Risk Note E
Substances with specific effects on human health (see Chapter 4 of Annex VI to Commission Directive 98/98/EC) that are classified as carcinogenic, mutagenic and/or toxic for reproduction in categories 1 or 2 are ascribed Note E if they are also classified as very toxic (T+), toxic (T) or harmful (Xn). For these substances, the risk phrases RŲ20, RŲ21, RŲ22, RŲ23, RŲ24, RŲ25, RŲ26, RŲ27, RŲ28, RŲ39, RŲ40, RŲ48 and RŲ65 and all combinations of these risk phrases shall be preceded by the word "Also''.
Example: R 45-23 "May cause cancer. Also toxic by inhalation''