This standard applies to those who are poisoned by long-term exposure to allyl chloride in the production of allyl chloride and in the industrial production of epichlorohydrin, sodium propylene sulfonate, dimethoate or batan. GBZ 6-2002 Occupational chronic allyl chloride poisoning diagnostic standard GBZ6-2002 standard download decompression password: www.bzxz.net

ICS 13.100
National Occupational Health Standard of the People's Republic of China GBZ6-2002
Diagnostic Criteria of Occupational Chronic Allyl Chloride 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 there is any inconsistency between the original standard GB4865-1985 and this standard, this standard shall prevail. Allyl chloride (3-chloropropene, allyl chloride) is a chemical raw material, mainly used in the production of epichlorohydrin, sodium propylene sulfonate, and dimethoate. This product is easy to volatilize at room temperature. Long-term contact under inadequate protection conditions can cause chronic poisoning mainly with peripheral nerve damage. In order to protect the health of workers and effectively prevent and treat chronic allyl chloride poisoning, this standard is formulated on the basis of summarizing domestic clinical practice experience and analyzing domestic and foreign research progress. Appendix A of this standard is an informative appendix. wwW.bzxz.Net
This standard is proposed and managed by the Ministry of Health of the People's Republic of China. This standard is drafted by the Institute of Occupational Health and Poisoning Control of the Chinese Center for Disease Control and Prevention and the Institute of Occupational Health and Occupational Disease Prevention and Control of Shandong Province.
This standard is interpreted by the Ministry of Health of the People's Republic of China. ..comDiagnostic Standard for Occupational Chronic Allyl Chloride Poisoning GBZ6-2002
Chronic allyl chloride poisoning is a disease with peripheral nerve damage caused by close contact with allyl chloride (allyl chloride) in industrial production. Its clinical manifestations include different degrees of distal limb sensory, motor or tendon reflex disorders, and neuro-electromyography can show neurogenic damage.
1 Scope
This standard is applicable to those who are poisoned by long-term contact with allyl chloride in the production of allyl chloride and in the industrial production of epichlorohydrin, sodium propylene sulfonate, dimethoate or batan.
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.
GBZ76 Diagnostic criteria for occupational acute chemical toxicity nervous system diseases 3 Diagnostic principles
According to the occupational history of long-term close contact with chloropropene and clinical symptoms, signs and neuro-electromyographic changes mainly characterized by multiple peripheral nerve damage, combined with on-site hygiene surveys and data on the determination of chloropropene concentrations in the air, after excluding peripheral neuropathy caused by other causes, chronic chloropropene poisoning can be diagnosed. 4 Observation subjects
Those who meet any of the following items can be listed as observation subjects. 4.1 Patients with symptoms such as heaviness and weakness in both legs, numbness, soreness, cramps, and coldness in the distal extremities, or suspected neurogenic damage on neuro-EMG, but no signs of peripheral nerve damage. 4.2 Patients with suspected neurogenic damage only on neuro-EMG but no typical symptoms and signs of peripheral nerve damage. 5 Diagnosis and grading standards
5.1 Mild poisoning
In addition to the above symptoms, patients with any of the following can be diagnosed with mild poisoning. 5.1.1 Symmetrical glove-stocking-like distribution of pain, touch, and tuning fork vibration sensation disorders, and weakened Achilles tendon reflexes. 5.1.2 Patients with mild or unobvious signs, but neuro-EMG shows definite neurogenic damage. 5.2 Severe poisoning
Patients with any three of the following four items can be diagnosed with severe poisoning. 5.2.1 Weakened limb muscle strength (muscle strength 3 degrees or less), or distal limb muscle atrophy. 5.2.2 Impaired pain, touch, and tuning fork vibration sensation in the limbs, most of which are symmetrically distributed like gloves and stockings, and the upper limit reaches the elbow or knee.
The Achilles tendon reflex disappears.
5.2.4 Electromyography examination shows neurogenic damage, and there are many spontaneous nerve loss potentials. Treatment principles
Treatment principles
It can be treated with B vitamins, energy mixtures, or traditional Chinese medicine with the effect of promoting blood circulation and unblocking collaterals, supplemented by physical therapy, physical therapy, acupuncture therapy, and symptomatic treatment.
6.2 Other treatments
The subjects are generally not transferred from the propylene chloride operation, and should be reviewed every six months, and neuro-electromyography examinations should be performed as much as possible for dynamic observation.
6.2.2 Those diagnosed with mild chronic chloropropene poisoning should be transferred away from chloropropene work and can engage in other work after short-term treatment and should be reexamined regularly.
Those diagnosed with severe chronic chloropropene poisoning should no longer engage in chloropropene and other work that is harmful to the nervous system. 6.2.3
After treatment, rest and work should be arranged according to the examination results. Instructions for the correct use of this standard
See Appendix A (Informative Appendix).
..com Appendix A
Instructions for the correct use of this standard
(Informative Appendix)
A.1 The measurement data of chloropropene concentration in workshop air are of reference significance for diagnosis. A.2 The main clinical manifestation of this disease is polyneuropathy. When conditions are not met for neuro-EMG examination, the diagnostic significance of a single abnormal sign is difficult to determine. The diagnosis can only be made when there are symptoms such as heaviness and weakness in both legs, soreness, numbness, and swelling in the limbs, as well as relatively constant peripheral distribution of pain, touch, sound and vibration disorders, and weakened Achilles tendon reflexes on one or both sides. Sensory examinations should be repeated several times, and Achilles tendon reflex examinations should be performed in the prone position with knees bent. For the grading criteria for muscle weakness, see Appendix C of GBZ76.
A.3 Neuro-EMG examination is of great significance for the early diagnosis of this disease. In chronic allyl chloride poisoning, peripheral nerve axonal damage should be the main focus, and the electromyography of distal limb muscles should be examined, such as the abductor pollicis brevis and abductor digiti minimi of the hand; because it is difficult for the examinee to cooperate with the examination of small muscles in the foot, the anterior tibialis or tibialis posterior is often used for lower limb examinations. When measuring nerve conduction velocity, the median nerve and ulnar nerve are generally taken for the upper limbs, and the common nerve and posterior tibial nerve are generally taken for the lower limbs. The judgment should be made in accordance with the unified operating methods in Appendix B.1 and B.2 of GBZ76, with reference to the relevant normal values ​​and the judgment criteria for neurogenic damage. A.4 Peripheral neuropathy can be caused by other diseases, such as diabetes, nutritional deficiency, compression injury, drug and other industrial poisoning, hereditary diseases, infectious diseases or connective tissue diseases, so it should be excluded from occupational history, medical history, physical examination and laboratory examination.
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