This standard specifies the diagnostic criteria and treatment principles for occupational trinitrotoluene cataracts. This standard applies to those who are occupationally exposed to trinitrotoluene. In clinical practice, any patient who has the morphological characteristics described in the diagnostic and grading criteria of this standard and has a history of close contact with trinitrotoluene can be diagnosed and treated according to the principles of this standard. GBZ 45-2002 Occupational trinitrotoluene cataract diagnostic criteria GBZ45-2002 standard download decompression password: www.bzxz.net

ICS 13.100
National Occupational Health Standard of the People's Republic of China GBZ45—2002
Diagnostic Criteria of Occupational Trinitrotoluene Cataract Issued on April 8, 2002
Implemented on June 1, 2002
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 GB11512-1989 is inconsistent with this standard, this standard shall prevail. In occupational activities, workers who are exposed to trinitrotoluene for a long time may develop toxic eye diseases with changes in the lens of the eye as the main manifestation. In order to diagnose and treat them as early as possible and to protect the health of workers, this standard is formulated. Appendix A of this standard is an informative appendix, and Appendix B is a normative appendix. This standard is proposed and managed by the Ministry of Health of the People's Republic of China. This standard was drafted by the Third Hospital of Peking University, and the Institute of Occupational Health and Poison Control of the Chinese Center for Disease Control and Prevention participated in the drafting.
This standard is interpreted by the Ministry of Health of the People's Republic of China. Diagnostic Standard for Occupational TNT Cataract GBZ45-2002
Occupational chronic TNT cataract is a toxic eye disease caused by long-term exposure to TNT, with changes in the lens as the main manifestation. 1 Scope
This standard specifies the diagnostic criteria and treatment principles for occupational TNT cataract. This standard is applicable to those who are occupationally exposed to TNT. In clinical practice, patients with the morphological characteristics described in the diagnosis and classification standards of this standard and who have a history of close contact with TNT can be diagnosed and treated according to the principles of this standard. 2 Normative References
The clauses in the following documents become clauses of this standard through reference in this standard. For any dated referenced document, 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 any undated referenced document, the latest version shall apply to this standard.
3 Diagnostic principles
Diagnostic criteria for occupational cataract
Based on a close history of occupational exposure and clinical manifestations dominated by changes in the lens opacity of both eyes, combined with necessary dynamic observations, reference to the investigation of the working environment, and comprehensive analysis, a diagnosis can be made only after excluding lens damage caused by other causes. 4 Observation subjects
Those with any of the following manifestations are listed as observation subjects: a) In the thorough examination, there are ring-shaped or nearly ring-shaped dot-shaped shadows in the peripheral part of the lens; b) In the slit lamp microscope examination, there are scattered fine dot-shaped opacities in the cortex of the peripheral part of the lens. 5 Diagnosis and grading standards
5.1 First-stage cataract: During the thorough examination, there is a ring-shaped shadow in the peripheral part of the lens, but the maximum ring width does not exceed one-third of the lens radius. The ring is formed by a number of wedge-shaped opacities connected, with the base of the wedge pointing to the periphery and the tip pointing to the center, or a slit lamp microscope examination shows that there are a number of gray-yellow fine punctate opacities of varying sizes gathered around the lens, located in the anterior and posterior cortex and the adult nucleus, and the transparency of the cortex is reduced. The distribution range is the same as before. 5.2 Second-stage cataract: The peripheral ring opacity range exceeds one-third of the lens radius, but does not exceed two-thirds. Some cases may show that the central part of the lens has a complete or incomplete ring opacity equal to the size of the pupil diameter, which is located in the anterior adult nucleus or the anterior cortex.
5.3 Third-stage cataract: The peripheral opacity of the lens exceeds more than two-thirds of the lens radius, or there are dense punctate or disc-shaped opacities in the central part, and the visual function (visual acuity and visual field) is significantly affected. Treatment principles
6.1 Treatment principles
Refer to GBZ35 for treatment.
Other treatments
Observed subjects should be reexamined once a year.
Work.
After the diagnosis of TNT cataract is established, the patient should be transferred away from TNT work in principle: patients in stage III can be appropriately engaged in light work. Instructions for the correct use of this standard
See Appendix A (Informative Appendix) and Appendix B (Normative Appendix). 1 Scope of application of this standard
Appendix A
(Informative Appendix)wwW.bzxz.Net
Instructions for the correct use of this standard
This standard is only applicable to those who are occupationally exposed to TNT. The morphology and color distribution of TNT cataract lens opacity have obvious characteristics. In clinical practice, patients with the morphological characteristics described in the diagnosis and grading standards of this standard and who have a history of close contact with TNT can be diagnosed and treated according to the principles of this standard. A.2 For occupational contraindications, please refer to the relevant provisions of the "Measures for the Administration of Occupational Health Monitoring". For cataracts caused by other reasons, such as lens opacity caused by certain drugs, pre-senile cataracts, etc., comprehensive analysis should be made according to different clinical manifestations and specific circumstances, and appropriate arrangements should be made.
Appendix B
(Normative Appendix)
Requirements for ophthalmic examination
Vision examination should include far and near vision and corrected vision. When asking about medical history, attention should be paid to whether there is night blindness.
B.3 After routine external eye examination, use phenylephrine or compound tropine amide eye drops 3 times. After both pupils are fully dilated, use direct ophthalmoscopy to examine the lens, vitreous body and fundus. Finally, use slit lamp microscope to examine the lens, record the characteristics of the lesions, and mark the scope of the lesions in the following format:
Illumination
Yu Nao Shu Ji
Photographic section of the lens
Tong Fu You Gong
Installation of methyl three life bases
Optical industry type
Wu Ying De Rong Nei Jiang Zhu
Installation of Si Gan Guo Qing Car
New car opening use Shi Lian Da Gu Li Lai
Fresh Pai Mouse
Production Industry Management
885880
Ru Run She Hui
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