Documented historical occupational exposure to glyphosate-based herbicides (most notably...

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

ID	`RF-OCC-GLYPHOSATE-PREVENTION`
Тип	Тривожна ознака
Статус	переглянуто 2026-05-19 \| очікує клінічного підпису
Хвороби	`DIS-DLBCL-NOS`
Джерела	`SRC-NCCN-BCELL-2025`

Походження тривожної ознаки

Визначення	Documented historical occupational exposure to glyphosate-based herbicides (most notably Roundup® and generic equivalents) — typical high-exposure occupations include agricultural workers (row-crop, orchard, and vineyard pesticide applicators), groundskeepers and landscape-maintenance staff (golf-course, parks, right-of-way), forestry workers, railroad-track vegetation control, and farm-family members involved in mixing / loading / application — with cumulative high-frequency exposure ≥10 years — in an individual without a current glyphosate-attributable malignancy diagnosis. IARC Monograph 112 (2015) classified glyphosate as Group 2A (probably carcinogenic to humans) — limited evidence in humans (positive associations with non-Hodgkin lymphoma, particularly diffuse-large-B-cell lymphoma, across multiple agricultural-cohort studies; chance / bias / confounding by other pesticides not fu...
Клінічний напрям	investigate
Категорія	other

Логіка спрацьовування

{
  "any_of": [
    {
      "finding": "occupational_glyphosate_exposure_documented",
      "value": true
    },
    {
      "finding": "occupational_glyphosate_exposure_years_ge_10",
      "value": true
    },
    {
      "finding": "occupational_agricultural_pesticide_high_frequency",
      "value": true
    }
  ],
  "type": "lab_value"
}

Нотатки

Prevention-persona RedFlag — v0.3 IARC 2A probable-carcinogen batch (2026-05-19). IARC Group 2A probable — limited human evidence; clinical recommendation more conservative than Group 1. IARC Monograph 112 (2015) is the canonical evidence anchor and is NOT yet a separate SRC entity in KB; cited in notes only. Evidence-base contestation: the IARC Group 2A classification is not concordant with EFSA / EPA / Health Canada / JMPR "unlikely to pose carcinogenic risk" conclusions. This RF is authored at severity:minor reflecting both the IARC 2A probable evidence quality AND the cross-regulatory disagreement. Counseling should disclose the controversy honestly rather than presenting IARC as settled science. Anchor scope: DLBCL only (the dominant NHL endpoint in IARC 112 limited-human-evidence summary). Other NHL subtypes (follicular, marginal zone, etc.) and other hematologic malignancies (MM, AML) carry inadequate or more-contested evidence and are deliberately excluded from relevant_diseases. Engine routes to 2-track PreventionPlan: (a) IND-OCC-GLYPHOSATE-PREVENTION-INTENSIFIED-SURVEILLANCE (standard) — symptom-awareness education, annual CBC, targeted lymphadenopathy / B-symptom histo...

Де використовується

Indications

IND-OCC-GLYPHOSATE-PREVENTION-INTENSIFIED-SURVEILLANCE - IND-OCC-GLYPHOSATE-PREVENTION-INTENSIFIED-SURVEILLANCE
IND-OCC-GLYPHOSATE-PREVENTION-OBSERVATION - IND-OCC-GLYPHOSATE-PREVENTION-OBSERVATION