Documented historical occupational exposure to formaldehyde (gaseous HCHO and aqueous for...

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

ID	`RF-OCC-FORMALDEHYDE-PREVENTION`
Type	Red flag
Status	reviewed 2026-05-18 \| pending_clinical_signoff
Diseases	`DIS-AML` `DIS-HNSCC`
Sources	`SRC-NCCN-AML-2025` `SRC-NCCN-BCELL-2025`

Red Flag Origin

Definition	Documented historical occupational exposure to formaldehyde (gaseous HCHO and aqueous formalin) — typical high-risk occupations include anatomical pathologists, autopsy technicians, embalmers / funeral- service workers, histology laboratory personnel, particleboard / plywood / MDF manufacturing workers, textile / garment workers handling formaldehyde-treated fabrics, and resin / plastics industry workers — in an individual without a current formaldehyde-associated malignancy diagnosis. Formaldehyde is an IARC Group 1 carcinogen (Monograph 100F, 2012) — established etiologic driver of nasopharyngeal carcinoma (primary endpoint) and myeloid leukemia (AML; sinonasal cancer is also Group-1-associated). Latency from first exposure to nasopharyngeal carcinoma is typically 20-40 years; latency to AML is shorter (5-15 years). There is NO curative intervention for prior exposure — exposure cessa...
Clinical direction	investigate
Category	other

Trigger Logic

{
  "any_of": [
    {
      "finding": "occupational_formaldehyde_exposure_documented",
      "value": true
    },
    {
      "finding": "occupational_formaldehyde_exposure_years_ge_10",
      "value": true
    }
  ],
  "type": "lab_value"
}

Notes

Prevention-persona RedFlag — v0.3 occupational batch-2 pilot. Fires when patient profile carries documented prior occupational formaldehyde exposure AND no confirmed formaldehyde-attributable malignancy diagnosis. Engine routes to 2-track PreventionPlan: (a) IND-OCC-FORMALDEHYDE-PREVENTION-INTENSIFIED-SURVEILLANCE (standard) — CBC q1y for leukemia surveillance; ENT symptom- awareness counseling (epistaxis, unilateral nasal obstruction, recurrent sinusitis, anosmia) with low-threshold ENT referral if symptoms develop; PPE counseling if active exposure persists. (b) IND-OCC-FORMALDEHYDE-PREVENTION-OBSERVATION (surveillance) — routine general-population care; patient declines structured CBC + ENT surveillance. Trigger findings are computed booleans from occupational-history intake at the patient-profile layer. Evidence base: IARC Monograph 100F (2012); Hauptmann et al. 2009 (NCI formaldehyde-exposed industry cohort — nasopharyngeal + leukemia excess); Beane Freeman et al. 2009 (NCI mortality follow-up). Nasopharyngeal RR ~1.8-2.1 in high-exposure cohorts; AML RR ~1.3-2.0. Sources TODO: IARC Monograph 100F (2012) as a new SRC entity. v0.3 source-authoring backlog. STUB pending two-Cli...

Used By

Indications

IND-OCC-FORMALDEHYDE-PREVENTION-INTENSIFIED-SURVEILLANCE - IND-OCC-FORMALDEHYDE-PREVENTION-INTENSIFIED-SURVEILLANCE
IND-OCC-FORMALDEHYDE-PREVENTION-OBSERVATION - IND-OCC-FORMALDEHYDE-PREVENTION-OBSERVATION