GBZ 21-2002 Occupational Photosensitive Dermatitis Diagnostic Criteria GBZ21-2002 Standard download decompression password: www.bzxz.net

ICS13.100
National Occupational Health Standard of the People's Republic of China GBZ 21—2002
Diagnostic Criteria of Occupational Photosensitive Dermatitis
Diagnostic Criteria of Occupational Photosensitive Dermatitis2002-04-08 Issued
Ministry of Health of the People's Republic of China
Implementation on 2002-06-01
Article 4.1 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". From the date of implementation of this standard, if there is any inconsistency between the original standard GB7807-1987 and this standard, this standard shall prevail. Occupational photosensitive dermatitis caused by photosensitizers accounts for a certain proportion of occupational skin diseases. Contactors often suffer from group diseases, recurrent attacks, and often secondary diffuse pigmentation, affecting the physical and mental health of workers. This standard is formulated to protect the health of occupational contacts and effectively prevent and treat occupational skin diseases. Appendix A of this standard is an informative appendix, and Appendix B is a normative appendix. This standard is proposed and managed by the Ministry of Health of the People's Republic of China. This standard was drafted by the Institute of Occupational Health and Poison Control of the Chinese Center for Disease Control and Prevention, Shanghai Second Medical University, Shanghai Hospital of Dermatology and Venereology, Shandong Provincial Institute of Labor Hygiene and Occupational Disease Prevention and Control, and Changchun Second Hospital. This standard is interpreted by the Ministry of Health of the People's Republic of China. ..comDiagnostic criteria for occupational photosensitivity dermatitis
GBZ21-2002
Occupational photosensitivity dermatitis refers to the inflammatory reaction of the skin caused by exposure to photosensitive substances (such as coal tar pitch, chlorpromazine and its intermediates, benzyl alcohol, etc.) and sunlight during work. 1 Scope
This standard specifies the diagnostic criteria and treatment principles for occupational photosensitivity dermatitis. This standard applies to the diagnosis and treatment of occupational photosensitivity dermatitis. 2 Diagnostic principles
Based on a clear history of occupational exposure to photosensitizers, there is a history of sunlight exposure before the onset of the disease (or at the time of onset), clinical manifestations: refer to the investigation of the working environment and the incidence of the same type of work; when necessary, it can be combined with the light patch test for comprehensive analysis to exclude skin diseases caused by other non-occupational factors before diagnosis. 3 Diagnostic criteria
3.1 Occupational phototoxic dermatitis
The skin lesions are localized flaky erythema with burning or pain. In severe cases, edema and blisters may occur or be accompanied by conjunctivitis and systemic symptoms, such as headache, dizziness, weakness, thirst, nausea, etc. Those with the following conditions can be diagnosed 3.1.1 There is a clear history of occupational exposure to a certain amount of photosensitizers before the onset of the disease, and exposure to sunlight of a certain intensity and time.
The skin lesions occur in the area that is in contact with photosensitizers and exposed to sunlight. 3.1.3
Most people with the same type of work and the same conditions will develop the disease. 3.1.4: Skin lesions begin within a few hours after exposure to sunlight. 3.1.5
After leaving contact with photosensitive substances or avoiding sunlight, dermatitis subsides quickly, and local pigmentation of varying degrees may remain.
3.1.6 If necessary, a light patch test can be performed, which will show a sunburn-like reaction. 3.2 Occupational photoallergic (allergic) dermatitis lesions are edematous erythema with unclear edges and small papules or blisters on it. There are varying degrees of itching. Those with the following conditions can be diagnosed:
3.2.1 There is a history of occupational contact with photosensitive substances and exposure to sunlight before the onset of the disease. 3.2.2 Skin lesions begin at the contact site and can later spread to the surrounding area and spread to other parts of the body. 3.2.3 Only a few people with the same type of work and the same conditions will develop the disease. 3.2.4 Skin lesions begin 5 to 14 days or longer after contact with photosensitive substances and sunlight. After sensitization, the disease usually occurs within 24 hours.
..com: The course of the disease is prolonged. After the contact is stopped, it usually takes about two weeks to heal. Sometimes it lasts for several months. After recovery, there is generally no obvious 3.2.5
pigmentation.
If necessary, a light patch test can be performed, which will show an eczema-like reaction. Treatment principles
Treatment principles
Remove the pathogens remaining on the skin in time
, and temporarily avoid contact with photosensitive substances and sunlight. 4.1.3
Symptomatic treatment according to the treatment principles of acute dermatitis. 4.2 Other treatments
4.2.1 For severe phototoxic dermatitis, appropriate rest can be given during the treatment period according to the needs of the condition. After recovery, improve working conditions and strengthen personal protection or avoid working under sunlight, and you can do your original work. , Severe photoallergic dermatitis, recurrent episodes, in addition to necessary rest and treatment, can consider changing jobs, 4.2.2
Avoid contact with photosensitive substances.
Instructions for the correct use of this standard
See Appendix A (Informative Appendix) and Appendix B (Normative Appendix). ..comAppendix A
(Informative Appendix)
Instructions for the correct use of this standard
A.1 This standard is only applicable to occupational photosensitive dermatitis. When diagnosing, attention should be paid to distinguishing it from occupational contact dermatitis and various non-occupational photosensitive skin diseases.
A.2 A clear history of contact with occupational photosensitizers and a history of sunlight exposure before (or during) the onset of the disease are important bases for diagnosis. A light patch test can be used to distinguish it from general contact dermatitis and distinguish it from phototoxic dermatitis or photoallergic dermatitis.
A.3 Phototoxic dermatitis and photoallergic dermatitis have different clinical symptoms, and the treatment principles (including labor capacity assessment) should be different. However, some photosensitizers can have both phototoxic and photosensitizing effects. When the clinical symptoms are difficult to distinguish, it is not necessary to classify them, and they can be collectively referred to as occupational photosensitivity dermatitis. The treatment principles should be treated according to photoallergic dermatitis. A.4 In addition to causing photosensitivity dermatitis, some photosensitive substances can also cause contact dermatitis. The treatment principles should be handled according to the nature of the disease.
A.5 Common photosensitive substances include: coal tar, coal tar pitch, acridine, onion, phenanthrene, psoralen, benzophenone, onion aldehyde dyes, chlorophenothiazines, chlorpromazine, halogenated salicylanilides, sulfonamides, promethazine, etc. ..comB.1 Light source
Appendix B
(Normative appendix)
Light patch test
General treatment uses mercury gas quartz lamp or water-cooled quartz lamp. The distance from the light source to the skin is 50cm. 2 MethodwwW.bzxz.Net
Light determination of the patient's minimum erythema dose (MED): a)
b) Use suspected pathogenic substances to make three closed patch tests on the patient's back; c)
After 24 hours, remove two patches and irradiate one of them with a sub-erythema dose (slightly lower than the MED). The other is irradiated with ultraviolet light filtered by ordinary window glass. The time is 20 to 30 times the MED. After removing the pathogenic substance, the third place is immediately covered with a dressing to avoid any light exposure and used as a control; observe the results 24, 48, and 72 hours after irradiation: the sunburn-like reaction that occurs at the sub-erythema dose irradiation site is a phototoxic reaction d)
An eczematous reaction to ultraviolet light filtered by window glass is a photoallergic reaction.
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