This standard specifies the diagnostic criteria and treatment principles for occupational acute thallium poisoning. This standard is applicable to the diagnosis and treatment of occupational acute thallium poisoning, and can also be used as a reference for non-occupational acute thallium poisoning. GBZ 64-2002 Occupational Acute Thallium Poisoning Diagnostic Standard GBZ64-2002 Standard download decompression password: www.bzxz.net

ICS13.100
National Occupational Health Standard of the People's Republic of China GBZ64-2002
Diagnostic Criteria of Occupational Acute Thallium Poisoning2002-04-08 Issued
2002-06-01 Implementation
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". From the date of implementation of this standard, if the original standard GB16385-1996 is inconsistent with this standard, this standard shall prevail. Acute thallium poisoning may occur in occupational activities involving contact with thallium. In order to protect the health of the contactors and effectively prevent and treat acute thallium poisoning, GB16385-1996 was issued. This standard is a revised version. This standard highlights the damage of thallium to the nervous system and makes a diagnostic classification based on the degree of damage. 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 was drafted by the Jiangxi Provincial Institute of Labor Health and Occupational Disease Prevention and Control. The Institute of Occupational Health and Poisoning Control of the Chinese Center for Disease Control and Prevention and the Shanggao County Health and Epidemic Prevention Station of Jiangxi Province participated in the drafting. This standard is interpreted by the Ministry of Health of the People's Republic of China. ..comDiagnostic criteria for occupational acute thallium poisoning
GBZ64-2002
Occupational acute thallium poisoning is a systemic disease with nervous system damage as the main manifestation caused by inhalation of a large amount of thallium-containing smoke, vapor or soluble thallium salts in occupational activities in a short period of time, and absorption through the respiratory tract, skin and digestive tract. 1 ScopewwW.bzxz.Net
This standard specifies the diagnostic criteria and treatment principles for occupational acute thallium poisoning. This standard is applicable to the diagnosis and treatment of occupational acute poisoning, and non-occupational acute thallium poisoning can also be implemented as a reference. 2 Normative references
The clauses in the following documents become the clauses of this standard through reference in this standard. For all dated references, all subsequent amendments (excluding errata) or revisions are not applicable to this standard. However, parties reaching an agreement based on this standard are encouraged to study whether the latest versions of these documents can be used. For all undated references, the latest versions are applicable to this standard.
3 Diagnostic principles
Diagnostic criteria for occupational chronic chloropropene poisoning Based on the exact occupational exposure history, combined with clinical symptoms, signs and on-site hygiene survey data, comprehensive analysis, and exclusion of similar diseases caused by other causes, diagnosis can be made. Increased urinary thallium content can be used as an exposure indicator. 4 Observation subjects
Dizziness, headache, fatigue, nausea, vomiting, abdominal pain, burning sensation in the throat and other symptoms appeared after exposure, and the urinary thallium content increased. 5 Diagnosis and classification standards
5.1 Mild poisoning
In addition to symptoms of dizziness, headache, fatigue, loss of appetite, and heaviness of lower limbs, any of the following is present at the same time: a)
Number of distal limbs, especially lower limbs, hyperalgesia, loss of pain and tactile sensation in a glove-like or stocking-like distribution, or weakened Achilles tendon reflex;
b) Neuro-electromyography shows neurogenic damage. For examination methods and judgment criteria, see GBZ76. 5.2 Severe poisoning
The above symptoms are aggravated, and any of the following is present: a) Toxic encephalopathy or toxic psychosis; b)
Obvious muscle atrophy in distal limbs and affecting motor function, or multiple cranial nerve damage; electromyography shows neurogenic damage and more spontaneous denervation potentials; c
d) Accompanied by obvious heart, liver or kidney damage.
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Treatment principles
Treatment principles
6.1.1 Immediately leave the scene. Those with contaminated skin or eyes should immediately rinse thoroughly with clean water. 6.1.2
The subject of observation needs to rest in bed and be closely observed for at least 48 hours, and receive necessary examinations and treatment. Symptomatic treatment Supportive therapy
Strengthen nutrition and use B vitamins. For severe poisoning, adrenal glucocorticoids should be used. For oral poisoning, use Prussian blue after gastric lavage. The general dosage is 250mg/(kg·d), divided into four oral doses, each time dissolved in 50mL of 15% mannitol. Catharsis and diuresis can also be used to promote the excretion of thallium. For severe poisoning, hemodialysis or hemoperfusion can be considered.
6.2 Other treatments
6.2.1 After a short rest after the treatment of mild poisoning, work can be arranged after recovery. Severe poisoning should be transferred from the original job, and rest or work arrangement should be decided according to the recovery of the disease. 6.2.2
Instructions for the correct use of this standard
See Appendix A (Informative Appendix).
..comA.1 Scope
Appendix A
(Informative Appendix)
Instructions for the correct use of this standard
This standard applies to acute poisoning caused by exposure to various thallium compounds. Non-occupational acute thallium poisoning can also be implemented as a reference, but due to different poisoning routes, such as oral poisoning, the first symptoms are prominent digestive tract symptoms. A.2 Diagnostic principles
Thallium is highly toxic, but there is a latent period from the ingestion of the poison to the onset of symptoms. The clinical manifestations of acute poisoning, especially in the early stage, have no specific symptoms and signs. Therefore, the diagnosis must be based on the exact occupational exposure history and the working environment conditions that can cause poisoning, combined with clinical manifestations and special laboratory tests for comprehensive diagnosis, and attention should be paid to differentiation from corresponding diseases. A.3 Diagnosis and classification standards.
The main clinical manifestations of acute thallium poisoning are in the digestive tract, nervous system, hair loss, etc. Symptoms of peripheral nerve damage usually appear 2 to 5 days after poisoning. The diagnosis of mild poisoning is mainly based on peripheral nervous system damage. Severe poisoning is caused by aggravated peripheral nervous system damage or central nervous system and multiple cranial nerve damage. Hair loss is one of the specific signs of thallium poisoning: it usually appears 2 to 3 weeks after poisoning, and the hair falls off in bundles. In severe cases, the hair may fall off within a month: the beard, armpit hair, pubic hair and eyebrows may also fall off or be easily pulled out, but the inner 1/3 of the eyebrows are often not affected. There are also poisoned patients who do not suffer from hair loss. This standard proposes urine tests, which can be used as exposure indicators and as a reference for diagnosis. Other indicators Neuro-electromyography examinations indicate neurogenic damage.
A.4 Treatment
Mainly symptomatic supportive treatment, a large amount of B vitamins, to protect organs such as the liver, kidneys, and heart. Regarding the application of complexing agents, calcium sodium edetate, sodium dithiopropane sulfonate, cysteamine, etc. have been tried, but none of them have a definite detoxification effect, so they are not recommended. Oral pullulan can be given.
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