Some standard content:
ICS13.100
National Occupational Health Standard of the People's Republic of China GBZ54—2002
Diagnostic Criteria of Occupational Chemical Eye Burns2002-04-08 IssuedWww.bzxZ.net
2002-06-01 Implementation
Ministry of Health of the People's Republic of China
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 the original standard GB16374-1996 is inconsistent with this standard, this standard shall prevail. In occupational activities, if the protection is not appropriate, direct contact of the eye with alkaline, acidic or other chemical gases, liquids or solids can cause corrosive damage to eye tissues. This standard is formulated to protect the health of workers, prevent chemical burns of the eye, and deal with them in a timely and correct manner.
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 Third Hospital of Peking University, and the Institute of Occupational Health and Poison Control of the Chinese Center for Disease Control and Prevention and the Industrial Hygiene Department of the Ministry of Chemical Industry participated in the drafting.
This standard is interpreted by the Ministry of Health of the People's Republic of China. ..comDiagnostic Standard for Occupational Chemical Eye Burns
GBZ54-2002
Occupational chemical eye burns are mainly caused by direct contact of the eye with alkaline, acidic or other chemical gases, liquids or solids at work, which causes corrosive and destructive damage to the eye tissue. 1 Scope
This standard specifies the diagnostic criteria and treatment principles for occupational chemical eye burns. This standard applies to the diagnosis and treatment of occupational chemical eye burns. 2 Diagnostic principles
Based on a clear history of occupational exposure to chemicals or irritation by high concentrations of chemicals in a short period of time, and clinical manifestations of corrosive damage to tissues such as the eyelid conjunctiva, cornea and sclera, refer to the investigation of the working environment, conduct a comprehensive analysis, and exclude other diseases with similar manifestations before diagnosis. 3 Diagnosis and grading standards
3.1 Chemical conjunctivitis keratitis
There are obvious symptoms of eye irritation: eye pain, burning sensation or foreign body sensation, tearing, eyelid spasm, conjunctival congestion, corneal epithelial detachment, etc. Fluorescein staining has scattered punctate staining. The facial fissure is most obvious under slit lamp observation. 3.2 Mild chemical eye burns
Patients with any of the following conditions can be diagnosed with mild chemical eye burns: a) hyperemia, edema and blisters on the eyelid skin or facial margins, without sequelae; b) hyperemia, hemorrhage and edema of the conjunctiva;
c) diffuse punctate or flaky exfoliation of the corneal epithelium under fluorescein staining slit lamp observation, shallow corneal parenchyma edema and turbidity, no ischemia of the corneal margin or ischemia of less than 1/4. 3.3 Moderate chemical eye burns
In addition to the above b and c, the following conditions are also present Patients with any of the following conditions can be diagnosed as having moderate chemical eye burns: a) conjunctival necrosis and facial adhesion during the healing period; b) deep corneal edema and opacity, with 1/4 to 1/23.4 ischemia of the corneal limbus. Severe chemical eye burns
Patients with any of the following conditions can be diagnosed as having severe chemical eye burns: a) ulceration of the eyelid skin, muscles and/or facial plate, with scarring of facial eversion and incomplete closure of facial fissures during the healing period; b) scleral necrosis, full-thickness corneal opacity and porcelain white color, even perforation, and 1/2 ischemia of the corneal limbus. Principles of treatment
4.1 Principles of treatment
..com4.1.1
Chemical conjunctivitis and keratitis and eyelid burns should be treated symptomatically, and contact should be removed if necessary4.1.2
Burned eyes should be immediately rinsed nearby: carefully check the conjunctival ridge to remove residual chemicals4.1.3 Prevent infection, accelerate wound healing, and prevent eyeball adhesion and other complications. Patients with severe eyelid deformities can undergo plastic surgery.
4.1.4 To prevent posterior synechiae, 1% atropine can be used to dilate the pupil. 4.2 Other treatments
4.2.1 Chemical conjunctivitis and keratitis and mild chemical eye burns usually recover completely within a few days, and vision is generally not affected. After recovery, the patient can resume his original work.
4.2.2 Moderate and severe chemical eye burns often produce serious complications or sequelae, and visual function may be impaired to varying degrees. Patients with one eye burns should be separated from contact with chemicals, and after proper rest, they should be arranged to work appropriately according to their recovery status. Patients with both eyes burns should decide whether to work or not according to their residual vision at the end of medical treatment. Instructions for the correct use of this standard
See Appendix A (Informative Appendix) and Appendix B (Normative Appendix). Appendix A
(Informative Appendix)
Instructions for the correct use of this standard
A.1 This standard is only applicable to chemical eye injuries caused by direct stimulation of chemicals at work, splashing into the eyes, or accidents. It is not applicable to acute and chronic toxic eye diseases caused by contact with chemicals outside the eyes. A.2 Eye injuries caused by non-occupational contact with chemicals can also refer to this standard. A.3 Immediate on-site treatment after eye burns is a key measure to determine the prognosis. The conjunctival sac should be thoroughly rinsed with physiological saline or clean water immediately and nearby, with a dosage of at least 500mL per eye, and the rinsing time is generally 5 to 10 minutes. A.4 In the assessment of work capacity, moderate and severe eye burns should be analyzed and treated according to the severity of the complications or sequelae after the burns and the damage to visual function. A.5 Chemicals that cause eye burns are mainly acids and alkalis, but can also be found in various other chemicals (see Table A.1). Table A.1 Chemicals that cause eye burns Chemical name 3. Alkali 3. Metal corrosives 4. Non-metallic inorganic irritants and corrosives 5. Oxidants 6. Irritating and corrosive hydrocarbons 7. Blisters 8. Tear gas 9. Surfactants 10. Organic solvents 11. Others Hydrochloric acid, chlorosulfonic acid, sulfuric acid, nitric acid, chromic acid, hydrofluoric acid, acetic acid (anhydride), trichloroacetic acid, glycolic acid, thioacetic acid, lactic acid, oxalic acid, Succinic acid (anhydride), maleic acid (anhydride), citric acid, caproic acid, 2-ethylacetic acid, trimethyladipic acid, sorbic acid, rhein
sodium carbonate, potassium carbonate, sodium aluminate, sodium nitrate, potassium salt of magnesium vanadium, lithium, calcium oxide, dry calcium sulfate, alkaline slag, calcium carbonate, calcium oxalate, calcium cyanamide, ammonium chloride, ammonium carbonate, ammonium hydroxide, silver nitrate, copper sulfate or copper nitrate, lead acetate, mercuric chloride (mercuric chloride), mercurous chloride (calomel), magnesium sulfate, vanadium pentoxide, zinc, beryllium, peptide, antimony, chromium, iron and money compounds, inorganic arsenic, arsenic trioxide, arsenic trichloride, arsenic tricyanide (swollen), selenium disulfide, phosphorus, phosphorus pentoxide, sulfur dioxide, hydrogen sulfide , dimethyl sulfate, dimethyl sulfoxide, silicon chloride, phosgene, bromine, iodine, potassium permanganate, hydrogen peroxide, sodium fluoride, hydrocyanic acid phenol, Lysol, methoxycresol, xylenol, menthol, wood oil, trinitrophenol, hydroquinone, resorcinol, nitromethane, nitropropane, nitronaphthalene, aminoethanol, phenylethanol, isopropanolamine, ethylethanolamine, aniline dyes (violet, Victoria blue, malachite green, methylene blue), p-phenylenediamine, methyl bromide, chloropicrin mustard gas, chloroethylamine, nitrosoamine, Louisiana vinyl chloride, bromobenzonitrile,
benzyl chloride, aerosol, local anesthetics, mushroom spores, acid, pyrethrum, onion, Croton oil, emetine, saliva tree, colchicine, hemp protein, red bean toxin, coa, propylene mustard oil gasoline, benzene, kerosene, asphalt, benzene, xylene, ethylbenzene, styrene, naphthalene, and beta-naphthol, chloroform, ethyl chloride, dichloroethane, dichloropropane, methanol, ethanol, butanol, formaldehyde, acetaldehyde, acrolein, butyraldehyde, crotonaldehyde, methylglyoxal, furfural, acetone, butanone, cyclohexanone, dichloroethyl ether, dioxane, methyl formate, ethyl formate, butyl formate, methyl acetate, ethyl acetate, propyl acetate, amyl acetate, benzyl acetate, iodoacetate, dichloroacetate, methyl methacrylate
metocarb, dibutyltin dilaurate, N,N-dicyclohexyldiimide, hexamethylenediamine, detergent, herbicide, chlorhexidine, rust remover, epoxy resin, gentian violet, methylthiophosphoryl chloride, methylamidophos, 401, diisopropylaminoethyl chloride, titanium tetrachloride, phosphorus oxychloride, promethazine, dimethyl phthalate, vanillic acid, octanoylcystine, sodium fluosilicate, cyclopentanone, polysiloxane, mesh silica gel, deltamethrin Appendix B
(Normative Appendix)
Requirements for Ophthalmic Examination
Perform routine external eye examination, including eyelid, periorbital skin, upper and lower facial margins, conjunctiva, sclera and corneal tissue. First, use a sterile glass rod to stick a small amount of 1% fluorescein into the conjunctival sac, then rinse with normal saline, observe the corneal lesion under a slit lamp microscope, and perform an internal eye examination, including the anterior chamber, iris, pupil and lens, etc.
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