF. Relation to the WHO Family of International Classifications is shown in the matrix in Table 1. Acceptance as a related member of the WHO-FIC We hope this information including the registration form in annex 2 will be sufficient for a decision about the status of the ISO 9999 as a related member of the WHO-FIC. The classification will keep its status as an ISO Standard as well. 3

References Technical aids for persons with disabilities Classification and terminology International Standard, ISO 9999, third edition 2002-10-15, reference number ISO 9999:2002(E) ISO, Geneva, 2002 Technical aids for persons with disabilities Classification and terminology (ISO 9999:2002) European Standard, EN ISO 9999, ref.no EN ISO 9999:2002 E Annexes Table 1 The World Health Organization Family of International Classifications (matrix) Annex 1 Example of ICF references in ISO 9999 next version class 27 Annex 2 ISO 9999 registration form 4

Table 1 The World Health Organization Family of International Classifications Area of Application Factors influence health and well Health and well being Interventions / Services Resources being 1 Environmental Personal Health Condition / disease/ problem Functioning and disability Prevention 3 Assessment/ diagnostic Therapeutic Maintenance 4 Research, Evaluation Monitoring, Other information, Financial, Material, Human Mortality (cause of death) Self report eg. Population health survey and reason for encounter Population and Environmental health Primary Care 5 - General practice - Emergency - Other Acute hospital admissions Specialised care 2 (residential or non-residential) ICD-10 ISO 9999 classifications of ICF, ISO 9999 ISO 9999 ICD-10 ISO 9999 ISO 9999 ISO 9999 ISO 9999 factors have not ICD-10 ICF ISO 9999 The United Nations maintains a range of variables relevant to this, including Industry and Occupation. These standard classifications, or classifications which are compatible with them, are to be used in health data collection. Some personal been defined and classified e.g. genetic profile or coping styles. - - - ISO 9999 ISO 9999 ISO 9999 ISO 9999 The United Nations maintains classifications of a range of variables relevant to these, including Industry and Occupation. These standard classifications, or classifications which are compatible with them, are to be used in health data collection. 5

Annex 1 Example of ICF References in ISO 9999, Class 27 27 Aids and equipment for environmental improvement, tools and machines Devices and equipment that helps improving personal environment in daily life, manually operated tools and powered machines Excluded is equipment to use for improvement of global environment 27 03 Aids for environmental improvement Non-personal devices that protect a person from adverse environmental influences e 1501 Design, construction and building products and technology for gaining access to facilities inside buildings for public use; e 1551 Design, construction and building products and technology for gaining access to facilities in buildings for private use 27 03 03 Aids for climate control (temperature, humidity, ventilation), e.g. humidifiers Devices that regulate the internal climatic features of a confined space e225 Climate; b550 Thermoregulatory functions; b 270 Sensory functions related to temperature and other stimuli 27 03 06 Air-cleaners Devices that remove pollutants from the air e260 air quality; b435 Immunological system functions;b440 Respiration functions 27 03 09 Aids for noise reduction Devices or materials that control or absorb noise e 250 Sound; b230 Hearing functions. 27 03 12 Aids to reduce vibrations Devices or materials that dampen vibrations e255 vibration 27 03 15 Aids for illumination control Devices that regulate the lighting conditions Light fixtures, see 18 06 Operating controls and devices, see 24 09 e240 light; b210 Seeing functions 27 03 18 Water-purifiers and water-softeners Devices or materials that purify or soften water Aids for dialysis therapy, see 04 15 e5300 utilities services 6

TITLE PURPOSE/DEFINITION OF THE CLASSIFICATION CLASSIFICATION STRUCTURE Annex 2 Registration form ISO 9999 Technical aids for persons with disabilities Classification and Terminology The international Standard establishes a classification of technical aids for persons with disabilities. It is restricted to technical aids intended mainly for the use of an individual. The classification consists of three hierarchical levels, termed classes, subclasses and divisions respectively. Each class, subclass or division consists of a code, a term and if necessary an explanatory note and/or reference to other part parts of the classification or the ICF. REVISION STATUS The ISO 9999 is being under revision at the moment, the publication of that version will be in January 2006 Year first published 1998 Years between revisions Three revisions Year of last revision 2002 Latest revision number ISO 9999: 2002 AVALABLE INDEXES AVAILABLE FORMATS Languages CD-ROM Alphabetical and analytical index PDF-format; Acces-version is under construction The formal languages of ISO being English, German, and French. The classification is also available in several other languages (such as Nordic, Dutch, Spanish, Japanese). TRAINING AND TRAINING MATERIALS RELATIONSHIPS WITH OTHER CLASSIFICATIONS Correspondence between revisions Correspondence with international, multinational, national classifications Relationships conceptual, structural and other pertinent RELATIONSHIPS WITH OTHER TERMINOLOGIES CUSTODIAN Person or organisation with responsibility for maintenance and updating the classification PROMOTER Person or organisation promoting the use of the classification INQUIRIES CONTACT ISO 9999 Annex A: Conversion table between 2 nd and 3 rd editions (1998 and 2002 respectively) Terminology of ICF is used. ISO 1087 (all parts), Terminology work - Vocabulary Terminology of the ICF is used in the introduction and definitions ISO TC 173, Technical systems and aids for disabled or handicapped persons, Subcommittee 2, Classification and terminology www.iso.ch ISO TC 173, Technical systems and aids for disabled or handicapped persons, Subcommittee 2, Classification and terminology www.iso.ch ISO TC173/SC2 Secretary: Stephanie Valk NEN P.O.Box 5059 2600 AX Delft The Netherlands Stephanie.valk@nen.nl 7