This standard specifies the medical examination of overexposure (GB 18196-2000 Medical examination of overexposure personnel GB18196-2000 Standard download decompression password: www.bzxz.net

GB18196-2000
This standard is formulated to unify and standardize the medical examinations for overexposed individuals. This standard is proposed by the Ministry of Health of the People's Republic of China. The drafting unit of this standard: Industrial Hygiene Laboratory of the Ministry of Health. The drafters of this standard: Xu Xiufeng, Ji Guiyun, Zheng Shanxiao. 449Www.bzxZ.net
1 Scope
National Standard of the People's Republic of China
Specifications of the medical examinationsfor the overexposed individuals
Specifications of the medical examinationsfor the overexposed individuals This standard specifies the necessary items and precautions for medical examinations for overexposed individuals (<1Gy). GB18196—2000
This standard applies to individuals who have been exposed to overexposure (<1Gy), including abnormal exposure, occupational exposure, medical exposure and nuclear war.
2 Referenced Standards
The provisions contained in the following standards constitute the provisions of this standard through reference in this standard. At the time of publication of this standard, the versions shown are valid. All standards are subject to revision, and parties using this standard should explore the possibility of using the latest versions of the following standards. GB8282—2000 Diagnostic criteria and treatment principles for radiation skin diseases GB8283--1987 Diagnostic criteria and treatment principles for radiation cataracts GB8284--1987 Diagnostic criteria and treatment principles for internal radiation sickness GB16386—1996 Judgment criteria and treatment principles for radiation tumors GB16392—1996 Diagnostic criteria and treatment principles for radiation-burn combined injuries 3 Definitions
This standard adopts the following definitions:
3.1 Overexposure
People are exposed to external radiation greater than the annual dose equivalent limit, or internal radiation greater than the annual intake limit of radionuclides. 3.2 Abnormal exposure When the radiation source is out of control, people are exposed to radiation that may exceed the dose equivalent limit, which is divided into accidental exposure and emergency exposure. 3.3 Accidental exposure The exposure to which personnel are exposed without any preparation due to an accidental event in which the radiation source is out of control. The dose cannot be predicted or controlled. Personnel exposed to small doses may not have perceptible clinical symptoms in the early stage, but may experience late effects. 3.4 Emergency exposure The exposure received in emergency actions taken in radiation accidents to rescue endangered people and property and prevent the situation from escalating is proactively arranged and a certain dose can be controlled, except in special circumstances. 4 Early medical examination refers to medical examinations conducted immediately, within days, weeks or six months after exposure. Personnel with a whole-body exposure dose ≥ 0.1 Sv should be subject to management investigations and medical examinations at local medical institutions; personnel with an exposure dose of 0.25 Sv should be subject to detailed medical examinations and observations.
4.1 Overexposure: including the time and place of exposure, the position and posture of the exposed person, the distance from the radiation source, the duration of stay, the type and intensity of the radiation source or radiation, the exposure method, the exposure dose and dose rate, the presence or absence of combined injuries, the presence or absence of radionuclide contamination, and the presence or absence of shielding and protective measures.
4.2 Medical history
4.2.1 Medical history before and after exposure, and the history of exposure to radiation and other physical and chemical toxins. 4.2.2 Marital history, childbearing history, and family medical history. 4.2.3 Health of children.
4.3 Clinical examination and observation
4.3.1 Pay attention to the mental state after exposure, and the time, duration and degree of skin erythema, nausea, vomiting, diarrhea, etc.; also pay attention to whether there are complex injuries and other subjective symptoms. 4.3.2 Clinical examinations in various departments: including general routine examinations of internal medicine, surgery, neuropsychiatry, skin, eyes (pay special attention to the lens), otolaryngology, oral cavity, obstetrics and gynecology, etc. and necessary special examinations (according to the specific condition of the exposed person). 4.4 Laboratory examinations
4.4. 1 Hematology and bone marrow examinations: including blood routine, platelet count, abnormal blood cells, etc., pay special attention to the peripheral blood lymphocyte and neutrophil count and fluctuation within 1~~2 days after exposure; bone marrow and semen examinations are performed when necessary; 4.4.2 According to the condition, special examinations such as immunology, endocrinology, chromosome aberration rate, micronucleus rate, and genes can be added. 4.5 If neutron exposure occurs, samples of hair, sputum, mouth, nose swabs, skin lesions and wound contaminants, blood, urine, feces, etc. should be collected for examination; and whole-body and organ dose monitoring, including physical and biological doses, should be conducted. 4.6 If excessive internal exposure occurs, chest X-rays, exhaled air, sputum cells, lung function, liver, kidney function, and internal (urine) radionuclides should be added. These examinations can be conducted in accordance with GB8284, and detailed records and necessary supplements should be made. 5 Medical examinations for long-term effects
refer to changes that occur 6 months, years, or even decades after exposure, including examinations of the exposed person himself and his offspring. In addition to early medical examinations, long-term follow-up observations of long-term effects should be conducted according to the exposure status and degree of damage. 5.1 Random effects: refers to radiation effects whose probability of occurrence after exposure is related to dose, including carcinogenic effects and genetic effects. 5.1.1 Carcinogenic effect: It is the most important long-term effect of radiation, mainly including leukemia and malignant solid tumors. It can be examined by general clinical tumor examination methods; pay attention to observe and examine various types of acute and chronic leukemia, and the presence or absence of thyroid tumors, breast cancer, lung cancer, multiple myeloma and other malignant bone tumors, and take possible corresponding treatment. The cause of disease can refer to GB16386.
5.1.2 Genetic effect: It refers to the effect of radiation on reproductive cells. It is mainly manifested in genetic diseases and congenital malformations. The objects of observation include the exposed person himself and his children and offspring. 5.1.2.1 The fertility of the exposed person, such as spontaneous abortion, surgical delivery, premature birth, stillbirth, malformation, multiple births, neonatal death and infertility. 5.1.2.2 The health of the children, pay attention to their physical and intellectual development, whether there are congenital malformations, genetic diseases, chromosomal abnormalities, dementia, etc.
5.2 Deterministic effect: It refers to the radiation effect that can only be produced when the tissue or organ is exposed to a dose above the reading dose. 5.2.1 Effects on the hematopoietic system: such as blood cell reduction, myeloproliferative disorder or various blood diseases. Peripheral blood and bone marrow examinations should be performed (see 5.4.1).
5.2.2 Effects on the reproductive system: sperm count may decrease, motility may decrease, abnormal sperm may increase, and fertility may decrease. Semen routine examination and fertility examination should be performed.
5.2.3 Effects of intrauterine exposure: lethal effects, developmental disorders, deformities, mental retardation, etc. may occur. Examinations should be conducted according to obstetrics and gynecology and pediatrics. 5.2.4 Effects on the eye lens: Generally, radiation cataracts will not occur with overexposure <1Gy. If necessary, the pupil may be dilated to observe whether the lens has turbidity, cavitation, etc., and the condition may also be examined and judged in accordance with GB8283. 5.2.5 Effects on the skin and mucous membranes: The condition may be examined and judged according to general clinical practice, and attention may be paid to whether there are radioactive composite burns, etc., and examinations may be conducted according to GB8282 and GB16392 if necessary. 451
GB18196—2000
5.3 Frequency of long-term radiation effect examination: Within 5 years after exposure: medical examination once a year; 5 to 10 years after exposure: medical examination once every 2 to 3 years; more than 10 years after exposure: medical examination once every 5 years. 452
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