Documented historical occupational exposure to benzene in an individual without a current...

Детермінований перегляд YAML-сутності з джерельної бази. Клінічний авторитет лишається за вказаними source ID та статусом клінічного sign-off.

ID	`RF-OCC-BENZENE-MALIGNANCY-PREVENTION`
Тип	Тривожна ознака
Статус	переглянуто 2026-05-18 \| очікує клінічного підпису
Хвороби	`DIS-AML` `DIS-MDS-HR` `DIS-MDS-LR`
Джерела	`SRC-ELN-AML-2022` `SRC-ESMO-MDS-2021` `SRC-NCCN-AML-2025`

Походження тривожної ознаки

Визначення	Documented historical occupational exposure to benzene in an individual without a current myeloid neoplasm diagnosis. Classic high-exposure occupations: petroleum refining, petrochemical manufacturing, rubber / tire industry, shoemaking (cement / adhesive use pre-regulation), printing / lithography (solvent use), pharmaceutical manufacturing, coke / coal-tar industry, motor- vehicle service (fuel-pump / gasoline exposure pre-vapor-recovery), laboratory work with benzene solvent (largely historical). Benzene is an IARC Group 1 carcinogen with the strongest hematopoietic- malignancy linkage of any non-radiation occupational exposure — established etiological driver of acute myeloid leukemia (especially AML with cytogenetic abnormalities of chromosomes 5, 7, 8; monosomy 7), myelodysplastic syndromes (low- and high-risk MDS subtypes both elevated), and acute lymphoblastic leukemia (smaller...
Клінічний напрям	investigate
Категорія	other

Логіка спрацьовування

{
  "any_of": [
    {
      "finding": "occupational_benzene_exposure_documented",
      "value": true
    },
    {
      "finding": "occupational_benzene_exposure_years_ge_5",
      "value": true
    },
    {
      "finding": "occupational_petroleum_refining_or_solvent_industry",
      "value": true
    }
  ],
  "type": "lab_value"
}

Нотатки

Prevention-persona RedFlag — v0.3 occupational pilot starter. Fires when patient profile carries documented prior occupational benzene exposure AND no confirmed myeloid neoplasm diagnosis. Engine routes such patients to a 2-track PreventionPlan: (a) IND-OCC-BENZENE-PREVENTION-INTENSIFIED-SURVEILLANCE (standard) — exposure-cessation counseling (if active), CBC q6-12 months with peripheral smear review for cytopenias, low-threshold bone marrow evaluation for persistent cytopenia (>3-6 months) or unexplained macrocytic anemia, co-management with hematology if any abnormality emerges. (b) IND-OCC-BENZENE-PREVENTION-OBSERVATION (surveillance) — symptom-triggered evaluation only; patient declines routine CBC surveillance for any reason. Evidence base (IARC Monograph 100F 2012; Vlaanderen et al. 2011 systematic review; Khalade et al. 2010 meta-analysis; Pulmonary Industry cohort studies eg, Pliofilm cohort Rinsky et al. 1987; Chinese cohort Hayes et al. 1997): - AML SMR ~2-3x in moderately exposed cohorts (cumulative dose ~40 ppm-years); ~10x in heavily exposed cohorts. Dose-response established at exposures >40 ppm-years. - MDS SMR ~2-4x; benzene-attributable MDS frequently progresses t...

Де використовується

Indications

IND-OCC-BENZENE-PREVENTION-INTENSIFIED-SURVEILLANCE - IND-OCC-BENZENE-PREVENTION-INTENSIFIED-SURVEILLANCE
IND-OCC-BENZENE-PREVENTION-OBSERVATION - IND-OCC-BENZENE-PREVENTION-OBSERVATION