Documented historical occupational exposure as a career firefighter (≥10 years in active...

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

ID	`RF-OCC-FIREFIGHTER-PREVENTION`
Type	Red flag
Status	reviewed 2026-05-18 \| pending_clinical_signoff
Diseases	`DIS-CRC` `DIS-MELANOMA` `DIS-MESOTHELIOMA` `DIS-NSCLC` `DIS-SCLC` `DIS-UROTHELIAL`
Sources	`SRC-NCCN-BCELL-2025` `SRC-NCCN-NSCLC-2025`

Red Flag Origin

Definition	Documented historical occupational exposure as a career firefighter (≥10 years in active fire-suppression / overhaul roles) — including municipal / structural firefighters, wildland firefighters, military / industrial / airport-rescue firefighters — in an individual without a current firefighter-attributable malignancy diagnosis. IARC re-classified "Occupational exposure as a firefighter" as a Group 1 carcinogen (Monograph 132, 2022) based on sufficient evidence for bladder cancer and mesothelioma and limited / suggestive evidence for prostate cancer, colon cancer, melanoma, non-Hodgkin lymphoma, and testicular cancer. Mixed-exposure hazards include products of combustion (PAHs, benzene, formaldehyde, particulate matter), asbestos exposure during overhaul of pre-regulation structures, and diesel-exhaust exposure from apparatus / station ventilation. There is NO curative intervention for...
Clinical direction	investigate
Category	other

Trigger Logic

{
  "any_of": [
    {
      "finding": "occupational_firefighter_career_documented",
      "value": true
    },
    {
      "finding": "occupational_firefighter_years_ge_10",
      "value": true
    }
  ],
  "type": "lab_value"
}

Notes

Prevention-persona RedFlag — v0.3 occupational batch-2 pilot. Fires when patient profile carries documented ≥10 years career-firefighter exposure AND no confirmed firefighter-attributable malignancy diagnosis. Engine routes to 2-track PreventionPlan: (a) IND-OCC-FIREFIGHTER-PREVENTION-INTENSIFIED-SURVEILLANCE (standard) — USPSTF-modified LDCT chest screening (career-firefighter extension to lower pack-year threshold); annual dermatology consultation with full-skin exam; GI screening eligibility from age 45 (NCCN average-risk guideline) with consideration of earlier initiation per firefighter-cohort guidance; urinalysis q1-2y; PPE / post- fire decontamination counseling for active firefighters. (b) IND-OCC-FIREFIGHTER-PREVENTION-OBSERVATION (surveillance) — routine general-population screening only; patient declines firefighter-specific intensified surveillance. Trigger findings are computed booleans from occupational-history intake at the patient-profile layer. Evidence base: IARC Monograph 132 (2022); LeMasters et al. 2006 meta-analysis; Daniels et al. 2014 NIOSH career-firefighter cohort. Bladder cancer SMR ~1.3-1.5; mesothelioma SMR ~2x (asbestos- overhaul-attributable); melano...

Used By

Indications

IND-OCC-FIREFIGHTER-PREVENTION-INTENSIFIED-SURVEILLANCE - IND-OCC-FIREFIGHTER-PREVENTION-INTENSIFIED-SURVEILLANCE
IND-OCC-FIREFIGHTER-PREVENTION-OBSERVATION - IND-OCC-FIREFIGHTER-PREVENTION-OBSERVATION