GB 8792-1988 Diagnostic criteria and treatment principles for occupational acute pentachlorophenol poisoning
Some standard content:
National Standard of the People's Republic of China
Occupational acute pentachlorophenol poisoning
Dingnostic criteria and principles of managemcrt afuccupational acutepentachlorophenol poisoningUDC 616-057 1 616
-07/-08 + 547
GB 879288
Occupational pentachlorophenol or sodium pentachlorophenol (hereinafter referred to as pentachlorophenol) poisoning is mainly a systemic disease caused by the abnormal hypermetabolism of the body after a large amount of pentachlorophenol is absorbed through the skin. The clinical manifestations are characterized by sudden onset, rapid progression, high fever, heavy sweating, extreme fatigue, irritability, etc., and lung, heart, liver, and kidney damage may occur. Diagnosis source
Diagnosis can be made based on the recent close occupational exposure history, clinical manifestations, and exclusion of other diseases that cause fever. Urine pentachlorophenol content can be used as a reference indicator for body absorption.
2 Diagnosis and grading standards
2.1 Observation subjects
Those with a history of close contact and symptoms such as dizziness, headache, sweating, and lower limb weakness can be listed as observation subjects. 2.2 Mild poisoning
In addition to severe symptoms such as dizziness, headache, sweating, fatigue, and weakness, fever, thirst, palpitations, shortness of breath, and nausea, vomiting, abdominal pain, etc., the urine pentachlorophenol content can exceed 10 mg/L. e2.3 Severe poisoning
Those with any of the following conditions can be diagnosed as severe poisoning: a. high fever, sweating, extreme weakness, irritability, and even coma and convulsions; b. obvious heart, liver, and kidney damage; severe adult respiratory distress syndrome, urine pentachlorophenol content can exceed 20mg/L. e.
3 Principles of treatment
Objective: Immediately take off clothes contaminated by pentafluorophenol, and wash the contaminated skin with water and soap. b. The subject should be carefully observed for 21 hours, with special attention to changes in consciousness and body temperature, and necessary measures should be taken in time. c. Early treatment is very important, especially when the patient has a fever. There is no need to wait for the high temperature to appear. Various cooling measures should be actively taken, such as physical cooling, hibernation drugs, etc., in order to achieve good therapeutic effects. d. There is no specific drug for this disease. The seven must be supportive and symptomatic treatment, reasonable fluid replacement, maintenance of electrolyte balance, glucocorticoids, energy supply, and protection of major organs.
e: Always use atropine, barbiturates
Ministry of Health of the People's Republic of China 1988-02:22 Approved 1988-09-01
Labor Capacity Assessment
GB 8792-88
After active treatment, patients with acute pentachlorophenol poisoning should be transferred to work until urine pentachlorophenol returns to normal before they can resume work. In the absence of laboratory tests, patients with mild poisoning should be transferred to work for at least 1 month after discharge. Patients with severe poisoning should be transferred to work for at least 3 months after discharge before they can resume their original work.
5 Requirements for health examination
Personnel working with pentachlorophenol should undergo a pre-employment physical examination, which includes internal medicine and neurology examinations. 6 Occupational certificate
Organic diseases of the nervous system, liver and kidney; h.
Skin allergic diseases and widespread skin diseases: Pregnant and lactating women should not be exposed to pentachlorophenol A.1 Principle
GB 879288
Appendix A
Urine pentachlorophenol determination method (4-aminoantipyrine colorimetric method) (Supplement)
After steaming in an acidic environment, urine pentachlorophenol reacts with sodium hydroxide in the receiver to form sodium pentachlorophenol. In the presence of potassium ferrocyanide, an oxidant, it reacts with 1-aminoantipyrine to produce a blue complex, which is extracted with dimethoate and quantified by colorimetry. The minimum detection limit of this method is 0.1 μg/ml, the recovery rate is 93~100%, and the coefficient of variation is 2.2~3.9%. A.2 Reagents
8, 1N and 0.1N sodium hydroxide solution.
b. Pentachlorophenol stock solution (1 ml is equivalent to mg): weigh 100.0 mg of pure pentachlorophenol, add 10 ml of 0.1 N sodium hydroxide to dissolve it, and dilute it to 100 ml with distilled water.
Pentachlorophenol standard solution (1 ml is equivalent to 0.1 mg): take 10 ml of pentachlorophenol stock solution and dilute it to 100 ml with distilled water. d. 20% citric acid solution (W/V).
e. pHG. Citric acid buffer: take 21.1% citric acid (C,H,O,·H,0), dissolve it with 200 ml of 1 N sodium hydroxide, and dilute it to 10m0ml with distilled water. Take 693ml of the upper solution and add 307ml of 0.1N sodium hydride, mix well, and it is pH5.6 buffer. f. 0. A% 4-aminoantipyrine solution (W/1) in a brown bottle and stored in the refrigerator for one week. 10% potassium ferric sulfate solution (W/V): stored in a brown bottle and stored in the refrigerator for one week. g.
h. Xylene (analytical grade).
A. 3 Operation steps
Urine sample distillation: Take 0 ml of urine sample and put it into a 500 ml distillation bottle with a vertical condenser, add 2.5 ml of 20% citric acid solution A. 3. 1
and 37.5 ml of distilled water for natural distillation. Use a 50 ml beaker as a receiver, add 2 ml of distilled water and 0.35 ml of 0.1N sodium hydroxide, and immerse the outlet of the condenser in water before distillation. Steam the stuffing until the stuffing liquid is about 50 ml and stop distillation. Add water to the distillate to 50 ml. A.3.2 Sample analysis: Take 20 ml of the effluent and put it into a stoppered test tube, add 1 ml of pH 5.6 citric acid buffer, 1 ml of 0.4% 1-nitroantipyrine, 1 ml of 10% potassium ferric hydroxide, and then extract with 5 ml of xylene for colorimetric quantification (for specific operations, see the standard curve drawing). A.3.3 At a wavelength of 580nm, use a blank tube to calibrate the absorbance to the "0\ point, read the absorbance of the measurement answer, find the microgram number of pentaoxyphenol on the standard curve 1, and calculate according to formula (1);
or market: x —Urine pentanophenol content t.mg/L; W—--pentanophenol content found by standard curve. F:. Then proceed according to formula (2):
1 yuan 1000
Wherein: Urine sample at specific gravity 1.12 before pentanophenol content, mg/L; Urine sample specific gravity
A, 4 Standard curve drawing
Or general numberWww.bzxZ.net
Pentanophenol standard solution, ml
Distilled water, ml
H5.6 Buffer wave, ml.
u.4 Head 4 Antimony scale, ml
10% potassium ferrocyanide, ml
Methyl cyanide, ml
GB 8792
Immediately shake and mix
Invert and mix, and read for no more than 2m. 0
After adding xylene, shake vigorously for 100 times (about half a minute), let it stand for stratification, and then pour the upper extract into a 10mm colorimetric cup. At a wavelength of 580nm, use a blank tube to collect the absorbance of the extraction point *0\, read the absorbance of each point, and draw a standard curve. 2.5 Instructions
A.5.1 Urine phenol and dichlorophenol have no obvious interference with this determination method and do not affect the determination of urine pentachlorophenol. A.5.2 Urine samples can be taken from the contact at any time for determination, and the volume of urine samples shall not be less than 50ml. Fresh urine samples are preferred for the determination of urine pentachlorophenol. If it cannot be determined in time, no preservatives are added to the urine sample, and it can be stored in a refrigerator at 1℃, but the storage time should not exceed 2 weeks. GB8792-88
Appendix B
Instructions for the correct use of standards
(reference)
Japan. Occupational acute The main cause of pentachlorophenol poisoning is that the skin is in direct contact with pentachlorophenol when the personal protective equipment is used during work. Therefore, when asking about occupational history and physical examination, attention should be paid to the skin contact with pentachlorophenol, and respiratory inhalation should not be ignored. B.2 Acute pentachlorophenol poisoning is characterized by fever, sweating, fatigue, nausea, vomiting and other prominent symptoms at the onset. It should be distinguished from fever diseases such as heatstroke and influenza and acute digestive system diseases. B.3 The clinical characteristics of acute pentachlorophenol poisoning are rapid onset and rapid progression of the disease, especially the body temperature can suddenly rise to more than 4IC within 1-2 hours, the patient immediately becomes confused, the mortality rate is high, the course of the disease is short, and it can be relieved in 21 hours. Therefore, the observation subjects and poisoned patients should be closely observed for changes in the disease and actively carry out symptomatic supportive treatment. The body temperature of poisoned patients is based on the rectal temperature. The hibernation drug can be chlorpromazine plus isopromazine.4 Controlling fever is the most important treatment measure. Cooling must be started in the early stage, when the body temperature has not yet exceeded 39℃, in order to achieve better results. If active treatment is only started after high fever has occurred, the effect is often better. This disease often occurs in hot parts of the body. When cooling measures are taken for patients during treatment, attention should be paid to cooling the environment. B. 5 Severe poisoning If there is obvious heart, liver, and kidney damage, the main manifestations are obvious myocardial damage, obvious changes in liver function, and the appearance of hematuria, proteinuria, and renal dysfunction.
B.6 This standard makes a diagnosis and classification based on the severity of the clinical manifestations of acute pentachlorophenol poisoning. Although urinary pentachlorophenol is a specific indicator of the degree of human absorption of pentachlorophenol and can assist in differential diagnosis, it is only used as a reference indicator in diagnosis and classification. Normal human urine does not contain pentachlorophenol, and the biological threshold value of urinary pentachlorophenol is 2 mg/L. This standard takes urinary pentachlorophenol below 2 mg/L as recovery to normal. B.7 Severely poisoned patients excrete pentachlorophenol slowly in their urine, and it often takes three months to return to normal. Therefore, severely poisoned patients should be transferred at least one month after recovery before returning to their original jobs.
B.8 This standard does not include acute contact dermatitis caused by pentachlorophenol. For its diagnosis and treatment, please refer to GB7804-87 "Occupational Skin Disease Diagnosis and Treatment Guidelines".
Additional Notes:
This standard was proposed by the Occupational Disease Diagnosis Subcommittee of the National Health Standards and Technical Committee. This standard was drafted by the Ministry of Railways Animal Health Research Institute, Tianjin Occupational Disease Prevention and Control Institute, and Taijin Dagu Chemical Vocational Hospital. This standard was entrusted by the Ministry of Health to the Institute of Labor Hygiene and Occupational Diseases of the Chinese Academy of Preventive Medicine for interpretation.
Tip: This standard content only shows part of the intercepted content of the complete standard. If you need the complete standard, please go to the top to download the complete standard document for free.