Patient with documented ≥2 distinct IARC Group 1 occupational carcinogen exposures during...

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

ID	`RF-UNIVERSAL-OCCUPATIONAL-EXPOSURE-MULTIPLE`
Type	Red flag
Status	reviewed 2026-05-18 \| pending_clinical_signoff
Diseases	None declared
Sources	`SRC-IARC-100C-ASBESTOS` `SRC-IARC-100D-RADON` `SRC-IARC-100F-BENZENE` `SRC-IARC-105-DIESEL-EXHAUST` `SRC-USPSTF-LUNG-LDCT-2021`

Red Flag Origin

Definition	Patient with documented ≥2 distinct IARC Group 1 occupational carcinogen exposures during working life. Examples of synergistic paired exposures: asbestos + tobacco smoking (lung-cancer relative risk ~50-90 in combined cohort vs ~5 for tobacco alone, ~5 for asbestos alone — supra-multiplicative interaction at low asbestos doses); benzene + radon; polycyclic-aromatic-hydrocarbon (PAH) exposure + tobacco; diesel-exhaust + silica; formaldehyde + wood- dust in joinery / cabinetmaking; ionizing-radiation + tobacco (lung carcinogenesis); painter / coke-oven / aluminum-smelter worker + tobacco. IARC Monographs Volumes 100A-F + 105 (diesel) + 132 (firefighting) document the individual Group 1 status and the WHO REACH database documents the synergistic combinations. Universal RedFlag (relevant_diseases ["*"]) — fires only when the occupational-history questionnaire documents ≥2 distinct Group 1...
Clinical direction	investigate
Category	other

Trigger Logic

{
  "any_of": [
    {
      "finding": "multiple_iarc_group1_occupational_exposures_documented",
      "value": true
    }
  ],
  "type": "composite_score"
}

Notes

Pre-triage universal RedFlag — multi-exposure occupational cancer risk per IARC Monographs 100A-F + 105 + 132 (synergistic combinations). Trigger uses explicit positive finding `multiple_iarc_group1_occupational_exposures_documented: true`. With relevant_diseases=["*"], engine does NOT attach Indication tracks via prevention path (plan.py:297 excludes "*") — universal Indications anchored to DIS-NSCLC (lung is the dominant multi-organ surveillance target for occupational synergies) are documentation / sidecar candidates pending future engine extension. STUB pending two-Clinical-Co-Lead signoff per CHARTER §6.1 dev-mode.

Used By

Indications

IND-UNIVERSAL-OCCUPATIONAL-EXPOSURE-PREVENTION-INTENSIFIED-SURVEILLANCE - IND-UNIVERSAL-OCCUPATIONAL-EXPOSURE-PREVENTION-INTENSIFIED-SURVEILLANCE
IND-UNIVERSAL-OCCUPATIONAL-EXPOSURE-PREVENTION-STANDARD-SCREENING - IND-UNIVERSAL-OCCUPATIONAL-EXPOSURE-PREVENTION-STANDARD-SCREENING