Documented historical occupational exposure to ionizing radiation — typical high-risk occ...

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

ID	`RF-OCC-IONIZING-RADIATION-PREVENTION`
Тип	Тривожна ознака
Статус	переглянуто 2026-05-18 \| очікує клінічного підпису
Хвороби	`DIS-AML` `DIS-BREAST` `DIS-NSCLC` `DIS-SCLC` `DIS-THYROID-PAPILLARY`
Джерела	`SRC-NCCN-AML-2025` `SRC-NCCN-BCELL-2025`

Походження тривожної ознаки

Визначення	Documented historical occupational exposure to ionizing radiation — typical high-risk occupations include radiologic technologists, interventional-radiology / interventional-cardiology staff, nuclear- industry workers (reactor operations, fuel-cycle, decommissioning), uranium miners (in a separate category from radon-only exposure; uranium miners receive mixed alpha + gamma exposure), industrial- radiography workers, medical-physics personnel, and military personnel with documented occupational radiation exposure — in an individual without a current radiation-attributable malignancy diagnosis. Ionizing radiation is an IARC Group 1 carcinogen (Monograph 100D, 2012) with cancer endpoints spanning multiple hematologic and solid-tumor sites: myeloid leukemia (AML; primary evidence anchor from Life Span Study + radiologist cohorts), thyroid cancer (papillary, dose-dependent — strongest in yo...
Клінічний напрям	investigate
Категорія	other

Логіка спрацьовування

{
  "any_of": [
    {
      "finding": "occupational_ionizing_radiation_exposure_documented",
      "value": true
    },
    {
      "finding": "occupational_ionizing_radiation_years_ge_10",
      "value": true
    }
  ],
  "type": "lab_value"
}

Нотатки

Prevention-persona RedFlag — v0.3 occupational batch-2 pilot. Fires when patient profile carries documented ≥10 years occupational ionizing-radiation exposure AND no confirmed radiation-attributable malignancy diagnosis. Engine routes to 2-track PreventionPlan: (a) IND-OCC-IONIZING-RADIATION-PREVENTION-INTENSIFIED-SURVEILLANCE (standard) — CBC q1y for hematologic surveillance; thyroid ultrasound q3-5y; lifetime dose-equivalent tracking (review of dosimetry records); ALARA / PPE counseling for active workers; breast-cancer screening at standard guideline-onset in female workers with consideration of earlier initiation per high-dose cohort guidance. (b) IND-OCC-IONIZING-RADIATION-PREVENTION-OBSERVATION (surveillance) — routine general-population screening only; patient declines structured CBC + thyroid surveillance. Trigger findings are computed booleans from occupational-history intake at the patient-profile layer. Evidence base: IARC Monograph 100D (2012); Life Span Study (atomic- bomb survivors — foundational dose-response evidence); UK NRRW pooled cohort (Muirhead 2009); INWORKS pooled cohort (Richardson 2015). AML excess relative risk per Gy ~1-4 (linear-no-threshold baseline a...

Де використовується

Indications

IND-OCC-IONIZING-RADIATION-PREVENTION-INTENSIFIED-SURVEILLANCE - IND-OCC-IONIZING-RADIATION-PREVENTION-INTENSIFIED-SURVEILLANCE
IND-OCC-IONIZING-RADIATION-PREVENTION-OBSERVATION - IND-OCC-IONIZING-RADIATION-PREVENTION-OBSERVATION