Chronic residential ambient air-pollution exposure with PM2.5 annual average >35 µg/m³ (W...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

ID	`RF-ENVIRONMENTAL-AIR-POLLUTION-LUNG-PREVENTION`
Type	Red flag
Status	reviewed 2026-05-18 \| pending_clinical_signoff
Diseases	`DIS-NSCLC`
Sources	`SRC-NCCN-BCELL-2025` `SRC-NCCN-NSCLC-2025`

Red Flag Origin

Definition	Chronic residential ambient air-pollution exposure with PM2.5 annual average >35 µg/m³ (WHO 2021 Interim Target 1; WHO Guideline target 5 µg/m³ annual mean is the long-term benchmark). Outdoor air pollution (specifically PM2.5 + diesel exhaust components) is an IARC Group 1 carcinogen (Monograph 109, 2013; reaffirmed Monograph 133 process) — established etiologic driver of lung cancer (both NSCLC adenocarcinoma + squamous-cell), with population-attributable fraction estimated 3-5% globally + higher in high-exposure regions. Meta-analyses (Hamra 2014; Pope 2020): each 10 µg/m³ increment in PM2.5 raises lung-cancer incidence by ~9% (RR ~1.09). Mechanisms: carbonaceous particle deposition in alveolar / small-airway epithelium; oxidative + inflammatory injury; transition-metal + PAH content as direct mutagens; KRAS/EGFR mutation enrichment in PM2.5-exposed non-smoker adenocarcinoma cohorts...
Clinical direction	investigate
Category	other

Trigger Logic

{
  "any_of": [
    {
      "finding": "residential_pm2_5_annual_average_gt_35",
      "value": true
    },
    {
      "finding": "high_traffic_density_residence",
      "value": true
    },
    {
      "finding": "industrial_air_pollution_zone_residence",
      "value": true
    }
  ],
  "type": "lab_value"
}

Notes

Prevention-persona RedFlag for chronic residential PM2.5 >35 µg/m³ annual average (WHO 2021 IT-1). IARC Group 1 outdoor air pollution + PM. Population-attributable fraction modest individually but large absolute burden in high-exposure regions including industrial Ukraine + during war-related fire / debris events. risk_category=occupational is the closest enum match — schema lacks an explicit 'environmental' enum (§20 ratification pending). Engine routes to PreventionPlan recommending exposure reduction + USPSTF lung-cancer screening eligibility + symptom-triggered evaluation. STUB pending two-Clinical-Co-Lead signoff per CHARTER §6.1 dev-mode.

Used By

Indications

IND-ENVIRONMENTAL-AIR-POLLUTION-LUNG-PREVENTION-MITIGATION - IND-ENVIRONMENTAL-AIR-POLLUTION-LUNG-PREVENTION-MITIGATION
IND-ENVIRONMENTAL-AIR-POLLUTION-LUNG-PREVENTION-OBSERVATION - IND-ENVIRONMENTAL-AIR-POLLUTION-LUNG-PREVENTION-OBSERVATION