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 labor and other occupational activities. It is not applicable to other diseases caused by long-term exposure to low-concentration barium compounds. GB 16384-1996 Diagnostic criteria and treatment principles for occupational acute barium poisoning GB16384-1996 Standard download decompression password: www.bzxz.net

National Standard of the People's Republic of China
Diagnostic criteria and principles of managementof occupational acute barium poisoningGB 163841996
Occupational acute barium poisoning refers to a systemic disease with muscle paralysis, cardiovascular damage and hypokalemia as the main manifestations caused by short-term exposure to large amounts of soluble barium compounds during production, transportation and use. 1 Subject content and scope of application
This standard specifies the diagnostic criteria and management 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, burned or damaged skin during production labor and other occupational activities. It is not applicable to other diseases caused by long-term exposure to low-concentration compounds. 2 Reference Standards
GB4865-85 Occupational chronic allyl chloride poisoning diagnostic criteria and treatment principles GB16371-1996 Occupational chemical skin burn diagnostic criteria and treatment principles 3 Diagnostic principles
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, as well as 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. 4 Diagnosis and grading standards
4.1 Contact reaction
Those with neurological and digestive system symptoms such as dizziness or headache, dry throat, nausea, mild abdominal pain and diarrhea, normal electrocardiogram and serum potassium, and self-recovery within a few hours to two days. www.bzxz.net
4.2 Mild poisoning
In addition to the aggravation of the above symptoms, there are also chest tightness, palpitations, numbness, weakness, weak limb movement, and muscle strength level V (see GB4865). The electrocardiogram shows early signs of hypokalemia or the serum potassium is slightly low. 4.3 Moderate poisoning
Muscle strength is 1 to Ⅱ (see GB4865), and muscle tension is reduced. The electrocardiogram and serum potassium show hypokalemia. 4.4 Severe poisoning
Flaxative paralysis of the limbs, muscle strength is 0 to I (see GB4865), and even respiratory muscle paralysis. The electrocardiogram and serum potassium show obvious hypokalemia, often accompanied by severe arrhythmias and conduction blocks. 5 Treatment principles
5.1 Immediately leave the scene. For those with skin burns, rinse thoroughly with 2% to 5% sodium sulfate and then treat burns according to routine procedures (see GB16371). For those who have compound dust entering through the respiratory tract and digestive tract, rinse the mouth and take an appropriate amount of sodium sulfate orally. 5.2 Those who have been exposed to the poison in an accident should be closely monitored for 48 hours and given preventive treatment. Approved by the State Administration of Technical Supervision on May 23, 1996 and implemented on December 1, 1996
GB16384-1996
5.3 For specific treatment, potassium should be supplemented in a timely and sufficient amount first, under the close monitoring of electrocardiogram and serum potassium, until the test indicators return to normal, and then the dosage should be reduced as appropriate, and the drug should be stopped after stabilization. At the same time, sodium sulfate or sodium thiosulfate should be injected or dripped intravenously. 5.4 Other first aid measures and symptomatic treatment are the same as those in internal medicine. 6 Assessment of labor capacity
6.1 After mild and moderate poisoning is cured, the original work can be resumed. 6.2 After severe cysts are cured, they should be transferred from the original work. 7 Requirements for health monitoring
7.1 All workers engaged in the operation of lock compounds should undergo a pre-employment physical examination and a physical examination every two years after employment. Physical examination should include internal medicine, neurology, electrocardiogram, etc. 7.2
8 Occupational Cai contraindications
Muscle disease,
Cardiovascular system disease;
Peripheral neuropathy.
GB16384—1996
Appendix A
Instructions for correct use of standards
(reference)
A1. When accidentally exposed to high-concentration barium compound dust, it can enter the digestive tract while 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. A2 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. A3 Diagnostic grading standards mainly use limb numbness, weak motor skills, and reduced muscle strength as the starting point for the diagnosis of mild poisoning. The occurrence of incomplete flaccid paralysis of the limbs, and low potassium in the electrocardiogram and serum potassium are considered as the boundary of moderate poisoning. The muscle strength changes of mild to moderate poisoning refer to the muscle weakness of two or more limbs. Severe poisoning is characterized by complete paralysis of the limbs, even involving the trunk and respiratory muscles, severe arrhythmias, conduction block and a significant decrease in serum potassium as the main indicators. A4 Differential diagnosis should exclude periodic paralysis, myasthenia gravis, progressive muscular dystrophy, peripheral neuropathy, acute polyradiculitis (Guillain-Barre), etc.
A5 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 are given intravenous drips, and the concentration and speed are controlled according to the condition. Intravenous injections should not be used. Potassium supplementation must be carried out under ECG monitoring and serum potassium 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, 500 mL of 2% sodium sulfate can be dripped intravenously or 20 mL of 10% sodium sulfate can be injected intermittently. A6 When barium sulfide poisoning occurs, in addition to the toxic effect of barium ions, hydrogen sulfide can also be produced to cause corresponding poisoning, which should be paid attention to during diagnosis and treatment.
A7 When high-temperature forging 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 GB16371.
A8 Although blood barium determination is a special requirement, this examination is not yet popularized, and the clinical development law after poisoning is not related to changes in blood barium, so it is not included in the standard.
Additional notes:
This standard was proposed by the Ministry of Health of the People's Republic of China. This standard was drafted by the Second Affiliated Hospital of Shanxi Medical College. This standard is interpreted by the Institute of Labor Hygiene and Occupational Diseases, Chinese Academy of Preventive Medicine, the technical management unit entrusted by the Ministry of Health. 333
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