GB 8790-1988 Occupational chloroprene poisoning diagnostic criteria and treatment principles
Some standard content:
National Standard of the People's Republic of China
Occupational chloroprene poisoning
Diagnostic criteria and principles of management ofinccupational chloroprene polsoningUDC 616-057 : 616
-07/-08 : 613
GB 8790—88
Occupational chloroprene poisoning is an acute or chronic systemic disease caused by the absorption of chloroprene vapor or liquid. Acute poisoning is mainly characterized by central nervous system depression and respiratory tract irritation. Chronic poisoning is mainly characterized by liver damage and neurasthenia syndrome, and most cases also have hair loss.
1 Diagnostic principles
According to the history of short-term, large-scale or long-term close occupational exposure and the clinical manifestations of liver damage mainly caused by anesthesia, combined with labor hygiene surveys and necessary dynamic observation data, comprehensive analysis is conducted to exclude other diseases, especially viral hepatitis, before diagnosis of acute or chronic nitrile poisoning can be made.
2 Diagnosis and classification standards
2.1 Observation subjects
Those with symptoms of neurocystic weakness syndrome such as dizziness, headache, insomnia, memory loss, fatigue, and loss of appetite, and one of the following changes:
Mild hair loss;
Nail discoloration:
The white-to-white contrast of β-globulin decreases by more than 20%#The liver is within 1.0 cm below the midclavicular line, and there are suspicious changes in quality and liver function. d
2.2 Chronic mild poisoning
In addition to the aggravation of the above-mentioned neurasthenia syndrome, patients with any of the following can be diagnosed as mild poisoning: a. Moderate or severe hair loss;
b. The lower edge of the liver is 1.0~1.5cm below the costal margin of the midclavicular line, accompanied by tenderness and abnormal liver function; or the liver is enlarged more than 1.5cm below the midclavicular line auxiliary edge, but there is no abnormal liver function; check the serological indicators of hepatitis B infection: HBaAg is (-), HBeAg is (-) anti-HBc-IgM (-), so as to exclude viral hepatitis B as much as possible. 2.3 Chronic severe poisoning
On the basis of chronic mild toxic liver disease caused by fludioxine, cirrhosis occurs. 2.4 Acute mild poisoning
Those with the following clinical manifestations can be diagnosed as mild poisoning: dizziness, headache, fatigue, numbness of limbs, unsteady gait or short consciousness disturbance, nausea, vomiting; a.
tears, dry and sore throat, cough, chest pain, dyspnea; b.
conjunctival congestion, pharyngeal congestion, scattered dry and wet rales in the lungs; chest X-ray may show enhanced lung texture
Ministry of Health of the People's Republic of China approved on February 22, 1988, implemented on September 1, 1988
2.5 Acute severe moderate poisoning
GB 8790
Those with the above clinical manifestations aggravated and one of the following manifestations: coma:
b. epileptic seizure.
3 Treatment principles
3. Acute poisoning: Immediately leave the scene, keep quiet, keep warm, give oxygen, clean the contaminated skin, change contaminated clothes, and rinse the contaminated eyes with clean water, saline or 12% sodium carbonate nitrogen solution. In the acute stage, you should pay attention to bed rest and symptomatic treatment. 3.2 Chronic poisoning: Proper rest, strengthen nutrition, symptomatic treatment, 4 Labor capacity assessment
4.1 Observation objects
Should be reexamined every six months.
4.2 Chronic mild poisoning
Moderate or severe hair loss should rest for 1 to 2 months and receive symptomatic treatment. Those with liver damage should be given timely treatment and resume their original work after recovery: Those with II\ quality changes should be transferred from chloroprene operation and reexamined every 3 to 6 months. 4.3 Severe moderate to moderate poisoning
All should no longer engage in chloroprene operation, but take a half-time break or engage in light work depending on the condition. 4.4 Acute mild poisoning
Resume original work after recovery
4.5 Acute severe poisoning
Resume original work after recovery: If liver damage occurs, take a rest for 2 months: If liver damage occurs, resume original work: If liver damage occurs, take 2 months after acute severe poisoning, liver damage may occur, and should be treated according to the above 4.2 liver damage.
4.6 Pregnant and lactating women should temporarily leave chlorodiene operations. 5 Requirements for health examination
Chlorodiene operators should undergo pre-employment and annual regular physical examinations, including internal medicine, liver function (Zn/T, TTT, SGIT), IL albumin electrophoresis, HBsAg, etc. 6 Occupational contraindications
7. Hepatitis virus surface antigenicity:
Various liver diseases;
Organic diseases of the nervous system:
Obvious chronic respiratory diseases:
Severe systemic skin diseases.
A.1 Scope of application of this standard
GB 8790—88
Appendix A
Instructions for correct use of the standard
(reference)
This standard applies to personnel engaged in the production of chloroprene, polymerization, chain breaking, coagulation, long web, drying, gluing, and the production and processing of various chloroprene rubbers, latex, adhesives, etc. containing chloroprene monomers, as well as analysis and inspection. A.2 Hair loss
Hair loss occurs when contacting chloroprene, and the degree is related to the contact concentration. Not all contact persons will experience hair loss. Hair loss degree:
a. Mild examination: If the examinee gently rubs the head and neck with his hands, a lot of hair will fall out: b. Moderate hair loss to the extent of obvious smearing, c. Severe cases: hair loss is almost complete, with loss of shield hair, armpit hair, pubic hair, A.3H globulin decreases by 20% by comparison. Compare with the results of pre-employment or regular physical examinations; compare with the results of examinations after 1-2 months of treatment without chloroprene exposure. An increase of 20% is also acceptable.
A.4 Diagnosis of chronic chloroprene toxic liver disease: Chloroprene workers have enlarged liver and gradual changes in quality; digestive system symptoms are not as obvious as neurasthenia syndrome, and there may be a decrease in globulin in serum protein electrophoresis; often have a history of moderate or above hair loss. The manifestations are used as a reference for the diagnosis of toxic liver disease caused by chloroprene. The examination of liver function and viral hepatitis serological indicators can be carried out using the local common methods. Do not use the results of a single examination as a basis for diagnosis. A.5 Other diseases should also be excluded for liver damage. Such as viral hepatitis, schistosomiasis, clonorchiasis, trichuriasis biliary infection, maternal hepatitis caused by drugs or other industrial toxins, fetal fatty liver, etc. Hair loss can also be caused by other diseases: such as systemic diseases (endocrine dysfunction diseases, severe acute infectious diseases and chronic diseases), skin diseases (baldness, tinea capitis, leprosy, syphilis, exfoliation Dermatitis, radiation dermatitis, seborrheic alopecia, long-term exposure to high-frequency current), drugs or other industrial toxins, etc. This should be excluded from occupational history, medical history, rest and other dynamic observations.
Additional remarks: bzxz.net
This standard was proposed by the Occupational Disease Diagnosis Standard Subcommittee of the National Health Standard Technical Committee. This standard was drafted by the Affiliated Hospital of Shanxi Medical College, the Occupational Disease Prevention and Control Institute of West China Medical University, the Institute of Labor Health and Occupational Diseases of the Chinese Academy of Preventive Medicine, and the Qingdao Textile Bureau Hospital. This standard is interpreted by the Institute of Labor Health and Occupational Diseases of the Chinese Academy of Preventive Medicine entrusted by the Ministry of Health.
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