This standard specifies the diagnostic criteria and treatment principles for occupational acute formaldehyde poisoning. This standard applies to the diagnosis and treatment of occupational acute formaldehyde poisoning, and can be used as a reference for non-occupational acute formaldehyde poisoning. GBZ 33-2002 Occupational Acute Formaldehyde Poisoning Diagnostic Standard GBZ33-2002 Standard download decompression password: www.bzxz.net

1CS13.100bzxZ.net
National Occupational Health Standard of the People's Republic of China GBZ33—2002
Diagnostic Criteria of Occupational Acute Formaldehyde 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 the original standard GB8791-1988 is inconsistent with this standard, this standard shall prevail. Formaldehyde is an irritating gas that has a strong irritating effect on the eyes, skin and mucous membranes. In occupational activities, accidents often cause leakage, escaping, dripping and leaking, and formaldehyde is inhaled through the respiratory tract, causing acute poisoning in the contact person. The revised standard is not only connected with GBZ73, but also highlights the characteristics of acute formaldehyde poisoning, making the standard classification more reasonable and convenient for application.
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 is drafted by the Jilin Provincial Institute of Occupational Disease Prevention and Control. The participating drafting units include the Institute of Occupational Disease Prevention and Control of Jilin Chemical Industry Corporation.
This standard is interpreted by the Ministry of Health of the People's Republic of China. Diagnostic criteria for occupational acute formaldehyde poisoning
GBZ33-2002
Occupational acute formaldehyde poisoning is a systemic disease mainly caused by eye and respiratory damage caused by short-term exposure to high concentrations of formaldehyde gas during occupational activities. 1 Scope
This standard specifies the diagnostic criteria and treatment principles for occupational acute formaldehyde poisoning. This standard is applicable to the diagnosis and treatment of occupational acute formaldehyde poisoning, and non-occupational acute formaldehyde poisoning can be implemented as a reference. 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, parties reaching 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 are applicable to this standard.
GB/T16180
3 Diagnostic principles
Diagnosis of occupational skin diseases (general principles)
Diagnostic criteria for occupational chemical eye burns
Evaluation of the degree of disability caused by work-related injuries and occupational diseases of employees Based on the occupational history of short-term exposure to high concentrations of formaldehyde gas, the clinical manifestations of acute damage to the eyes and respiratory system and chest X-ray findings, refer to the results of on-site labor hygiene investigations, conduct a comprehensive analysis, and exclude similar diseases caused by other causes before diagnosis.
4 Irritation reaction
Manifested as transient eye and upper respiratory tract irritation symptoms, no positive signs in the lungs, and no abnormal findings in chest X-ray examination.
5 Diagnosis and classification standards
5.1 Mild poisoning
One of the following conditions:
Having obvious eye and upper respiratory tract mucosal irritation symptoms, signs of conjunctival congestion and edema, coarse breath sounds in both lungs, scattered dry and wet rales, and chest X-ray examination showing increased and thickened lung textures. The above manifestations are consistent with acute tracheobronchitis.
b) First to second degree laryngeal edema.
5.2 Moderate poisoning
One of the following conditions:
a) Continuous cough, expectoration, chest tightness, dyspnea, dry and wet rales in both lungs, scattered dot-like or small patchy shadows in chest X-ray examination. The above manifestations are consistent with acute bronchopneumonia. Third degree laryngeal edema
Blood gas analysis shows mild to moderate hypoxemia. 5.3 Severe poisoning
One of the following conditions:
a) Pulmonary edema;
b) Fourth degree laryngeal edema.
Blood gas analysis shows severe hypoxemia.
6 Treatment principles
6.1 Treatment principles
6.1.1 On-site treatment Immediately leave the scene, take off the contaminated clothes in time, rinse the contaminated skin thoroughly with plenty of clean water, and then wash it with soapy water or 2% sodium bicarbonate solution. If it splashes into the eyes, rinse immediately with plenty of clean water. 6.1.2 After inhaling a large amount of formaldehyde gas in a short period of time, those who have upper respiratory tract irritation reactions should be observed for at least 48 hours to avoid aggravating the condition after activities.
6.1.3 Those who are exposed to high concentrations of formaldehyde can be given 0.1% dilute ammonia water for inhalation; early, sufficient, and short-term use of glucocorticoids can effectively prevent laryngeal edema and pulmonary edema. 6.1.4 Keep the airway open by giving bronchial antispasmodics and defoaming agents, and perform tracheotomy when necessary. 6.1.5
Reasonable oxygen therapy.
6.1.6 Symptomatic treatment, prevention of infection, and prevention of complications. 6.2 Other treatments
After treatment of mild and moderate poisoning, after a short rest, they can generally resume their original work; but those who are allergic to formaldehyde should be transferred from their original work; for severe poisoning, depending on the recovery of the disease, non-toxic work should be arranged as appropriate. If labor capacity assessment is required, it shall be handled in accordance with the relevant provisions of GB/T16180.
7 Instructions for the correct use of this standard
See Appendix A (Informative Appendix).
Appendix A
(Informative Appendix)
Instructions for the correct use of this standard
A.1 This standard applies to acute formaldehyde poisoning. Acute poisoning of other aldehyde compounds, especially low molecular weight aldehydes and open chain aldehydes, such as acetaldehyde and acrolein, can also refer to this standard. A.2 This disease is mainly caused by respiratory damage, so the respiratory system symptoms and signs and chest X-ray examination are the main diagnostic basis for diagnosis, and laboratory examination is used as a reference indicator. If the clinical manifestations and chest X-ray examination are inconsistent, a graded diagnosis can be made based on the more serious indicators. Stimulation reactions do not belong to the category of acute poisoning. Acute bronchitis and first to second degree laryngeal edema are the starting points for the diagnosis of this disease.
A.3 Acute formaldehyde poisoning may be accompanied by eye burns or skin damage. For its diagnostic classification, please refer to GBZ54 and GBZ18. A.4 The dyspnea caused by laryngeal edema caused by formaldehyde poisoning is divided into four degrees: first degree: no dyspnea at rest, inspiratory dyspnea during activity; second degree: "three-depression sign" at rest, aggravated during activity, but does not affect sleep, and there is no irritability; third degree: obvious inspiratory dyspnea, "three-depression sign" is obvious, and there is irritability and difficulty falling asleep; fourth degree: in addition to the manifestations of third-degree dyspnea, there is also restlessness, cold sweat, pale face or hair. A.5 Formaldehyde can cause asthma, which is an allergic disease and is not listed in this standard. A.6 The incubation period of this disease is as long as 48 hours. There may be no obvious clinical symptoms and signs before the onset. Therefore, those who are exposed to high concentrations of formaldehyde should be carefully observed and active preventive measures should be taken. In the early stage, 0.1% dilute ammonia water can be inhaled to promote the conversion of formaldehyde into less toxic hexamethylenetetramine (urotropine) to protect the respiratory mucosa. A.7 Blood gas analysis shows that the PaO2 value is a reference indicator for the diagnosis and classification of acute formaldehyde poisoning. Hypoxemia is divided into three degrees: mild [PaO, <10.7kPa (80mmHg) 1, moderate [PaO, <8kPa (60mmHg)], and severe [PaO2 <5.3kPa (40mmHg)].
A.8 There is no specific antidote for the treatment of this disease, and adrenal glucocorticoids are commonly used.
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.