Documented historical occupational exposure to hardwood dust (oak, beech, mahogany, walnu...

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

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

Red Flag Origin

Definition	Documented historical occupational exposure to hardwood dust (oak, beech, mahogany, walnut, teak) or leather dust — typical high-risk occupations include cabinetmakers, furniture manufacturing / woodworking-shop workers, parquet flooring installers, sawmill workers in hardwood operations, and leather / shoe / boot manufacturing workers (tanning, cutting, finishing) — in an individual without a current dust-associated malignancy diagnosis. Hardwood dust and leather dust are IARC Group 1 carcinogens (Monograph 100C, 2012), with the strongest epidemiologic association being sinonasal adenocarcinoma (a rare histologic subtype of head & neck cancer with near-pathognomonic association in heavily-exposed woodworkers). Latency is typically ≥30-40 years from first exposure; the rarity of sinonasal adenocarcinoma at general-population baseline means occupational attribution is particularly clean....
Clinical direction	investigate
Category	other

Trigger Logic

{
  "any_of": [
    {
      "finding": "occupational_hardwood_dust_exposure_documented",
      "value": true
    },
    {
      "finding": "occupational_leather_dust_exposure_documented",
      "value": true
    }
  ],
  "type": "lab_value"
}

Notes

Prevention-persona RedFlag — v0.3 occupational batch-2 pilot. Fires when patient profile carries documented prior occupational hardwood or leather-dust exposure AND no confirmed dust-attributable malignancy diagnosis. Engine routes to 2-track PreventionPlan: (a) IND-OCC-WOOD-LEATHER-DUST-PREVENTION-INTENSIFIED-SURVEILLANCE (standard) — annual ENT consultation with symptom-review (unilateral nasal obstruction, epistaxis, anosmia, facial pain); low-threshold CT sinus if persistent unilateral symptoms develop; PPE counseling if active exposure persists. (b) IND-OCC-WOOD-LEATHER-DUST-PREVENTION-OBSERVATION (surveillance) — routine general-population care; patient declines annual ENT consultation but receives symptom-triggered evaluation. Trigger findings are computed booleans from occupational-history intake at the patient-profile layer. Evidence base: IARC Monograph 100C (2012); Hayes et al. 1986 (Netherlands woodworkers cohort); Demers et al. 1995 (international pooled woodworker analysis). Sinonasal adenocarcinoma SMR ~50-900x baseline in heavily-exposed cohorts depending on cumulative dose and species (hardwood >> softwood). Sources TODO: IARC Monograph 100C (2012) as a new SRC en...

Used By

Indications

IND-OCC-WOOD-LEATHER-DUST-PREVENTION-INTENSIFIED-SURVEILLANCE - IND-OCC-WOOD-LEATHER-DUST-PREVENTION-INTENSIFIED-SURVEILLANCE
IND-OCC-WOOD-LEATHER-DUST-PREVENTION-OBSERVATION - IND-OCC-WOOD-LEATHER-DUST-PREVENTION-OBSERVATION