Documented historical occupational exposure to asbestos fibres (chrysotile, amosite, croc...

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

ID	`RF-OCC-ASBESTOS-MALIGNANCY-PREVENTION`
Type	Red flag
Status	reviewed 2026-05-18 \| pending_clinical_signoff
Diseases	`DIS-MESOTHELIOMA` `DIS-NSCLC` `DIS-OVARIAN` `DIS-SCLC`
Sources	`SRC-ESMO-NSCLC-EARLY-2024` `SRC-NCCN-NSCLC-2025` `SRC-NCCN-SCLC-2025`

Red Flag Origin

Definition	Documented historical occupational exposure to asbestos fibres (chrysotile, amosite, crocidolite, anthophyllite, tremolite, actinolite) in an individual without a current asbestos-associated malignancy diagnosis. Classic high-risk occupations: shipyard workers, insulators, boilermakers, pipefitters, asbestos-cement manufacture / installation, brake-lining manufacture / repair, demolition / construction trades pre-regulation, miners and millers of asbestos ore. Asbestos is an IARC Group 1 carcinogen — established etiological driver of malignant mesothelioma (pleural and peritoneal), lung cancer (synergistic with tobacco — multiplicative risk), and (per the 2012 IARC Monograph 100C update) ovarian and laryngeal cancer. Latency from first exposure to mesothelioma is typically 20-50 years; lung-cancer latency is shorter (10-30 years) and cumulative-dose- and smoking-dependent. There is NO c...
Clinical direction	investigate
Category	other

Trigger Logic

{
  "any_of": [
    {
      "finding": "occupational_asbestos_exposure_documented",
      "value": true
    },
    {
      "finding": "occupational_asbestos_exposure_years_ge_5",
      "value": true
    }
  ],
  "type": "lab_value"
}

Notes

Prevention-persona RedFlag — v0.3 occupational/environmental pilot starter (CHARTER §3 prevention scope, ratified 2026-05-18 Path A, HCP-mediated). Fires when patient profile carries documented prior occupational asbestos exposure AND no confirmed asbestos-associated malignancy diagnosis. Engine routes such patients to a 2-track PreventionPlan: (a) IND-OCC-ASBESTOS-PREVENTION-INTENSIFIED-SURVEILLANCE (standard) — counseling on exposure cessation (typically irrelevant for retired / non-active workers), smoking- cessation counseling (paramount due to multiplicative lung- cancer synergy), annual LDCT chest from 10-20 years post first exposure adjusted by smoking status, discussion of pleural surveillance. (b) IND-OCC-ASBESTOS-PREVENTION-OBSERVATION (surveillance) — routine general-population screening only; patient declines intensified imaging surveillance for any reason (cost, radiation concerns, anxiety, preference). Trigger findings are computed booleans from occupational-history intake at the patient-profile layer (FHIR Patient + Observation / Condition extensions; computation pipeline downstream of KB and not yet implemented). Evidence base (IARC Monograph 100C 2012; LeMasters e...

Used By

Indications

IND-OCC-ASBESTOS-PREVENTION-INTENSIFIED-SURVEILLANCE - IND-OCC-ASBESTOS-PREVENTION-INTENSIFIED-SURVEILLANCE
IND-OCC-ASBESTOS-PREVENTION-OBSERVATION - IND-OCC-ASBESTOS-PREVENTION-OBSERVATION