GB 16375-1996 Diagnostic criteria and treatment principles for occupational acne
Some standard content:
National Standard of the People's Republic of China
Diagnostic criteria and principles ofmanagement of occupational acne GB16375--1996
Occupational acne refers to chronic inflammatory damage to the hair follicles and sebaceous glands of the skin caused by contact with mineral oils or certain halogenated hydrocarbons during production labor. Acne caused by coal tar, shale oil, natural petroleum and its high-boiling point fractionation products and tar is called oil acne; acne caused by certain halogenated aromatic hydrocarbons, polychlorinated phenols and polyvinyl chloride thermal decomposition products is called chloracne. 1 Subject content and scope of applicationwww.bzxz.net
This standard specifies the diagnostic criteria and management principles of occupational acne. This standard applies to the diagnosis and management of occupational acne. 2 Reference standards
GB7804 Occupational skin disease diagnostic criteria and treatment principles (general principles) 3 Diagnostic principles
Based on a clear history of occupational exposure, unique clinical manifestations and sites of disease onset; refer to length of service, age of onset, work environment survey and epidemiological survey data, combined with dynamic observation of the condition, conduct a comprehensive analysis, exclude common acne and non-occupational exogenous acne, and then make a diagnosis. 4 Diagnostic criteria
4.1 Oily acne
Most follicular lesions occur at the contact site, manifested as pore dilation, keratinization of follicles, broken hair and blackheads. There are often inflammatory papules, folliculitis, nodules and cysts. Larger blackheads often leave depressed scars after squeezing out blackhead lipid emboli. Skin lesions generally have no subjective symptoms or have mild itching or tingling. It often occurs on the eyelids, auricles, and the extensor side of the limbs, especially in areas that rub against oily clothes, but not limited to the face, neck, chest, back, shoulders, and other areas prone to acne vulgaris. 4.2 Fluorine acne
Patches of follicular lesions occur at the contact site, with blackheads as the main manifestation. At the beginning, dense black spots as big as a needle tip often appear below the eye and on the face. Over time, larger blackheads appear around the auricles, abdomen, buttocks, and scrotum, accompanied by keratinization of the follicles, occasional miliary lesions, and inflammatory papules are less common. There are often straw-yellow cysts around the auricles and scrotum. 5 Treatment principles
Refer to the treatment principles of acne vulgaris and treat symptomatically. Pay attention to timely removal of pathogens remaining on the skin. For larger cysts, surgical removal may be considered.
6 Assessment of labor capacity
Occupational acne generally does not affect labor capacity. With enhanced protection, the original work can be continued. Those with multiple folliculitis, multiple cysts and aggregated acne who are ineffective in treatment may consider changing jobs to avoid contact with pathogens. The State Bureau of Technical Supervision approved on May 23, 1996 and implemented on December 1, 1996
Requirements for health examinations
GB16375-1996
A dermatological examination should be conducted before employment and detailed records should be kept. Regular physical examinations should be conducted every 12 years. Pay attention to the occurrence of acne-like skin lesions and identify whether they are related to occupation.
8 Contraindications of occupational drugs
Patients with obvious sebum secretion or severe acne should not engage in work involving contact with tar, asphalt, high-boiling-point fractions of mineral oil, polychlorinated benzenes, polychlorinated naphthalenes, polychlorinated phenols and certain bromoaromatic compounds. 286
Main differences
Age of onset
Location of onset
Clinical manifestations
Evolution of the disease
15-25 years old
Acne vulgaris
Rarely seen in people over 30 years old
Face, neck, upper chest, back, shoulders
GB 16375-1996
Appendix A
Difference between occupational acne and common acne
(Supplement)
Oil acne
Can occur at any age
Can occur at any contact site, especially at the friction site of oily clothes, commonly seen on the face
neck, extensor side of limbs, abdomen, buttocks and scrotum
Acne, inflammatory papules, folliculitis, purulent cancer, enlarged pores, keratinization of hair follicles, prying hair fold nodules, cysts. Blackheads are rare
Chloracne
Can occur at any age
Can occur at any contact site, commonly seen on the lower part of the eye, forehead, around the auricle, chest, back, buttocks and external genitalia
Blackheads, keratinization of hair follicles, mulberry papules, straw-yellow cysts. Inflammatory papules are rare.
Intermittent papules, blackheads, nodules, cysts. Verrucous organisms are often complicated
Skin lesions change with age and have no obvious relationship with contact with oils and halogen compounds
Appendix B
It has nothing to do with age changes. After a certain period of time away from contact with pathogenic substances, skin lesions can improve and heal, and relapse after resuming contact
Instructions for the correct use of standards
(reference)
B1 This standard is only applicable to the diagnosis and treatment of oil acne and chloracne caused by occupational reasons. Other acne with a clear causal relationship with occupational contact can be diagnosed and treated with reference to this standard according to the principles stipulated in GB7804-87. B2 Occupational acne is a chronic skin lesion. The incubation period of the disease depends on the comprehensive factors such as the nature, dosage, duration of action and individual quality of the contact pathogen. Therefore, the standard only stipulates that there must be a clear and long-term occupational exposure history, but does not specify a specific period. The diagnosis can be made based on comprehensive considerations. B3 Occupational acne is a multi-factorial disease. Acne caused by various pathogens has different clinical manifestations. For ease of understanding, it is classified into two categories: oil acne and chloracne according to the main pathogens and those with similar clinical manifestations. The two are just classifications, not fixed rash types. When diagnosing, they should be uniformly diagnosed as occupational acne. For ease of handling, the pathogens can be indicated in brackets when necessary, such as occupational acne (caused by ××).
B4 Before the onset of oil acne, there must be a clear and long-term occupational history of contact with tar (or crude oil), asphalt and high-boiling point fractions of mineral oil (such as diesel, engine oil and various lubricants).
Before the onset of chloracne, there must be a clear and long-term occupational history of contact with polychlorinated benzenes, polychlorinated naphthalenes, polychlorinated phenols, certain bromoaromatic hydrocarbons and polyvinyl chloride pyrolysis products.
Oil acne and chloracne both occur in areas that are frequently in contact with pathogens; they can occur at any age, and there can be more patients of the same type of work under the same working conditions. After a certain period of time without contact with pathogens, the condition can be alleviated or cured, but the cysts are not easy to disappear; after a certain period of time of resuming contact with pathogens, the condition can worsen or relapse. B5 Occupational acne should be differentiated from common acne in diagnosis. Common acne has its fixed predilection sites (face, neck, chest, back, shoulders) and predilection age (15 to 25 years old), while occupational acne can occur at any age and any contact site, which is of great significance in differential diagnosis. For acne that occurs in young workers at work, if the skin lesions are limited to the face, it is difficult to distinguish whether it is occupational acne or common acne; if there are skin lesions on the limbs, genitals, etc. at the same time, it can be clearly diagnosed as occupational acne. B6 Chloracne refers to acne caused by certain halogen compounds, mainly aromatic compounds of fluorine and bromine. Chlorine and bromine alone do not cause acne. The main compounds that cause acne are polychlorinated naphthalenes, polybrominated naphthalenes, polychlorinated biphenyls, polybrominated biphenyls, polychlorinated benzenes, polyfluorophenols, etc. In addition to skin contact, inhalation or ingestion of certain chlorinated aromatic hydrocarbons can cause chloracne, such as acne-like rashes on the skin when polychlorinated biphenyls are poisoned. In this case, the problem of systemic poisoning should be dealt with first.
B7 Occupational contraindications stipulate that patients with obvious sebum secretion or severe acne should not engage in work that contacts acne-causing substances. This is because the occurrence of acne is related to sebum secretion. Arranging work according to physical constitution may reduce the incidence, but it is not absolute. Therefore, it cannot be used as a basis for changing jobs for those who are already employed.
Additional notes:
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 Shanghai Institute of Labor Hygiene and Occupational Disease Prevention and Control, Shanghai Second Medical University, Shandong Institute of Labor Hygiene and Occupational Disease Prevention and Control, and Changchun Second Hospital. This standard was interpreted by the Institute of Labor Hygiene and Occupational Diseases, Chinese Academy of Preventive Medicine, the technical unit entrusted by the Ministry of Health.
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