Documented historical occupational exposure to polychlorinated biphenyls (PCBs) — typical...

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

ID	`RF-OCC-PCB-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 polychlorinated biphenyls (PCBs) — typical high-exposure occupations include capacitor / transformer manufacturing and servicing (pre-1979 US ban; later in some other jurisdictions), electrical-equipment maintenance / decommissioning, hydraulic-fluid handling in industrial presses, carbonless-copy-paper production (pre-1971), and environmental- remediation work at PCB-contaminated sites (lagoons, river-sediment dredging) — in an individual without a current PCB-attributable malignancy diagnosis. PCBs were historically classified by IARC as Group 2A (probably carcinogenic) but were RECLASSIFIED to Group 1 (carcinogenic to humans) in IARC Monograph 107 (2015 publication of the 2013 working-group decision) — sufficient evidence in humans (positive associations with malignant melanoma + suggestive associations with non-Hodgkin lymphoma + breast...
Клінічний напрям	investigate
Категорія	other

Логіка спрацьовування

{
  "any_of": [
    {
      "finding": "occupational_pcb_exposure_documented",
      "value": true
    },
    {
      "finding": "occupational_pcb_capacitor_transformer_pre_1979",
      "value": true
    },
    {
      "finding": "occupational_pcb_remediation_site_exposure",
      "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; reclassified Group 1 in 2013 IARC Monograph 107 (published 2015) — authored at 2A-conservative severity per batch scope. Reclassification context: PCBs were Group 2A from the 1970s IARC assessments through the 2012 update; the 2013 working group reclassified to Group 1 based on additional occupational-cohort follow-up showing sufficient human evidence for melanoma and mechanistic data on dioxin-like congeners. The 2A→1 transition affects the evidence-quality narrative but the practical clinical recommendations (no curative intervention, surveillance + symptom- awareness) are similar at the individual-patient level. This RF is intentionally authored to mirror the conservative IARC 2A framing of the other batch pilots; a future revision may upgrade severity to major to reflect the Group 1 status if maintainer review favors that framing. Anchor scope: DLBCL only (per task brief, NHL signal). Melanoma is the strongest cancer endpoint in the IARC 107 reclassification but is not the anchor here. A futur...

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Indications

IND-OCC-PCB-PREVENTION-INTENSIFIED-SURVEILLANCE - IND-OCC-PCB-PREVENTION-INTENSIFIED-SURVEILLANCE
IND-OCC-PCB-PREVENTION-OBSERVATION - IND-OCC-PCB-PREVENTION-OBSERVATION