GBZ 4-2002 Diagnostic criteria for occupational chronic carbon disulfide poisoning
Some standard content:
ICs13.100
National Occupational Health Standard of the People's Republic of China GBZ4-2002
Diagnostic Criteria of Occupational Chronic Carbon Disulfide PoisoningPublished 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 there is any inconsistency between the original standard GB3233-1982 and this standard, this standard shall prevail. Chronic carbon disulfide poisoning may occur in occupational activities with long-term exposure to carbon disulfide. In order to protect the health of the contactors and effectively prevent and treat chronic carbon disulfide poisoning, GB3233-1982 was issued. This standard is a revised version. The revised standard highlights the damage of chronic exposure to carbon disulfide to the nervous system, especially the peripheral nervous system, and makes diagnostic classifications based on the degree of damage.
Appendix A of this standard is an informative 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 Institute of Occupational Health and Poison Control of the Chinese Center for Disease Control and Prevention. The participating units include the Jiangxi Provincial Institute of Labor Health and Occupational Disease Prevention and Control, Xinxiang Occupational Disease Prevention and Control Institute, Xinxiang Bailu Chemical Fiber Group Co., Ltd. Central Hospital, Jiangxi Chemical Fiber Factory, Liaoning Provincial Occupational Disease Prevention and Control Institute, Dandong Occupational Disease Prevention and Control Institute, and Dandong Chemical Fiber Factory. This standard is interpreted by the Ministry of Health of the People's Republic of China. ..comDiagnostic Standard for Occupational Chronic Carbon Disulfide Poisoning GBZ4-2002
Occupational chronic carbon disulfide poisoning is a systemic disease characterized by changes in the nervous system due to long-term close contact with carbon disulfide in occupational activities.
1 Scope
This standard specifies the diagnostic criteria and treatment principles for occupational chronic carbon disulfide poisoning. This standard applies to the diagnosis and treatment of occupational chronic carbon disulfide poisoning. 2 Normative references
The clauses in the following documents become the clauses of this standard through reference in this standard. For all dated references, all subsequent amendments (excluding errata) or revisions are not applicable to this standard. However, the parties who reach an agreement based on this standard are encouraged to study whether the latest versions of these documents can be used. For all undated references, the latest versions apply to this standard.
GB/T16180
3 Diagnostic principles
Identification of the degree of disability caused by work-related injuries and occupational diseases Diagnostic criteria for occupational acute chemical poisoning of nervous system diseases Based on the occupational history of long-term close contact with carbon disulfide, clinical manifestations of multiple peripheral neuropathy, neuro-electromyographic changes or clinical manifestations of toxic encephalopathy, combined with on-site hygiene survey data, and excluding similar diseases caused by other causes, diagnosis can be made.
4 Observation subjects
Those with any of the following:
a) Headache, dizziness, fatigue, sleep disorder, memory loss, or weakness in the lower limbs, numbness in the limbs, etc.; b) Retinal microaneurysms appear in the fundus;
) Neuro-EMG shows suspected neurogenic damage without typical symptoms and signs of peripheral nerve damage. 5 Diagnosis and classification standards
5.1 Mild poisoning
Those with any of the following:
a) Symmetrical glove- and stocking-like distribution of pain, touch or tuning fork vibration sensation disorders in the limbs, and weakened Achilles tendon reflex;
b) The above signs are mild or not obvious, but neuro-EMG shows neurogenic damage. 4.2 Severe poisoning
Those with any of the following:
a) Sensory disturbance in the distal limbs, disappearance of Achilles tendon reflex, accompanied by significant decrease in limb muscle strength, or distal limb muscle atrophy; electromyography shows neurogenic damage, accompanied by a significant slowing of nerve conduction velocity or a significant decrease in evoked potential: b) Toxic encephalopathy;
c) Toxic psychosis.
6 Treatment principles
6.1 Treatment principles
B vitamins and energy mixtures can be used, supplemented by physical therapy, physiotherapy and symptomatic treatment. Severe poisoning should also strengthen supportive therapy.
6.2 Other treatments
6.2.1 Observation subjects
Generally, they are not transferred from carbon disulfide operations, and should be reviewed once every six months, and neuro-electromyography examinations should be performed as much as possible for dynamic observation.
Mild poisoning
Patients with mild poisoning can engage in other work after recovery and undergo regular reexamination. 6.2.3 Severe poisoning
Should be transferred away from carbon disulfide and other jobs that are harmful to the nervous system. After treatment, they should be arranged to rest or work according to the examination results. Those who need to undergo labor capacity assessment shall be handled in accordance with GB/T16180. Instructions for the correct use of this standard
See Appendix A (Informative Appendix).
Appendix AwwW.bzxz.Net
(Informative Appendix)
Instructions for the correct use of this standard
A.1 This standard applies to chronic poisoning caused by the production or use of carbon disulfide. Carbon disulfide is mainly used in the production of viscose fiber, cellophane and rubber vulcanization industries. In addition, it is also used in ore flotation, the manufacture of carbon tetrachloride, waterproof glue, grain fumigation, refined paraffin, petroleum, and as a solvent for dissolving fats, varnishes, resins, etc. A.2 Regarding "long-term close occupational exposure history", it generally refers to the direct exposure to carbon disulfide for more than one year, and the carbon disulfide concentration in the workshop air is several times higher than the maximum allowable concentration of the national standard (10mg/m2), and occasionally more than 10 times higher for a short time.
A.3 The starting point for the diagnosis of mild poisoning is the symptoms and signs of definite peripheral nerve damage, or the peripheral nerve damage is not obvious, but the neuro-electromyography examination shows definite neurogenic damage (see Appendix B of Standard GBZ76). A.4 Neuro-electromyography examination is of great significance for the diagnosis of this disease. Carbon disulfide poisoning is mainly caused by peripheral nerve axonal damage, so the electromyography and distal nerve evoked potential of the distal muscles of the limbs should be examined in particular. The examination methods and results are shown in Appendix B of GBZ76.
A.5 The impact of carbon disulfide on the central nervous system is mainly manifested in the early stage of cerebral asthenia syndrome (such as headache, dizziness, insomnia, fatigue, forgetfulness, etc.) and autonomic dysfunction (such as palpitations and sweating). In severe poisoning, toxic encephalopathy may occur, with symptoms such as cerebellar ataxia, Parkinson's syndrome, pyramidal tract signs (hemiplegia, pseudobulbar palsy), or toxic psychosis, such as irritability, depression, disorientation, hallucinations, delusions, or even manic or depressive psychosis. Brain CT or brain MRI of patients with toxic encephalopathy may show brain shrinkage. After excluding brain degenerative diseases, vascular dementia, and other causes of mental illness, severe poisoning should be considered. A.6 When making a diagnosis, it is necessary to exclude various diseases that cause peripheral neuropathy, such as poisoning by furans, isoflurane, arsenic, allyl chloride, acrylamide, methyl n-butyl ketone, n-hexane, and diseases such as diabetes and infectious polyneuritis. A.7 The fundus should be examined with an ophthalmoscope after the pupil is dilated. If retinal microaneurysms are found, other diseases that cause microaneurysms need to be ruled out, such as diabetes, retinal vein occlusion, chorioretinitis, sickle cell disease, Eales disease, pulselessness, Costs disease, severe hypertensive retinopathy, anemia, chronic glaucoma, Leber disease, retinoblastoma and some toxic retinopathy. ..com
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