GB 16374-1996 Occupational chemical eye burns diagnostic criteria and management principles
Some standard content:
National Standard of the People's Republic of China
Diagnostic criteria and principles of management ofoccupational chemical eye burnsGB16374—1996
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 damage to the eye tissue. 1 Subject content and scope of application
This standard specifies the diagnostic criteria and management principles for occupational chemical eye burns. This standard is applicable to the diagnosis and treatment of occupational chemical eye burns. 2 Diagnostic principles
Based on a clear occupational history of eye contact with chemicals or stimulation by high concentrations of chemicals in a short period of time, and the clinical manifestations of corrosive damage to tissues such as the eyelid, conjunctiva, cornea and sclera, refer to the investigation of the working environment, and conduct a comprehensive analysis to exclude other diseases with similar manifestations before diagnosis can be made.
3 Diagnosis and grading criteria
3.1 Chemical conjunctivitis and 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
If any of the following is present, mild chemical eye burns can be diagnosed: congestion, edema and blisters on the eyelid skin or facial margins, without sequelae. a
b. Conjunctival congestion, hemorrhage and edema.
Observation under slit lamp with fluorescein staining shows diffuse punctate or flaky detachment of the corneal epithelium, and edema and turbidity in the shallow layer of the corneal parenchyma. c.
No ischemia or ischemia <1/4 of the corneal margin.
3.3 Moderate chemical eye burns
In addition to the above two items b and c, if any of the following items are present, it can be diagnosed as moderate chemical eye burns: conjunctival necrosis occurs, and facial adhesion occurs during the repair period. a.
Deep corneal edema and turbidity, and 1/4~1/2 of the corneal limbus ischemic. b.
3.4 Severe chemical eye burns
Severe chemical eye burns can be diagnosed as severe chemical eye burns if any of the following items are present: ulceration of the eyelid skin, muscles and/or facial plate, and scar-like facial eversion and incomplete closure of facial fissures during the repair period. a.
Necrosis of the sclera, full-thickness corneal turbidity and porcelain white color, even perforation, and >1/2 of the corneal limbus ischemic. b.
Approved by the State Administration of Technical Supervision on May 23, 1996, and implemented on December 1, 1996
4 Treatment principles
GB 16374-1996
4.1 Chemical conjunctivitis and keratitis and eyelid burns should be treated symptomatically and removed from contact if necessary. 4.2 Patients with eyeball burns should be rinsed immediately nearby, and the conjunctival dome should be carefully inspected to remove residual chemicals. 4.3 Prevent infection, accelerate wound healing, and prevent facial adhesion and other complications. Patients with severe eyeball deformities can undergo plastic surgery. 4.4 To prevent posterior synechiae, 1% atropine can be used to dilate the pupil. 5 Work capacity assessment
5.1 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 return to his original job.
5.2 Moderate and severe chemical eye burns often produce serious complications or sequelae, and visual function may be impaired to varying degrees. Patients with unilateral burns should be separated from contact with chemicals, and after proper rest, they should be arranged to work appropriately according to their recovery. For patients with bilateral burns, whether they should work or not should be determined based on their residual vision at the end of medical treatment.
6 Requirements for health examinations
Chemical practitioners should undergo pre-employment eye examinations, including vision, corneal fluorescein staining, and slit lamp observation. The examinations should be conducted every 1 to 2 years.
7 Occupational contraindications
Active corneal disease.
b. Obvious residual corneal lesions.
GB 16374--1996
Appendix A
Requirements for ophthalmic examination
(Supplement)
Perform routine external eye examination, including eyelid, periorbital skin, subocular rim, 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 physiological saline, observe the corneal lesion under a slit lamp microscope, and perform internal eye examination, including anterior chamber, iris, aperture and lens. Appendix B
Instructions for the correct use of standards
(Reference)
B1 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. B2 Eye injuries caused by non-occupational contact with chemicals can also be implemented in accordance with this standard. B3 Immediate treatment on the spot after eye burns occurs is the key measure to determine the prognosis. The conjunctival sac should be thoroughly flushed with physiological saline or clean water immediately and nearby. The amount used is at least 500mL per eye, and the flushing time is generally 5 to 10 minutes. B4 In the assessment of labor capacity, moderate and severe eye burns should be evaluated according to the severity of complications or sequelae after burns and the damage to visual function. Different cases should be analyzed comprehensively and specifically, and appropriate treatment should be given. B5 Chemicals that cause eye burns are mainly acids and alkalis, and can also be found in various other chemicals (see Table B1). Table BI Chemicals that cause eye burns
Chemical name
1. Acid
2. Alkali
3. Metal corrosive
Hydrochloric acid, chlorosulfonic acid, sulfuric acid, nitric acid, chromic acid, hydrofluoric acid, acetic acid (anhydride), triaminoacetic acid, glycolic acid, thioacetic acid, lactic acid, oxalic acid, succinic acid (anhydride), maleic acid (anhydride), citric acid, hexanoic acid, 2-ethylacetic acid, trimethyladipic acid, sorbic acid, rhein Sodium carbonate, potassium carbonate, sodium aluminate, sodium nitrate, potassium salt 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 fluoride (calomel), magnesium sulfate, vanadium pentoxide, zinc, beryllium, titanium, antimony, chromium, iron and money compounds
4. Non-metallic inorganic thornsbzxZ.net
Inorganic arsenic, arsenic trioxide, arsenic trichloride, arsenic trihydrogen (arsenic), selenium disulfide, selenium dioxide, phosphorus, phosphorus pentoxide, oxidizing agents and corrosives
5. Oxidizing agents
Sulfur, hydrogen sulfide, dimethyl sulfate, dimethyl sulfide, silicon chloride, phosgene, bromine, iodine, potassium permanganate, hydrogen peroxide, sodium fluoride, hydrochloric acid insect phenol, lysol, methoxycresol, xylenol, menthol, creosote, trinitrophenol, hydroquinone, resorcinol, Nitromethane, nitropropane, irritating and corrosive hydrocarbons. Seven. Blisters. Eight. Tear gas. Nine. Surfactants. Ten. Organic solvents. Alkane, nitrobutane, nitronaphthalene, aminoethanol, phenylethanol, isopropanolamine, ethylethanolamine, aniline dyes (violet, Victoria blue, malachite green, methylene blue, etc.), p-phenylenediamine, methyl bromide, chloropicrin mustard gas, fluoroethylamine, nitrosoamines, Louisiana vinyl chloride, benzonitrile, fluorochloroamine, aerosols, local anesthetics, mushroom spores, spicy acid, pyrethrum, onion, croton oil, emetine , saliva tree alkaloids, colchicine, hemp protein, red bean toxin, coa, propylene mustard oil gasoline, benzene, kerosene, asphalt, benzene, xylene, ethylbenzene, styrene, naphthalene, α and β naphthol, chloroform, fluoroethane, dichloroethane, difluoropropane, methanol, ethanol, butanol, formaldehyde, acetaldehyde, acrolein, butyraldehyde, crotonaldehyde, methylglyoxal, furfural, acetone, butanone, cyclohexanone, dichloroacetaldehyde, dioxane, methyl formate, ethyl formate, butyl formate, methyl acetate, ethyl acetate, propyl acetate, amyl acetate, taro acetate, iodoacetate, dichloroacetate, methyl methacrylate 283
XI. Others
Additional instructions:
GB 163741996
Continued Table B1
Chemical Name
Methocarb, dibutyltin dilaurate, N,N\Dicyclohexyldiimide, hexamethylenediamine, detergent, herbicide, chlorhexidine, rust remover, epoxy resin, gentian violet, methylthiophosphoryl chloride, methylamidophos, 401, diisopropylaminoethyl chloride, titanium tetrafluoride, triammine, promethazine, dimethyl phthalate, vanillic acid, octanoylcystine, sodium fluosilicate, cyclopentanone, polysiloxane, reticulated silica gel, cypermethrin This standard is proposed by the Ministry of Health of the People's Republic of China. This standard was drafted by the Third Hospital of Beijing Medical University, and the Institute of Labor Health and Occupational Diseases of the Chinese Academy of Preventive Medicine and the Industrial Hygiene Department of the Ministry of Chemical Industry participated in the drafting.
This standard is interpreted by the Institute of Labor Health and Occupational Diseases of the Chinese Academy of Preventive Medicine, the technical management unit entrusted by the Ministry of Health. 284
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