This standard specifies the diagnostic criteria and treatment principles for chronic radiation sickness caused by external exposure. This standard applies to occupational radiation workers, and non-occupational radiation workers can also refer to this standard for diagnosis and treatment. GB 8281-2000 Diagnostic criteria and treatment principles for chronic radiation sickness caused by external exposure GB8281-2000 Standard download decompression password: www.bzxz.net

National Standard of the People's Republic of China
Diagnostic criteria and principles of management for chronic radiadonslckness from external exposureUDC: 616-07/-08
: 616 -001.26
GB 8281—87
Chronic radiation sickness from external exposure refers to a systemic disease characterized by hematopoietic tissue damage and other systemic changes caused by a certain cumulative dose of radiation workers who are continuously or intermittently exposed to external radiation exceeding the dose equivalent limit for a long period of time. 1 Diagnostic principles
There are no specific diagnostic indicators for chronic radiation sickness from external exposure. A comprehensive analysis must be conducted based on the exposure history exceeding the dose equivalent limit, the exposure dose (with personal dose records), clinical manifestations and laboratory examination findings combined with health records to exclude other diseases before a diagnosis can be made.
2 Grading Diagnostic Criteria
Those who meet the following conditions can be diagnosed as Grade I:
2.1.1 History of long-term radiation exposure and/or intermittent exposure exceeding the dose equivalent limit, with a provisional cumulative dose equivalent of more than 1.6Sv. 2.1.2 Healthy before exposure to radiation, but after several years of exposure, obvious weakness-type neurasthenia syndrome develops, and the rise and fall of symptoms are related to the withdrawal and exposure to radiation.
2.1.3 Normal hematopoietic function before exposure to radiation, but after several years of exposure, hematopoietic function is abnormal after repeated dynamic observations (normal value of peripheral blood is based on earlobe blood).
2.1.3.1 The total white blood cell count decreases progressively and remains below 4.0×10°/L for a long time (more than six months), which may be accompanied by a long-term platelet count below 80×10°/L, a decrease in red blood cell count (less than 3.5×1012/L for men and less than 3.0×1012/L for women) and a decrease in hemoglobin (less than 110g/L for men and less than 100g/L for women). 2.1.3.2 Bone marrow hyperplasia is active or low, or a series of cell production is poor or maturation disorders. 2.1.4 May be accompanied by an abnormality in the following objective examinations: 2.1.4.1 Decreased adrenal cortex function.
2.1.4.2 Decreased thyroid function.
2.1.4.3 Decreased reproductive function.
2.1.4.4 Decreased immune function.
2.1. 4.5 Metabolic disorders.
2.1.5 It can be relieved or recovered after being removed from the radiation and actively treated. 2.2 Grade I
In addition to Grade I 2,1.1, those who have the following items can be diagnosed as Grade II: 2.2.1 There are more stubborn subjective symptoms, and there may be obvious bleeding tendency. 2.2.2 The white blood cell count is continuously below 3.0×10°/L; the white blood cell count is continuously between 3.0~4.0×10°/L and the platelet count and (or) hemoglobin level continue to decrease.
The Ministry of Health of the People's Republic of China approved it on December 10, 1987 and implemented it on October 1, 1988
38281—87
2.2.3 Brachial myelopathy is hypoplastic.
2.2.4 There are one or more abnormalities in 2.1.4. 2.2.5 Slow recovery after being removed from the radiation.
3 Treatment principles
a.1 Grade I: Combined Chinese and Western medicine for symptomatic treatment, temporary withdrawal from radiation, enhanced nutrition, and annual comprehensive review. After recovery, continue observation for another year, and radiation work can be gradually resumed, and the diagnosis of external exposure chronic radiation sickness grade I can be cancelled. 3,2 Grade II: Active treatment and withdrawal from radiation work, complete rest, convalescence when necessary, regular follow-up, and comprehensive review every two years. According to the recovery situation, non-radioactive work within the capacity can be participated. GB 8281-—87
Appendix A
Radiation reaction and observation objects
(supplement)
A.1 Radiation reaction refers to the exposure to radiation for a short time (usually a few months to 2 years), the radiation dose is not large, and some symptoms of asthenic neurasthenia appear; the number of white blood cells increases or decreases, or the fluctuation range is large, and the classification may have an increase in eosinophils or basophils, and there is no other reason to be found. Recovery can be achieved without withdrawal from radiation or a short withdrawal from radiation. Individuals with obvious symptoms and whose white blood cell counts do not recover for a long time (more than six months) can be transferred away from radiation work. A2 Observation subjects refer to those who have been working in radiation for a long time, have been exposed to a certain dose, have certain symptoms of asthenic neurasthenia, and have certain changes in laboratory tests, but have not yet reached the diagnostic criteria for external chronic radiation sickness grade I. Generally, they should not be separated from radiation, pay attention to protection, symptomatic treatment and regular follow-up. bZxz.net
GBB28187
Appendix B
Diagnostic criteria reference indicators and differential diagnosis
(reference)
B.1 The chromosome aberration rate of peripheral blood lymphocytes is significantly increased and (or) the micronucleus rate of peripheral blood lymphocytes is significantly increased. B.2 There are obvious chronic radiation skin damage and (or) radiation cataracts. B.3 Differential diagnosis of chronic radiation sickness caused by external exposure. Changes in the hematopoietic system should be differentiated from hematological changes caused by chronic benzene poisoning, thrombocytopenia, iron deficiency anemia and malnutrition anemia, as well as infections (viruses, rickettsia, etc.), certain diseases (viral hepatitis, hypersplenism, etc.), certain drugs and chemicals. Clinical symptoms should be differentiated from diseases such as neurasthenia, inner ear vertigo, and menopausal syndrome.
GB 828187
Appendix C
Instructions for the correct use of this standard
(reference)
C.1 The purpose of this standard is to enable personnel who have been exposed to excessive dose limits for a long time or intermittently to receive timely and correct diagnosis and treatment, prevent the development of the disease, and promote recovery.
C.2 This standard applies to all personnel exposed to ionizing radiation, including those exposed in occupational exposure, accidental exposure, and medical exposure. The treatment and handling of chronic radiation sickness caused by external exposure due to occupational exposure shall be handled in accordance with relevant national regulations. The diagnosis of chronic radiation sickness caused by external irradiation of Ca is a highly professional and technical work. Therefore, this standard should be implemented by radiation medicine professional institutions or radiation sickness diagnosis teams in provinces, cities and autonomous regions. Additional notes:
This standard was proposed by the National Health Standard Technical Committee and reviewed and approved by the Radiological Disease Diagnosis Standard Subcommittee. This standard was drafted by the Institute of Radiation Medicine of the Chinese Academy of Medical Sciences, the Industrial Hygiene Laboratory of the Ministry of Health and the Sichuan Institute of Labor Health and Occupational Diseases.
This standard is interpreted by the Industrial Health Laboratory of the Ministry of Health, the technical coordination unit entrusted by the Ministry of Health. From the date of implementation of this standard, the section on the diagnostic standards and treatment principles for chronic radiation sickness in the original "Diagnostic Standards and Treatment Principles for Radiation Sickness" (GBW1-80) will be invalidated.
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