GBZ 32-2002 Diagnostic criteria for occupational chloroprene poisoning
Some standard content:
1CS13.100
National Occupational Health Standard of the People's Republic of China GBZ32—2002
Diagnostic Criteria of Occupational Chloroprene PoisoningPublished on April 8, 2002
Implemented on June 1, 2002
Ministry of Health of the People's Republic of China
Article 5.1 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 GB8790-1988 and this standard, this standard shall prevail. In occupational activities, especially in the manufacturing process of chloroprene rubber, workers may be exposed to chloroprene vapor or liquid, causing acute or chronic poisoning. This standard is formulated to protect the health of exposed workers. 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 West China Occupational Hospital of Sichuan University, the Second Affiliated Hospital of Shanxi Medical University, the Institute of Occupational Health and Poison Control of China Center for Disease Control and Prevention, and Qingdao Textile Bureau Hospital. This standard is interpreted by the Ministry of Health of the People's Republic of China. Diagnostic criteria for occupational chloroprene poisoning
GBZ32-2002
Chloroprene poisoning is an acute or chronic systemic disease caused by the absorption of chloroprene vapor or liquid. Acute poisoning is mainly characterized by central nervous system depression and respiratory tract irritation. Chronic poisoning is mainly characterized by liver damage and neurasthenia syndrome, and most cases also have hair loss
1Scope
This standard specifies the diagnostic criteria and treatment principles for occupational chloroprene poisoning. This standard applies to the diagnosis and treatment of occupational chloroprene poisoning. 2. Diagnostic principles
Acute or chronic chloroprene poisoning can be diagnosed based on a history of short-term, large-scale or long-term close occupational exposure and clinical manifestations dominated by anesthetic effects or liver damage, combined with labor hygiene surveys and necessary dynamic observation data, after comprehensive analysis, and exclusion of other diseases, especially viral hepatitis. 3. Observation subjects
Those with symptoms of neurasthenia syndrome such as dizziness, headache, insomnia, memory loss, loss of appetite, and one of the following changes:
a) Mild hair loss:
b) Nail discoloration:
β-globulin self-contrast decreased by more than 20%:
d) The liver is within 1.0 cm below the costal margin of the midclavicular line, and there are suspicious changes in quality and liver function. 4. Diagnostic and grading standards
Chronic mild poisoning
In addition to the above neurasthenia In addition to worsening symptoms of asthenia syndrome, patients with any of the following conditions can be diagnosed as mild poisoning: a) moderate or severe hair loss; b) liver margin 1.0-1.5 cm below the midclavicular line costal margin, accompanied by tenderness and abnormal liver function; or liver enlargement exceeding 1.5 cm below the midclavicular line costal margin, without abnormal liver function; serological indicators of hepatitis B virus infection are checked: HBsAg is (-), HBeAg is (-), anti-HBc-IgM (-), so as to exclude viral hepatitis B as much as possible. 4.2 Chronic severe poisoning Patients with cirrhosis on the basis of chronic mild toxic liver disease caused by chloroprene. 4.3 Acute mild poisoning
Those with the following clinical manifestations can be diagnosed as mild poisoninga) dizziness, headache, fatigue, numbness of limbs, unsteady gait or transient disturbance of consciousness, nausea, vomiting;b) tearing, dry and sore throat, cough, chest tightness, dyspnea:c) conjunctival congestion, pharyngeal congestion, scattered dry and wet rales in the lungs:d) X-ray chest film may show enhanced lung texture. 4.4 Acute severe poisoning
Those with the above clinical manifestations aggravated and one of the following manifestations:a) coma:
b) epileptic convulsions.
Treatment principles
Treatment principles
5.1.1 Acute poisoning Immediately leave the scene, keep quiet, keep warm, give oxygen, clean contaminated skin, change contaminated clothes, and rinse the contaminated eyes with clean water, saline or 1% to 2% sodium bicarbonate solution. In the acute stage, attention should be paid to bed rest and symptomatic treatment.
5.1.2 Chronic poisoning: Proper rest, enhanced nutrition, and symptomatic treatment. 5.2 Other treatments
Observation subjects
Should be reexamined every six months.
5.2.2 Chronic mild poisoning.
For moderate or severe hair loss, rest for 1 to 2 months and receive symptomatic treatment. For patients with liver damage, timely treatment should be given and the original work should be restored after recovery. For patients with II° quality changes, they should be transferred away from chloroprene operations; reexamined every 3 to 6 months. 5.2.3 Chronic severe poisoning
Full rest: No longer engaged in chloroprene operations, half-rest or light work can be performed depending on the condition. 5.2.4: Acute mild poisoning
Resume original work after recovery.
5.2.5 Acute severe poisoningwww.bzxz.net
After recovery, the patient should rest for 2 months: if there is no liver damage, the patient should resume the original work; liver damage may occur 1-2 months after acute severe poisoning, and the liver damage should be treated according to the above 5.2.2. 5.2.6 Pregnant and lactating women should temporarily stop working with chloroprene. 6 Instructions for the correct use of this standard
See Appendix A (Informative Appendix).
A.1 Scope of application of this standard
Appendix A
(Informative Appendix)
Instructions for the correct use of this standard
This standard applies to personnel engaged in the production and processing of chloroprene, polymerization, chain breaking, coagulation, long web, drying, gluing, and various chloroprene rubbers, latex, adhesives containing chloroprene monomers, as well as analysis and inspection. A.2 Hair loss
Hair loss occurs when people are exposed to chloroprene, and the degree of hair loss is related to the exposure concentration, but not all people exposed to chloroprene will experience hair loss. The degree of hair loss is as follows:
a: Mild cases: when the examinee gently wipes the top of the head with his hand, a lot of hair will fall out: b. Moderate hair loss to the extent of obvious thinning: C. Severe cases: basically all hair will fall out, and eyebrows, armpit hair, and pubic hair may fall out. A.3 Self-contrast of β-globulin decreases by 20%
Self-contrast with the results of this item before taking up the post or regular physical examination: Self-contrast with the results of the examination after 1 to 2 months of treatment without contact with chloroprene. An increase of 20% is also acceptable. A.4 Diagnosis of chronic chloroprene toxic liver disease: Chloroprene workers have enlarged livers and gradual changes in quality; digestive system symptoms are not as obvious as neurasthenia syndrome. Serum protein electrophoresis β-globulin may be reduced; there is often a history of moderate or above hair loss. The above manifestations are for reference in the diagnosis of toxic liver disease caused by chloroprene.
The examination of liver function and viral hepatitis serological indicators can be carried out using the local common methods. Do not use the results of a single examination as the basis for diagnosis.
A.5 Liver damage should also exclude other diseases. Such as viral hepatitis, schistosomiasis, Clonorchiasis sinensis, Giardia lamblia biliary infection, drug-induced or other industrial poisonous liver disease, fatty liver, etc. Hair loss can also be caused by other diseases: such as systemic diseases (endocrine dysfunction diseases, severe acute infectious diseases and chronic diseases), skin diseases (baldness, tinea capitis, leprosy, syphilis, exfoliative dermatitis, radiation dermatitis, seborrheic alopecia, long-term exposure to high-frequency current), drugs or other industrial poisons, etc. Therefore, it should be excluded from the dynamic observation of occupational history, medical history, physical examination and other examinations.
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