GB 16376-1996 Diagnostic criteria and management principles for byssinosis
Some standard content:
National Standard of the People's Republic of China
Diagnostic criteria and principles ofmanagement of byssinosis
GB 16376-1996
Byssinosis is a respiratory obstructive disease caused by long-term exposure to cotton, hemp and other plant dusts, with characteristic symptoms such as chest tightness and/or chest tightness, shortness of breath, and acute decreased ventilation function. Long-term repeated attacks can cause chronic ventilation function damage. 1 Subject content and scope of application
This standard specifies the diagnostic criteria and management principles of byssinosis. This standard is applicable to the diagnosis and treatment of byssinosis. 2 Diagnostic principles
Diagnostic can only be made based on the occupational history of long-term exposure to cotton, hemp and other plant dusts, characteristic respiratory system symptoms and acute or chronic pulmonary ventilation function damage, combined with on-site labor hygiene investigation, and excluding other causes of obstructive respiratory diseases such as smoking. 3 Diagnosis and classification standards
3.1 Observation subjects
Occasionally have chest tightness and/or chest tightness, shortness of breath and other characteristic respiratory symptoms, and a decrease in the first second forced vital capacity FEV1., but the decrease does not exceed 10% after the work shift compared with the pre-work shift. 3.2 Byssinosis Grade I
Chest tightness and/or chest tightness, shortness of breath and other characteristic respiratory symptoms often occur on the first day of work after a break or on several days during the work week. FEV1..decreases by more than 10% after the work shift compared with the pre-work shift. 3.3 Byssinosis Grade
Respiratory symptoms continue to worsen, accompanied by chronic ventilation function damage, FEV1. or forced vital capacity FVC is less than 80% of the expected value.
4 Treatment principles
According to the treatment principles of obstructive respiratory diseases, symptomatic treatment is the main treatment. 5 Work capacity assessment
5.1 Observation subjects should undergo regular health examinations to observe changes in their condition. 5.2 Patients with grade 1 byssinosis should receive symptomatic treatment and be transferred from dusty jobs if necessary. 5.3 Patients with grade 1 byssinosis should be transferred from jobs involving contact with cotton, hemp and other plant dusts and receive symptomatic treatment. 6 Requirements for health examinations
A physical examination should be conducted before employment and every 2 to 3 years after employment. In addition to routine medical examinations, the patient must also register item by item according to a unified symptom questionnaire and undergo a lung ventilation function test. Approved by the State Bureau of Technical Supervision on May 23, 1996 and implemented on December 1, 1996
Occupational Certificate
Obvious chronic respiratory disease.
16376-1996
Date of birth
Correspondence address
Occupational history
Start and end dates
GB16376-1996
Appendix A
Questionnaire for respiratory symptoms of workers exposed to cotton and linen dust (supplement)
Question time
Do you often cough when you wake up or get up in the morning? Type of work
Subtotal of length of service
Years, months/12
Dust concentration
Questioner
Dust exposure
mg·year
(Including the first time you cough when smoking and the first time you cough when you go outdoors. Occasional coughs when you cough your throat are not counted. “Frequent” means 5 days or more per week).
Do you often cough during the day or at night?
(If you answer "No" to both 1 and 2, please go to 6) Do you have this cough most of the time for three months or more each year? 3.
(If you answer "Yes", go to 4; if you answer "No", go to 6)
How many years have you been coughing like this?
Is your cough worse in winter?
Do you always cough on a specific day during the work week? 6.
(If you answer "Yes", go to 6a; if you answer "No", go to 7)
Which day? The first, wwW.bzxz.Net
, second, third, fourth, fifth, sixth day after work after a break, not fixed (mark "√*" in the corresponding place) 7.
Do you often cough up phlegm when you get up early in the morning?
(Including coughing up phlegm the first time you smoke and coughing up phlegm the first time you go outside, excluding phlegm from the nasal cavity) Do you often cough up phlegm during the day or at night?
(If you answer "No" to both 7 and 8, ask 12)
GB 16376-1996
Continued Table A1
9. Do you have this kind of expectoration for three months or more every year? ("Yes" ask 10, "No" ask 12)
Does the expectoration get worse every winter?
How many years have you been expectorating like this?
Chest tightness
Do you feel any tightness or tightness in your chest? 12.
("Yes" ask 13, "No" ask 14)
Does your chest tightness or tightness occur on the first day after a break? 13.
Do you have this symptom every day after a break? How many days does this symptom last during the work week? Have you ever had chest tightness or tightness in the past? (“Yes” ask 14a, b; “No” ask 15) 14a.
188.
In the past, did you feel chest tightness or tightness on the first day back to work after a break? How many years did this symptom last?
Do you feel short of breath when walking fast on the ground or going upstairs? Do you feel short of breath when walking on the ground with people of the same age? Do you have to stop and rest for a while because of shortness of breath when walking on the ground? Is the shortness of breath more obvious on a particular day of the work week? Which day?
Have you ever had a fever during or after get off work? When did the fever start?19a.
Have you ever had a fever after the following circumstances?After doing cotton or linen work for the first time?
20b.After being exposed to cotton or linen dust in large quantities?20c.
Previous disease
After leaving cotton or linen work?
Just entered the factory Have you ever suffered from the following diseases after working for 21 years? (Put a “√” on the “Yes” item and record the starting time, duration, frequency and diagnosis unit in detail afterwards) Heart disease Bronchitis Pleurisy Tuberculosis Emphysema Bronchiectasis Chronic cor pulmonale Bronchial asthma Mouth
Hay fever (or other allergic diseases)
Do you smoke now?
(“No”, ask 23)
How old were you when you started smoking?
How many years have you smoked?
How much do you smoke?
Have you ever smoked regularly?
How old were you when you started smoking?
How many years have you quit smoking?
How much did you smoke in the past?
B1 Measurement items
VC Vital capacity
FVC Forced vital capacity
FEVi. Forced vital capacity in one second
Requirements for selecting instruments
GB16376-1996
Continued Table A1
Appendix B
Methods and requirements for pulmonary function measurement
(Supplement)
The accuracy of the instrument should be maintained within ±50mL or the reading error should be within 3%. The vital capacity range measured by the instrument is 0 to 7 L (BTPS). The flow rate measurement device should be able to measure the flow rate of 0 to 12L/s. The instrument should have a capacity average related to the BTPS state. Whether
There is a device to record flow rate-volume or time-volume. When measuring FEV1.o, the minimum paper speed should reach 2cm/s, and the capacity should be at least 10mm high per liter.
The instrument should accumulate gas for at least 10 s does not move, when the flow rate is between 25mL/s and 50mL/s, the instrument should not pause for at least 293
0. 5 s.
GB16376-1996
name. The instrument should be able to be calibrated on site, and the volume calibration device should provide at least 2L of volume displacement. Perform horizontal adjustment before use, check the rotation of each pulley, and reduce its resistance to the minimum. B3 Method
B3.1 The measurement is carried out when the subject has no cold or respiratory infection. The subject can stand or sit, and the same posture should be maintained when repeating the measurement. Use a clamp. Stop smoking on the day of the test, and rest for 10 minutes before the test. B3.2 Use the same instrument in the experiment.
B3.3 Ask the subject to loosen his clothes. When measuring, pay attention to slightly raise the lower neck of the subject and stretch the neck. The subjects were required to slowly expand their chests and fully inhale to the maximum amount, then blow air into the spirometer with maximum effort, maximum speed, and without interruption. B3.4 The FVC measurement that met the requirements should be performed at least three times, and the difference between the best two readings should be within 5% or 0.Within 1L. The maximum value of FVC and FEVi.o is used. Corrected by BTPS status. B3.5 The pulmonary ventilation function should be measured on the first day after work after work. "Work break" means leaving the dust exposure for more than 36 hours. B3.6 The pulmonary function should be measured before and after the mid-shift on the working day to evaluate the acute decline in ventilation function. "After work" means 6 hours after work. If the FEVt. after work decreases, it should be measured again 20 minutes after the spray inhalation of bronchodilator. The inhalation test is positive if it is 15% or more higher than the measured value before inhalation.
B4 Precautions
The following situations should be considered as unqualified:
The maximum inhalation degree is not reached before exhalation.
The maximum force is not used during the entire exhalation process. b.
Continuous exhalation is less than 5s or there is no obvious flat segment on the time-volume curve. Coughing or closing of the glottis during inhalation or exhalation. Mouthpiece or tube obstruction (tongue, dentures, etc.). The exhalation starts slowly and it is difficult to determine the starting point. The difference between the three measured values is greater than 10%.
Appendix C
Instructions for the correct use of the standard
(reference)
C1 This standard applies to byssinosis caused by long-term contact with cotton, flax, soft hemp and other plant dusts, such as spinning, cotton fluffing, felting, and velveting. It does not include "mill fever" and "weavers cough" caused by the first contact with cotton, flax and other plant dusts. C2 According to domestic and foreign data, the length of service for the onset of byssinosis is generally more than 10 years. In some cotton fluffing and felt-making factories, due to poor cotton quality and high dust concentration, the length of service for the onset can also be around 4 years. Workers who have experienced "cotton fever" are prone to byssinosis, which is of reference value for diagnosis. C3 Symptom inquiry should use the standardized questionnaire in Appendix A, and be conducted by an experienced doctor. Those with a positive medical history should be asked again after a certain period of time to ensure the reliability of the results. C4 Characteristic respiratory symptoms refer to chest tightness and/or chest distress, shortness of breath caused by airway obstruction that start at a specific time, and may be accompanied by coughing and a small amount of sputum. Symptoms usually begin to occur a few hours after work on the first workday after a break. However, as the disease progresses, they may also occur on other workdays besides the first workday. C5 The typical respiratory symptom is chest tightness, but the workers may express their complaints in different ways, such as chest distress, chest pressure, shortness of breath, chest discomfort, and breathlessness. C6 Patients with decreased lung function should be followed up, repeatedly measured, and comprehensively evaluated. 291
GB16376—1996
The predicted value of ventilation function is calculated using the predicted value calculation formula of the local population of this laboratory. Additional note,
This standard is proposed by the Ministry of Health of the People's Republic of China. This standard was drafted by the Institute of Labor Hygiene and Occupational Diseases, Chinese Academy of Preventive Medicine, with participation from the Beijing Institute of Labor Hygiene and Occupational Diseases, Heilongjiang Institute of Labor Hygiene and Occupational Disease Prevention and Control, and Tianjin Institute of Occupational Disease Prevention and Control. This standard is interpreted by the Institute of Labor Hygiene and Occupational Diseases, Chinese Academy of Preventive Medicine, the technical unit entrusted by the Ministry of Health. 295
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