This standard specifies the diagnostic criteria and treatment principles for occupational chronic arsenic poisoning. This standard applies to the diagnosis and treatment of occupational chronic arsenic poisoning caused by long-term exposure to arsenide. The diagnosis and treatment of non-occupational chronic arsenic poisoning can refer to this standard, but it is not applicable to hydrogen arsenide poisoning. GBZ 83-2002 Occupational chronic arsenic poisoning diagnostic criteria GBZ83-2002 standard download decompression password: www.bzxz.net

CS 13.100
National Occupational Health Standard of the People's Republic of China GBZ83-2002
Diagnostic Criteria of Occupational Chronic Arsenic PoisoningPublished on April 8, 2002
Implemented on June 1, 2002
Published by the Ministry of Health of the People's Republic of China
Article 6.1 of this standard is recommended, and the rest are mandatory. This standard is formulated in accordance with the "Law of the People's Republic of China on the Prevention and Control of Occupational Diseases". Arsenic is an ancient poison that involves a wide range of areas and a large number of people. Arsenic causes serious damage to multiple organ systems in the body. Arsenic poisoning is a common and relatively serious occupational hazard. In order to protect the health of workers and control the occupational hazards of arsenic, it is necessary to develop a diagnostic standard for arsenic poisoning.
This standard is formulated for the first time based on the epidemiological survey of occupational chronic arsenic poisoning, summarizing the clinical incidence and treatment experience of poisoning, and referring to the relevant foreign data on occupational arsenic poisoning. Appendix A of this standard is an informative appendix.
This standard is proposed and managed by the Ministry of Health of the People's Republic of China. This standard is drafted by the Hunan Institute of Labor Hygiene and Occupational Disease Prevention and Control. This standard is interpreted by the Ministry of Health of the People's Republic of China. Diagnostic criteria for occupational chronic arsenic poisoning
GBZ83—2002
Occupational chronic arsenic poisoning refers to a systemic disease with skin and liver damage as the main manifestation caused by long-term exposure to arsenic compounds in occupational activities.
1 Scope
This standard specifies the diagnostic criteria and treatment principles for occupational chronic arsenic poisoning. This standard is applicable to the diagnosis and treatment of occupational chronic arsenic poisoning caused by long-term exposure to arsenic compounds. The diagnosis and treatment of non-occupational chronic arsenic poisoning can be implemented in accordance with this standard, but it is not applicable to hydrogen poisoning. 2 Normative references
The clauses in the following documents become the clauses of this standard through reference in this standard. For all references with dates, all subsequent amendments (excluding errata) or revisions are not applicable to this standard. However, the parties to the agreement based on this standard are encouraged to study whether the latest versions of these documents can be used. For all references without dates, the latest versions are applicable to this standard. bzxz.net
GB/T16180
3 Diagnostic principles
Diagnostic criteria for occupational chronic allyl chloride poisoning Diagnosis of occupational skin diseases (general principles)
Diagnostic criteria for occupational toxic liver diseases
Evaluation of the degree of disability caused by work-related injuries and occupational diseases of employees Based on the occupational history of close contact with arsenic for a long period of time, the clinical manifestations of dermatitis, skin hyperkeratosis, skin pigmentation and digestive system and nervous system mainly appear, and the laboratory test results such as hair arsenic are referred to, and comprehensive analysis is conducted to exclude other causes of similar diseases; only then can the diagnosis be made.
4 Observation subjects
Have symptoms such as headache, dizziness, insomnia, dreaminess, fatigue, indigestion, weight loss, discomfort in the liver area, etc.: Arsenic hair exceeds the local normal reference value.
5 Diagnosis and classification standards
Chronic mild poisoning
In addition to the above symptoms, have one of the following conditions: skin hyperkeratosis, especially warty hyperkeratosis in the palms and soles: a)
Diffuse black or brown pigmentation and depigmentation spots on the trunk and limbs; b)
Mild liver damage;
d) Mild peripheral neuropathy.
Chronic severe poisoning
On the basis of chronic mild poisoning, have one of the following symptoms: Cirrhosis of the liver:
Peripheral neuropathy with limb movement disorders or limb paralysis; b)
Skin cancer.
Treatment principles
Treatment principles
Stop contacting arsenic, take dithiothiocarbamate or sodium dithiothiosulfate or sodium dithiothiosulfate to drive out arsenic, and supplement with symptomatic supportive treatment such as selenium supplementation and vitamin C.
6.2 Other treatments
Observation subjects
Generally, the patient should be reexamined once every six months or one year, but he/she can still do the original work. Chronic poisoning
Anyone diagnosed with chronic arsenic poisoning shall not continue to engage in arsenic work: severely poisoned persons shall avoid contact with chemical substances; those who need to be assessed for labor capacity shall be treated in accordance with GB/T16180. Instructions for the correct use of this standard
See Appendix A (Informative Appendix).
Appendix A
(Informative Appendix)
Instructions for the correct use of this standard
A.1 This standard applies to the diagnosis of occupational chronic arsenic poisoning caused by long-term exposure to arsenide in occupational activities. This standard does not apply to hydrogen arsenide poisoning.
A.2 Arsenic damage to the skin Arsenic can cause contact dermatitis. Chronic contact can cause skin hyperkeratosis and pigmentation or/and depigmentation changes, such as dryness, desquamation, and hyperkeratosis of the skin on the limbs and/or trunk. Hyperkeratosis of the palms and soles can form raised wart-like growths: diffuse black or brown pigmentation appears on the trunk and limbs: pigmentation and depigmentation exist alternately to form scattered black and white spots: in severe cases, infection and necrosis occur on the basis of hyperkeratosis, forming long-lasting ulcers, and skin cancer may occur. These skin changes are characteristic manifestations of chronic arsenic poisoning, so this standard lists it as one of the diagnostic indicators.
A.3 Arsenic compounds are hepatotoxic and can cause cirrhosis in severe cases. The diagnosis and classification of liver damage can be carried out completely in accordance with GBZ59. Laboratory tests for liver damage are also carried out according to the specific situation, selecting items in Appendix D of the standard. A.4 Peripheral nerve damage caused by mild chronic arsenic poisoning. See GBZ76. A.5 Hair arsenic has reference value for the diagnosis of chronic arsenic poisoning, and its normal reference value is 5μg/g. The determination method uses molybdenum blue colorimetry and diethyldithiocarbamate silver colorimetry (DDC-Ag). A.6 When differentially diagnosing liver damage caused by arsenic poisoning and viral hepatitis, it is not possible to simply exclude arsenic poisoning based on the positive serological markers of viral hepatitis. The possibility of cross-action between the two causes should be considered. In clinical practice, it should be combined with occupational history and characteristic symptoms and signs of arsenic poisoning, hair arsenic and urine arsenic content, etc., for comprehensive analysis to help identification. For details, please refer to Appendix C of GBZ59.
A.7 Regarding the treatment of chronic arsenic poisoning
Oral dithiothiocarbamate or conventional dithiothiothiosulfate sodium and dithiothiothiosulfate sodium can be used for arsenic removal treatment, and supportive therapy can be used at the same time.
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