This standard specifies the diagnostic criteria and treatment principles for occupational acute methyl bromide poisoning. This standard applies to the diagnosis and treatment of occupational acute methyl bromide poisoning. Non-occupational acute methyl bromide poisoning can also be implemented as a reference. GBZ 10-2002 Occupational Acute Methyl Bromide Poisoning Diagnostic Criteria GBZ10-2002 Standard download decompression password: www.bzxz.net

ICS13.100
National Occupational Health Standard of the People's Republic of China GBZ10—2002
Diagnostic Criteria of Occupational Acute Methyl Bromide Poisoning2002-04-08 Issued
Ministry of Health of the People's Republic of China
Implementation on 2002-06-01
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 GB7796-1987 is inconsistent with this standard, this standard shall prevail. Acute methyl bromide poisoning may occur in occupational activities involving contact with methyl bromide. In order to protect the health of the contactors and effectively prevent and control methyl bromide poisoning, the state promulgated GB7796-1987 in 1987. In combination with the research progress in recent years, the relevant contents were revised and supplemented. And the text and structure were changed according to the requirements of the specification. The diagnostic system is consistent with the series of standards of "Diagnostic Standards for Occupational Acute Chemical Poisoning". 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 Xi'an Central Hospital and the Institute of Occupational Health and Poison Control of the Chinese Center for Disease Control and Prevention. Shandong Weifang People's Hospital and Xi'an Health Bureau participated in the drafting. This standard is interpreted by the Ministry of Health of the People's Republic of China. ..comDiagnostic Standard for Occupational Acute Methyl Bromide Poisoning GBZ10-2002
Occupational acute methyl bromide poisoning refers to a systemic disease with damage to the nervous system and respiratory system as the main manifestation caused by exposure to a large amount of methyl bromide in a short period of time during occupational activities. 1 Scope
This standard specifies the diagnostic criteria and treatment principles for occupational acute methyl bromide poisoning. This standard is applicable to the diagnosis and treatment of occupational acute methyl bromide poisoning. Non-occupational acute methyl bromide 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 referenced documents with dates, all subsequent amendments (excluding errata) or revisions are not applicable to this standard. However, parties that reach an agreement based on this standard are encouraged to study whether the latest versions of these documents can be used. For all referenced documents without dates, the latest versions are applicable to this standard.
GB/T16180
3 Diagnostic principles
Diagnostic criteria for occupational chemical skin burns
Diagnostic criteria for occupational toxic liver diseases
Diagnostic criteria for occupational acute chemical poisoning respiratory diseasesDiagnostic criteria for occupational acute chemical poisoning heart diseasesDiagnostic criteria for occupational acute chemical poisoning nervous system diseasesIdentification of the degree of disability caused by work-related injuries and occupational diseases of employeesBased on the occupational history of short-term exposure to large amounts of methyl bromide, clinical manifestations mainly of acute central nervous system and respiratory system damage and other necessary clinical examination results, refer to the on-site labor hygiene survey, and make a comprehensive analysis to exclude similar diseases caused by other causes before diagnosis can be made.
Contact reactions
There are symptoms of eye and upper respiratory tract irritation, or headache, dizziness, fatigue and other nervous system symptoms, which usually disappear within 24 hours after the contact is broken.
5 Diagnosis and classification standards
Mild poisoning
After a latent period of several hours to several days, obvious symptoms such as dizziness, headache, fatigue, gait, loss of appetite, nausea, vomiting, cough, chest tightness, etc. will appear, and one of the following conditions will occur: a) Mild impaired consciousness;
b) Mild dyspnea, a small amount of dry or wet rales can be heard in the lungs. ..com2 Severe poisoning
The above conditions are significantly aggravated and one of the following conditions will appear: a) Severe impaired consciousness;
b) Pulmonary edema.
6 Treatment principles
6.1 Treatment principles
6.1.1 Immediately leave the scene and change contaminated clothing. If there is skin contamination, wash it with clean water, 2% sodium bicarbonate solution or soapy water. 6.1.2 Those with contact reactions should be observed for at least 48 hours and treated according to the situation. The poisoned patient should rest in bed, keep quiet, and observe the changes in the condition closely.
6.1.3 Treatment is mainly symptomatic and supportive. Brain edema, pulmonary edema and other conditions should be treated early and actively. 2 Other treatmentsWww.bzxZ.net
Patients with acute mild methyl bromide poisoning can return to their original work after recovery; patients with severe poisoning should be transferred from their original jobs. If labor capacity assessment is required, it should be handled in accordance with GB/T16180. Instructions for the correct use of this standard
See Appendix A (Informative Appendix).
..comAppendix A
(Informative Appendix)
Instructions for the correct use of this standard
A.1 The clinical manifestations of acute methyl bromide poisoning in the two main target organs of the nervous system and respiratory system are the most prominent, so this is used as the main basis for classification. In addition to the clinical manifestations of the nervous and respiratory systems, kidney damage is common. In mild cases, protein, casts, and red and white blood cells can be seen in the urine. In severe cases, renal failure may occur, and death from uremia may occur (see GBZ79). Liver damage is also common (see GBZ59). In some cases, myocardial damage occurs, and in severe cases, peripheral circulatory failure may also occur (see GBZ74). Pay attention to this in diagnosis and treatment. A.2 The incubation period of this disease is 2 minutes to 48 hours, mostly 4-6 hours, and up to 5 days in some cases. Therefore, those who have been exposed should be observed for at least 48 hours.
A.3 Blood bromine, urine bromine and on-site air methyl bromide concentrations are all exposure indicators. If the exposure history is unclear and differential diagnosis is difficult, the determination of the above indicators is of reference value.
Normal blood bromine is below 25umo1/L. Generally, blood bromine >62.5umo1/L (50mg/L) is a dangerous level, and poisoning symptoms appear when it reaches 187.5μmo1/L. The normal reference value of urine bromine is 12.5μmo1/L (10mg/L). A.4 Acute methyl bromide poisoning should be differentiated from acute carbon monoxide poisoning, acute hydrogen sulfide poisoning, acute phosphine poisoning and acute central nervous system infectious diseases. A.5 There is no specific antidote for this disease, and supportive and symptomatic treatment is the main treatment. In view of the fact that the mechanism of methyl bromide poisoning may be related to the inhibition of enzymes containing sulphuric groups in the body, drugs containing sulphuric groups such as cysteine ​​and glutathione can be tried. Early application of glucocorticoids plays an important role in preventing and treating lung, brain and kidney damage.
A.6 Liquid or high concentration methyl bromide can cause skin burns. Its diagnosis and treatment can refer to GBZ51. ..com
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