GBZ 34-2002 Diagnostic criteria for occupational acute pentachlorophenol poisoning
Some standard content:
1CS13.100
National Occupational Health Standard of the People's Republic of China GBZ34—2002
Diagnostic Criteria of Occupational Acute Pentachlorophenol PoisoningPublished on April 8, 2002
Implemented on June 1, 2002
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 GB8792-1988 is inconsistent with this standard, this standard shall prevail. Acute pentachlorophenol poisoning may be caused in occupational activities involving contact with pentachlorophenol or sodium pentachlorate. In order to protect the health of the contactors and facilitate the prevention and control of poisoning, GB8792-1988 was issued, and this standard is a revised version. This revision, based on the summary and analysis of clinical cases, analyzes the onset of acute poisoning, changes in the condition and damage to important organs, and makes partial adjustments and modifications to the diagnostic classification, highlighting the clinical characteristics of acute pentachlorophenol 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 is drafted by the Jiangxi Provincial Institute of Labor Health and Occupational Disease Prevention and Control and the Jiangsu Provincial Institute of Occupational Disease Prevention and Control. The participating units are Tianjin Dagu Chemical Plant Staff Hospital, Nanchang Railway Bureau Central Health and Epidemic Prevention Station and Jiangxi Shanggao County Health and Epidemic Prevention Station.
This standard is interpreted by the Ministry of Health of the People's Republic of China. Occupational Acute Pentachlorophenol Poisoning Diagnostic Criteria GBZ34-2002
Occupational acute pentachlorophenol poisoning refers to a systemic disease characterized by abnormal heat energy metabolism caused by short-term exposure to a large amount of pentachlorophenol in occupational activities. Central nervous system and lung, heart, liver and kidney damage may also occur. 1 Scope
This standard specifies the diagnostic criteria and treatment principles for occupational acute pentachlorophenol poisoning. This standard applies to acute poisoning caused by exposure to pentachlorophenol and sodium pentachlorophenol in occupational activities. This standard can also be used as a reference for acute poisoning caused by exposure to pentachlorophenol in non-occupational activities. 2 Normative referenced standard documents
The clauses in the following documents become the clauses of this standard through reference in this standard. For all dated referenced documents, all subsequent amendments (excluding errata) or revisions are not applicable to this standard. However, the parties who reach an agreement based on this standard are encouraged to study whether the latest versions of these documents can be used. For all undated referenced documents, the latest versions are applicable to this standard.
3 Diagnostic principles
Diagnostic criteria for occupational skin diseases (general principles) Diagnosis can be made based on the occupational history of exposure to a large amount of pentachlorophenol in a short period of time, typical clinical manifestations, combined with comprehensive analysis of on-site labor hygiene investigations, and exclusion of similar diseases caused by other causes. 4 Contact reaction
There is a history of close contact and symptoms such as mild dizziness, headache, sweating, and weakness in the lower limbs. 5 Diagnosis and classification standardswww.bzxz.net
5.1 Mild poisoning
In addition to the aggravation of the above symptoms, there are symptoms such as low fever, thirst, palpitations, shortness of breath, chest tightness, and nausea, vomiting, and abdominal pain.
5.2 Severe poisoning
After the symptoms of mild poisoning appear, the condition changes sharply in a short period of time (1-2 hours), with high fever, profuse sweating, extreme fatigue, increased heart rate, rapid breathing, irritability, and even sudden death. 6 Treatment principles
6.1 Treatment principles
6.1.1 Immediately take off contaminated clothing and wash contaminated skin with soapy water. 6.1.2 The contact reaction should be observed for at least 24 hours, paying special attention to changes in consciousness and body temperature, and taking necessary measures in time. 6.1.3 Early treatment is very important, especially when the patient has a fever, and various cooling measures should be taken immediately, such as physical cooling, hibernation drugs, etc.
6.1.4 Treatment is mainly symptomatic and supportive. Reasonable fluid replacement, maintaining electrolyte balance, adrenal glucocorticoids when necessary, supply energy, and pay attention to protecting major organs. Avoid using atropine and barbiturates.
6.2 Other treatments
Acute pentachlorophenol poisoning patients can resume work only after active treatment, symptoms and signs disappear, and urine pentachlorophenol determination returns to normal. In the absence of laboratory testing, mildly poisoned patients should be transferred at least one month after discharge, and severely poisoned patients should be transferred at least three months after discharge before they can resume their original work.
Instructions for the correct use of this standard
See Appendix A (Informative Appendix).
Appendix A
(Informative Appendix)
Instructions for the correct use of this standard
A.1 Occupational acute pentachlorophenol poisoning is often caused by direct skin contact with pentachlorophenol due to failure to use personal protective equipment as required during work. Therefore, when inquiring about occupational history and physical examination, attention should be paid to understanding the situation of skin contact with pentachlorophenol, and respiratory inhalation should not be ignored.
A.2 Acute pentachlorophenol poisoning has an acute onset, mainly with symptoms such as fever, sweating, fatigue, loss of appetite, nausea, and vomiting. It should be distinguished from fever diseases such as heat stroke and influenza and acute digestive system diseases. A.3 The clinical characteristics of acute pentachlorophenol poisoning are rapid development of the disease, and the body temperature can suddenly rise to above 40℃ within 1-2 hours. The patient quickly falls into a coma or even dies suddenly. Mild cases can generally be relieved within 24 hours, so the changes in the condition of those who have contact reactions should be closely observed and symptomatic supportive treatment should be actively carried out.
A.4 Severe poisoning often causes obvious damage to the heart, liver, kidney and brain, mainly manifested as obvious myocardial damage, obvious changes in liver function, hematuria, proteinuria, renal dysfunction and impaired consciousness. A.5 This standard mainly diagnoses and grades acute pentachlorophenol poisoning based on the severity of clinical manifestations. Although urinary pentachlorophenol is a specific indicator reflecting the degree of pentachlorophenol absorption by the human body, it is not completely parallel to the severity of the disease, so it is not used as an indicator for diagnosis and classification, but can be used as an auxiliary differential diagnosis indicator. Normal human urine does not contain pentachlorophenol. The biological threshold value of urinary pentachlorophenol is 2mg/L. This standard takes urinary pentachlorophenol below 2mg/L as recovery to normal. A.6 Treatment is mainly to control fever, and physical cooling and hibernation therapy can be used. Chlorpromazine plus promethazine can be used as hibernation drugs. Atropine can inhibit sweating and heat dissipation and aggravate the disease. Barbiturates have a toxic effect on this poison and should be banned. Cooling must be started in the early stage, when the body temperature has not yet exceeded 38.5℃, in order to achieve better therapeutic effects. If active treatment is only started after high fever has occurred, the effect is often poor. This disease often occurs in hot seasons. When taking cooling measures for patients during treatment, attention should be paid to cooling the environment.
A.7 Severely poisoned patients excrete pentachlorophenol slowly in their urine, and it often takes three months to return to normal. Therefore, severely poisoned patients should be transferred for at least three months after recovery before returning to their original work. A.8 For the diagnosis and treatment of acute contact dermatitis caused by pentachlorophenol, please refer to GBZ18.
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