Documented historical occupational exposure to respirable crystalline silica (RCS; α-quar...

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

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

Походження тривожної ознаки

Визначення	Documented historical occupational exposure to respirable crystalline silica (RCS; α-quartz, cristobalite, tridymite) — typical high-risk occupations include underground / surface miners and quarry workers, stone-cutting and stone-fabrication workers (especially engineered- stone / quartz-surface fabrication), sandblasters, foundry workers, ceramic / pottery / glass manufacturing workers, tunnel construction, and concrete / masonry workers — in an individual without a current silica-associated malignancy diagnosis. RCS is an IARC Group 1 carcinogen (Monograph 100C, 2012) — established etiologic driver of lung cancer (primary endpoint), with risk elevated further in the context of clinically-apparent silicosis (radiographic / functional pneumoconiosis). Latency to lung cancer is typically 20-40 years from first exposure and is smoking-modified (additive-to- multiplicative interaction). T...
Клінічний напрям	investigate
Категорія	other

Логіка спрацьовування

{
  "any_of": [
    {
      "finding": "occupational_silica_exposure_documented",
      "value": true
    },
    {
      "finding": "occupational_silica_exposure_years_ge_10",
      "value": true
    }
  ],
  "type": "lab_value"
}

Нотатки

Prevention-persona RedFlag — v0.3 occupational batch-2 pilot. Fires when patient profile carries documented prior occupational respirable crystalline silica exposure AND no confirmed silica-attributable malignancy diagnosis. Engine routes to 2-track PreventionPlan: (a) IND-OCC-SILICA-PREVENTION-INTENSIFIED-SURVEILLANCE (standard) — HRCT chest if silicosis suspected (functional / symptomatic / baseline CXR abnormality); risk-adjusted annual LDCT chest for lung-cancer screening (USPSTF-modified for silica cumulative exposure); smoking-cessation counseling (imperative); exposure-cessation / PPE counseling if active exposure persists (note: engineered-stone fabrication is an emerging high-exposure occupation worldwide). (b) IND-OCC-SILICA-PREVENTION-OBSERVATION (surveillance) — routine general-population USPSTF screening only; patient declines silica-modified intensified imaging surveillance. Trigger findings are computed booleans from occupational-history intake at the patient-profile layer. Evidence base: IARC Monograph 100C (2012); Steenland et al. 2001 (pooled silica-exposed cohort meta-analysis — lung-cancer SMR ~1.3-1.5 in silica-only, higher with silicosis); Vida et al. 2010 (Q...

Де використовується

Indications

IND-OCC-SILICA-PREVENTION-INTENSIFIED-SURVEILLANCE - IND-OCC-SILICA-PREVENTION-INTENSIFIED-SURVEILLANCE
IND-OCC-SILICA-PREVENTION-OBSERVATION - IND-OCC-SILICA-PREVENTION-OBSERVATION