GBZ 90-2002 Occupational Vinyl Chloride Poisoning Diagnostic Criteria GBZ90-2002 Standard download decompression password: www.bzxz.net

Food Standards Network (Http://spbz.cn) GBZ090-2002
Occupational vinyl chloride poisoning diagnosis standard
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 publication of this standard, the original Ministry of Health standard "Occupational vinyl chloride poisoning diagnosis standard and treatment principles" will be abolished at the same time. Vinyl chloride is the main raw material for the production of polyvinyl chloride plastics. Contact with vinyl chloride during production and use can cause a variety of occupational hazards. This standard is formulated to protect the health of workers and effectively prevent and control occupational vinyl chloride poisoning. 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 Tianjin Occupational Disease Prevention and Control Institute, Tianjin Dagu Chemical Co., Ltd. Staff Hospital, Daze Medical University School of Public Health, and Tianjin Chemical Plant Hospital. This standard is interpreted by the Ministry of Health of the People's Republic of China. Diagnostic Criteria of Occupational Chloroethylene Poisoning GBZ90-2002 Acute vinyl chloride poisoning refers to a systemic disease characterized by central nervous system depression caused by workers inhaling large doses of vinyl chloride gas in a short period of time during their occupational activities: Chronic vinyl chloride poisoning refers to a systemic disease characterized by liver and spleen damage, acroosteolysis, hepatic angiosarcoma, etc. caused by workers being exposed to vinyl chloride gas for a long period of time during their occupational activities. bzxz.net
1 Scope
This standard specifies the diagnostic criteria and treatment principles for vinyl chloride poisoning. This standard is applicable to the diagnosis and treatment of poisoning caused by exposure to vinyl chloride in occupational activities. The diagnosis of vinyl chloride poisoning caused by exposure to vinyl chloride in non-occupational activities can refer to this standard. 2 Normative references
Food Standards Network (Http://spbz.cn) The provisions of the following documents become the provisions of this standard through reference in this standard. For any dated referenced document, its subsequent amendments (excluding errata) or revisions are not applicable to this standard. However, the parties to an agreement based on this standard are encouraged to study whether the latest versions of these documents can be used. For any undated referenced document, its latest version shall apply to this standard.
GBZ7 Diagnostic standard for occupational hand-arm vibration disease GBZ18 Diagnostic standard for occupational skin diseases (general principles) GBZ2O Diagnostic standard for occupational contact dermatitis GBZ59 Diagnostic standard for occupational toxic liver disease GB/T16180 Identification of disability degree caused by work-related injuries and occupational diseases GBZ94 Diagnostic standard for occupational tumors
3 Diagnostic principles
3.1 Acute vinyl chloride poisoning
Acute vinyl chloride poisoning can only be diagnosed when a large dose of vinyl chloride gas is inhaled in a short period of time, and the main clinical manifestation is analgesia in the central nervous system, and other causes are excluded. 3.2 Chronic vinyl chloride poisoning
There is an occupational history of long-term exposure to vinyl chloride, with clinical manifestations such as liver and/or spleen damage, acroosteolysis and hepatic angiosarcoma. Combined with laboratory tests, on-site hazard investigation and evaluation, comprehensive analysis is conducted, and similar damage caused by other diseases is excluded before it can be diagnosed as chronic vinyl chloride poisoning. 4 Contact reactions and observation objects
4.1 More or less contact reactions: Dizziness, nausea, chest tightness, fatigue and no consciousness disorder occur after inhaling high concentrations of vinyl chloride gas in a short period of time.
4.2 Observation objects: People who have long-term exposure to vinyl chloride have brain asthenia syndrome such as dizziness, headache, fatigue, sleep disorders, and digestive dysfunction such as nausea, loss of appetite, and hepatic pain, but their liver function tests are normal. 5 Diagnostic grading standards
5.1 Acute vinyl chloride poisoning
5.1.1 Mild poisoning
Mild consciousness disorder occurs.
5.1.2 Severe poisoning
With any of the following manifestations:
a) Impairment of consciousness above moderate level;
b) Respiratory and circulatory failure.
5.2 Chronic vinyl chloride poisoning
5.2.1 Mild poisoning
Food Standards Network (Http://spbz.cn) Appearance of systemic symptoms such as fatigue, nausea, and loss of appetite, accompanied by any of the following manifestationsa) Painful and swollen liver;
b) Mild abnormality in liver function test;
c) Raynaud's syndrome;
5.2.2 Moderate poisoning
The above systemic symptoms are aggravated, and with any of the following manifestations:a) Acroosteolysis;
b) Progressive enlargement of the liver;
c) Persistent abnormality in liver function test;
d) Splenomegaly.
5.2.3 Severe poisoning
Liver cirrhosis;
6 Treatment principles
6.1 Treatment of shock
6.1.1 Acute poisoning
The poisoned patient should be quickly moved to a place with fresh air, and the contaminated clothes should be taken off immediately. The contaminated skin should be washed with clean water, and the patient should keep warm and rest in bed. The first aid measures and symptomatic treatment principles are the same as those for internal medicine. 6.1.2 Chronic poisoning
Food Standards Network (Http://spbz.cn) Liver protection and symptomatic treatment can be given. Splenectomy can be performed for those who meet the surgical indications. Patients with acroosteolysis should be separated as soon as possible.
6.2 Other treatments
6.2.1 Acute poisoning
a) After the mild poisoning is cured, the patient can return to the original job; b) After the severe poisoning is cured, the patient should be transferred away from the toxic job. 6.2.2 Chronic poisoning
a) After mild and moderate poisoning is cured, the person should be transferred from the toxic and harmful job position; b) Severe poisoning should be transferred from the toxic and harmful job position, and should be given appropriate treatment and long-term rest. If occupational disease disability assessment is required, it should be handled in accordance with 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 About the object of observation
The course of chronic vinyl chloride poisoning progresses slowly, and planned dynamic observation is of great significance for early diagnosis and protection of workers' health. Therefore, the object of observation should be reviewed regularly. A.2 About differential diagnosis
Attention should be paid to the differential diagnosis of the effect of vinyl chloride poisoning on the liver and viral hepatitis (see GBZ59), and the possibility of cross-action between the two causes should be considered in particular. A comprehensive analysis should be conducted clinically. Do not rule out the impact of vinyl chloride poisoning on the liver simply based on the positive serological indicators of viral hepatitis.
A.3 About acroosteolysis
Acroosteolysis is a special dissolving lesion of the distal phalanges that occurs in workers who work with vinyl chloride. It may have Raynaud's symptoms. See GBZ8. Early X-ray examinations can show marginal defects in the tuberosity of the distal phalanges of one or several fingers, followed by the formation of fracture lines, which gradually widen the defects, causing the tuberosity to gradually separate from the bone shaft, and may also be accompanied by cortical sclerosis. Finally, the phalanges become shorter and thicker, forming a quadruple
-shaped finger. Individual toe bone lesions can also be seen.
A.4 About hepatic angiosarcoma
See GBZ94-2002
A.5 About liver function tests
Food Standards Network (Http://spbz.cn) Vinyl chloride is one of the main poisons that harm the human liver. Differential diagnosis of the causes of liver damage and clinical application of liver function tests are very important in the diagnosis of chronic vinyl chloride poisoning. For its principles and methods, please refer to Appendix B: Diagnosis and differential diagnosis points and Appendix C: Clinical application of liver function tests in GBZ59. A.6 Skin damage caused by occupational exposure to vinyl chloride For skin diseases caused by occupational exposure to vinyl chloride, please refer to GBZ18 and GBZ20 for diagnosis and treatment. This standard does not include skin frostbite caused by contact with liquid vinyl chloride. Its diagnosis and treatment are the same as those of general skin frostbite. 5
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