Some standard content:
ICS13.100
National Occupational Health Standard of the People's Republic of China GBZ 108-2002
Diagnostic criteria for acute uranium intoxication Issued on April 8, 2002
Ministry of Health of the People's Republic of China
Implementation on June 1, 2002
Chapters 4, 5, 6 and 7 of this standard are mandatory, and the rest are recommended. GBZ108-2002
This standard is specially 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, the original standard WS/T197-2001 "Diagnostic criteria and treatment principles for acute uranium poisoning" will be abolished at the same time. There is currently no international standard for the diagnosis of acute poisoning that can be used as a reference. This standard is compiled based on existing literature and past practical experience, and the dose estimation part of it quotes the relevant national standard (GB/T16148-1995). Considering that acute uranium poisoning is mainly characterized by acute toxic nephropathy, the diagnostic criteria for toxic nephropathy will be issued in China. In addition, dose estimation standards directly targeting uranium will be compiled and issued. Therefore, users of this standard should pay attention to and refer to the above two standards to be issued in the future.
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. Drafting unit of this standard: China Institute of Radiation Protection Main drafter of this standard: Sun Shiquan.
This standard is interpreted by the Ministry of Health of the People's Republic of China. GBZ108—2002
1 Scope
Diagnostic criteria for acute uranium poisoning
This standard specifies the diagnostic criteria and treatment principles for acute uranium poisoning. This standard applies to people with acute uranium poisoning after occupational acute exposure to natural uranium compounds. 2 Normative references
The clauses in the following documents become the clauses of this standard through reference in this standard. All subsequent amendments (excluding errata) or revisions of dated references are not applicable to this standard. However, parties to an agreement based on this standard are encouraged to study whether to use the latest versions of these documents. For undated references, the latest versions apply to this standard.
GB/T16148 Specification for Estimation of Radionuclide Intake and Internal Exposure Dose 3 Terms and Definitions
The following terms and definitions apply to this standard! 3.1 Acute uranium intoxication Acute uranium poisoning is a systemic disease with acute toxic nephropathy as the main symptom caused by chemical damage caused by excessive intake of natural uranium compounds through different routes in a short period of time. 4 Diagnostic principles
Diagnosis is based on the history of acute exposure to uranium compounds, the type of uranium compounds, the route of intake, the estimated maximum renal clamp content, as well as clinical manifestations and laboratory test results. 5 Diagnostic indicatorsbZxz.net
5.1 Renal uranium content
5.1.1 When acute exposure to uranium compounds may have occurred, daily urine samples should be collected as soon as possible to measure the uranium content in urine and give mgU/L and/or mgU/24h. The number of collections and measurements can be reduced after 2 weeks. If combined with body surface uranium contamination, the level and area of body surface contamination should be measured.
According to Appendix B of GB/T16148, based on the type of uranium compound exposed, the route of ingestion, the particle size of aerosol particles and 5.1.2
The intake, absorption and maximum renal uranium content (mgU) are estimated according to the urine uranium values after different exposure times. If necessary, the committed equivalent dose and committed effective dose of different target organs after a certain period of time should be estimated. 5.2 Test indicators and results of early kidney damage Abnormal urine routine examination: Increased urine protein content, especially low molecular weight protein: Increased urine amino acid nitrogen creatinine ratio: Increased urine catalase: Increased urine alkaline phosphatase, lactate dehydrogenase or other urine enzymes reflecting kidney damage. 5.3 Test indicators and results of kidney dysfunction GBZ108-2002
Increased blood non-protein nitrogen, urea nitrogen and creatinine; decreased blood carbon dioxide binding capacity and/or hyponatremia and hyperkalemia; decreased glomerular filtration rate test indicators; oliguria or anuria. 6 Clinical staging
6.1 Early stage, 1 to 2 days after exposure; weakness and anorexia appear, early kidney damage test indicators are positive and gradually worsen, and urine volume may increase once and then decrease.
6.2 Extreme stage, 3 to 7 days after exposure: The whole body condition gradually deteriorates, the test indicators of kidney dysfunction are positive and gradually worsen, or abnormal findings of liver damage appear. If combined with large-area skin burns, the condition will be more serious. If the poisoning is extremely serious and the rescue is ineffective, it will develop into acute renal failure and even cause death. If the poisoning is mild or the rescue is effective, it will enter the recovery period. 6.3 Recovery period, about 7 to 30 days after exposure: the condition improves and various test indicators gradually return to normal. Usually, there will be no persistent damage to the kidneys in the long term.
7 Grading standards and complications
7.1 Mild acute uranium poisoning
With a history of acute exposure to uranium compounds: within a few days after exposure, more than 3 of the early kidney damage test indicators (5.2) are positive for each test; blood non-protein nitrogen increases: the estimated maximum uranium content in the kidney is greater than 3mg: the condition does not enter the critical stage or show signs of acute renal failure, and enters the recovery period earlier. 7.2 Severe acute uranium poisoning
There is a history of severe acute exposure to uranium compounds, the estimated maximum uranium content in the kidney is greater than 10mg, the condition quickly enters the critical stage, all indicators of renal dysfunction (5.3) are positive and aggravated sharply, urine volume is extremely reduced or anuria occurs, and acute renal failure occurs. 7.3 Complications
Acute exposure to uranium hexafluoride gas may be accompanied by acute damage to the respiratory tract, skin and conjunctiva, and acute pulmonary edema may occur in severe cases. Severe contamination of the body surface by acidic uranium compound solutions may be accompanied by chemical burns of the skin. If liver damage indicators are positive at the same time, it means acute toxic liver damage has occurred.
8 Treatment principles
8.1 Evacuate the scene as soon as possible after the accident, and collect 24h urine samples as soon as possible to estimate the uranium content in the kidney. 8.2 Start drug excretion promotion treatment as soon as possible, and determine the duration of treatment based on the amount of uranium in the urine and its changes. When severe poisoning begins to enter the extreme stage (2 days after poisoning), uranium excretion-promoting drugs that can increase kidney damage should be used with caution or not used. 8.3 When the body surface is contaminated with uranium or other radionuclides, it should be cleaned and decontaminated as soon as possible, the level of surface contamination should be monitored, and local debridement and skin grafting should be performed if necessary.
GBZ108-2002
8.4 In severe uranium poisoning, various effective measures should be taken, such as fluid replacement and diuresis, improvement of renal perfusion, and alkaline drugs to correct acidosis, in order to block the development of acute renal failure, and early dialysis treatment should be started if necessary. 8.5 Symptomatic treatment, liver protection treatment, and prevention of complications. 8.6 When combined with severe skin burns or pulmonary edema, necessary treatment should be carried out as soon as possible. If the treatment measures conflict with the treatment principles of acute uranium poisoning, comprehensive consideration should be given to rescuing the damage that may endanger life. A1 General requirements
Appendix A
(Informative Appendix)
Selection and application of uranium excretion-promoting drugs;
GBZ108-2002
Low toxicity, especially low toxicity to the kidneys; can form highly stable complexes in the body that are easily soluble, easy to diffuse, and can be quickly excreted from the body; does not participate in the metabolism of substances in the body or other chemical changes; maintains effective concentration in the body for a long time. A2 Drug types
Sodium bicarbonate: catechol compounds, such as Tiron and quinamic acid; aminocarboxylic chelating agents, such as diethylenetriamine pentaacetic acid calcium sodium salt (DTPA-CaNa3) and ethylenediaminetetraacetic acid calcium sodium salt (EDTA-CaNa2).
Tip: This standard content only shows part of the intercepted content of the complete standard. If you need the complete standard, please go to the top to download the complete standard document for free.