This standard specifies the diagnostic criteria and treatment principles for occupational acute barium poisoning. This standard applies to occupational acute poisoning caused by large amounts of barium compounds entering the body through the respiratory tract, digestive tract, burns or damaged skin during production and other occupational activities. It does not apply to other diseases caused by long-term exposure to low-concentration barium compounds. GBZ 63-2002 Diagnostic criteria for occupational acute barium poisoning GBZ63-2002 Standard download decompression password: www.bzxz.net

ICS13.100
National Occupational Health Standard of the People's Republic of China GBZ63-2002
Diagnostic Criteria of Occupational Acute Barium Poisoning2002-04-08 Issued
2002-06-01 Implementation
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 GB16384-1996 is inconsistent with this standard, this standard shall prevail. Barium compounds are chemical raw materials. During the production, transportation and use process, if there is improper protection, short-term exposure to a large amount of soluble barium compounds can cause acute poisoning with muscle paralysis, cardiovascular damage and hypokalemia as the main symptoms, and sudden death may occur without obvious early symptoms. In order to facilitate the early diagnosis and treatment of poisoning and protect the health of workers, 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. This standard is proposed and managed by the Ministry of Health of the People's Republic of China. This standard is drafted by the Second Affiliated Hospital of Shanxi Medical University. This standard is interpreted by the Ministry of Health of the People's Republic of China..comDiagnostic criteria for occupational acute barium poisoning
GBZ63-2002
Occupational acute barium poisoning refers to a systemic disease with muscle paralysis, cardiovascular damage and hypokalemia as the main manifestations caused by short-term contact with a large amount of soluble barium compounds during production, transportation and use. 1 Scope
This standard specifies the diagnostic criteria and treatment principles for occupational acute barium poisoning. This standard applies to occupational acute poisoning caused by a large amount of barium compounds entering the body through the respiratory tract, digestive tract, burns or damaged skin during production labor and other occupational activities. It is not applicable to other diseases caused by long-term contact with low concentrations of barium compounds.
2 Normative references
The clauses in the following documents become clauses of this standard through reference in this standard. For all the referenced documents with dates, all the 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 the referenced documents without dates, the latest versions are applicable to this standard.
3 Diagnostic principles
Diagnostic criteria for occupational acute chemical toxicity nervous system diseases Diagnostic criteria for occupational chemical skin burns Based on the exact occupational history of exposure to large amounts of barium compounds, clinical manifestations mainly characterized by muscle paralysis, cardiovascular damage, and hypokalemia, and the results of electrocardiogram and serum potassium examinations, combined with on-site investigations, comprehensive analysis is conducted to exclude similar diseases caused by other reasons before diagnosis can be made.
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Those with symptoms of nervous and digestive systems such as dizziness or headache, dry throat, nausea, mild abdominal pain and diarrhea, and normal electrocardiogram and serum potassium, can recover on their own within a few hours to two days. 5 Diagnosis and classification standards
5.1 Mild poisoning
In addition to the aggravation of the above symptoms, there are chest tightness, palpitations, numbness, weakness, weak limb movement, and muscle strength level IV (see GBZ76). The electrocardiogram shows early hypokalemia or the serum potassium is slightly low. 5.2 Moderate poisoning
Muscle strength level I, II, and III (see GBZ76), and decreased muscle tension. The electrocardiogram and serum potassium show hypokalemia. 5.3 Severe poisoning
Flaxative paralysis of the limbs, muscle strength level 0 to I (see GBZ76), and even respiratory muscle paralysis. The electrocardiogram and serum potassium show obvious hypokalemia, often accompanied by severe arrhythmias and conduction blocks. 6 Treatment principles
6.1 Treatment principles
6.1.1 Immediately leave the scene. For skin burns, rinse thoroughly with 2% to 5% sodium sulfate solution and then follow the routine treatment for burns (see GBZ51). For those who have been exposed to compound dust through the respiratory tract and digestive tract, rinse the mouth and take an appropriate amount of sodium sulfate orally. 6.1.2 Contact reactants and accidental poisoning personnel should be closely monitored for 48 hours and given preventive treatment at the same time. 6.1.3 Specific treatment, first of all, potassium should be supplemented in a timely and sufficient amount, under the close monitoring of electrocardiogram and serum potassium, until the test indicators return to normal, then reduce the dosage as appropriate, and stop the drug after stabilization. At the same time, sodium sulfate or sodium thiosulfate solution should be injected or dripped intravenously. 6.1.4 Other first aid measures and symptomatic treatment are the same as those for internal medicine. 6.2 Other treatments
6.2.1 After mild and moderate poisoning is cured, the original work can be resumed. After the severe poisoning is cured, the original work should be transferred away. 6.2.2
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 When accidentally exposed to high-concentration locked compound dust, it can enter the digestive tract at the same time as entering through the respiratory tract. Therefore, the clinical manifestations are basically the same as those of life poisoning, and the treatment of the digestive tract cannot be ignored during treatment. A.2 For those who are poisoned by skin absorption, the early digestive tract symptoms are mild or absent. It is necessary to pay attention to the monitoring of electrocardiogram and serum potassium, be alert to systemic poisoning and treat it in time to avoid sudden death. A.3 Diagnostic grading standards mainly use limb numbness, weak motor power, and reduced muscle strength as the starting point for the diagnosis of mild poisoning. The presence of incomplete limb flaccid paralysis and low potassium in electrocardiogram and serum potassium are the boundaries of moderate poisoning. The change of muscle strength in mild to moderate poisoning refers to the weakening of muscle strength in two or more limbs. Severe poisoning is characterized by complete paralysis of the limbs, even involving the trunk and respiratory muscles, and severe arrhythmias, conduction block and a significant decrease in serum potassium as the main indicators. A.4 Differential diagnosis should exclude periodic paralysis, myasthenia gravis, progressive muscular dystrophy, peripheral neuropathy, acute polyradiculitis (Guillain-Barre), etc. A.5 Regarding the use of potassium chloride, it can be taken orally or intravenously for contact reactions and mild poisoning. Both moderate and severe poisoning patients need to be given intravenously, and the concentration and speed should be controlled according to the condition. Do not push intravenously. Potassium supplementation must be carried out under ECG monitoring and serum clock monitoring. When the condition is relieved and the ECG and serum potassium return to normal, the dosage should be reduced and maintained. Do not stop the drug suddenly to prevent recurrence of the condition. For the use of sodium sulfate, 500mL of 2% sodium sulfate solution can be used for intravenous drip or 20mL of 10% sodium sulfate solution can be used for intermittent push injection.
A.6 When sulfide lock poisoning occurs, in addition to the toxic effect of barium ions, hydrogen sulfide can also be produced to cause corresponding poisoning, which should be noted during diagnosis and treatment.
A.7 When high-temperature lock compound burns the skin and causes poisoning, in addition to special treatment, the burned area should also be diagnosed and treated in accordance with the provisions of GBZ51.
A.8 Although blood barium determination is specific, this examination is not yet popularized, and the clinical development law after poisoning has nothing to do with blood lock changes, so it is not included in the standard. ..com
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