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GBZ44-2016 English PDF

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GBZ44-2016: Diagnosis of occupational acute arsine poisoning
Status: Valid

GBZ44: Evolution and historical versions

Standard ID	Contents [version]	USD	STEP2	[PDF] delivered in	Standard Title (Description)	Status	PDF
GBZ 44-2016	English	109	Add to Cart	3 days [Need to translate]	Diagnosis of occupational acute arsine poisoning	Valid	GBZ 44-2016
GBZ 44-2002	English	239	Add to Cart	3 days [Need to translate]	Diagnostic Criteria of Occupational Acute Arsine Poisoning	Obsolete	GBZ 44-2002

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Basic data

Standard ID	GBZ 44-2016 (GBZ44-2016)
Description (Translated English)	Diagnosis of occupational acute arsine poisoning
Sector / Industry	National Standard
Classification of Chinese Standard	C60
Classification of International Standard	13.100
Word Count Estimation	5,525
Date of Issue	2016-08-23
Date of Implementation	2017-02-01
Older Standard (superseded by this standard)	GBZ 44-2002
Regulation (derived from)	State-Health-Announcement (2016)14
Issuing agency(ies)	General Administration of Quality Supervision, Inspection and Quarantine of the People's Republic of China

GBZ44-2002: Diagnostic Criteria of Occupational Acute Arsine Poisoning

---This is a DRAFT version for illustration, not a final translation. Full copy of true-PDF in English version (including equations, symbols, images, flow-chart, tables, and figures etc.) will be manually/carefully translated upon your order.
Diagnostic Criteria of Occupational Acute Arsine Poisoning ICS 13.100 C60 GBZ People's Republic of China National Occupational Health Standards Diagnostic criteria for occupational acute arsenic poisoning Released in.2002-04-08 2002-06-01 Implementation Issued by the Ministry of Health of the People's Republic of China

Foreword

Article 6.1 of this standard is recommended and the remainder is mandatory. According to the "People's Republic of China Occupational Disease Prevention Law" to develop this standard. Since the implementation of the standard date, the original standard GB 11511-1989 inconsistent with this standard, subject to this standard. Arsenic is arsenic containing metal slag in the case of acid or its burning waste water generated by the exhaust gas. In the professional activities, often due to accidents Accident or improper protection, causing acute poisoning contacts. The revised standard is in line with the "occupational acute chemical poisoning diagnostic criteria," the relevant part of the convergence, but also prominent Acute arsenic poisoning itself, the characteristics of the principle of modification and supplement the original standard diagnostic indicators and treatment principles related to the content, Make it more clear, reasonable, easy to apply. Appendix A to this standard is an informative appendix. This standard is proposed and centralized by the Ministry of Health of the People's Republic of China. This standard is responsible for drafting units. Shanghai Chemical Industry Occupational Disease Prevention and Control Hospital, Shanghai Zhabei District Central Hospital. Participate in drafts . The Third Hospital of Peking University, Shenyang Institute of Occupational Health and Occupational Diseases, Occupational Hospital of Shanxi Province, Zhejiang Province Anti-control center, Lanzhou City, Gansu Province, silver research firm, Shanghai Industrial Hospital, Yunnan Province Institute of Occupational Disease Prevention and Control. This standard is interpreted by the Ministry of Health of the People's Republic of China. Diagnostic criteria for occupational acute arsenic poisoning Occupational acute arsine poisoning refers to the occupational activity, short-term inhalation of high concentrations of arsine gas caused by the urgent Intravascular hemolysis-based systemic disease, severe cases can occur acute renal failure.

1 Scope

This standard specifies the diagnostic criteria and principles of occupational acute arsenic poisoning. This standard applies to occupational activities inhalation of arsine gas caused by acute poisoning. Does not apply to arsenic, arsenic oxide and Arsenate caused by poisoning.

2 normative reference documents

The terms of the following documents are hereby incorporated by reference into this standard. Any date that references the date of the document All subsequent amendments (excluding corrigenda) or revisions do not apply to this standard, however, The parties to the agreement are able to use the latest version of these documents. Those who do not mind the date of the reference file, its latest The version applies to this standard. GBZ 75 Occupational Acute Chemicals Toxicity Diagnostic criteria for blood system diseases Diagnostic criteria for occupational acute toxic nephropathy Identification of Occupational Injury and Occupational Disease Disability in Staff and Workers GB/T 16180

3 diagnostic principles

According to the short-term inhalation of higher concentrations of arsine gas occupational history and acute intravascular hemolytic clinical manifestations, combined with The results of laboratory tests, reference to the scene of labor hygiene survey data, comprehensive analysis, excluding other causes of similar diseases Disease, can be diagnosed.

4 contact reaction

With fatigue, dizziness, headache, nausea and other symptoms, from the contact after the symptoms quickly disappeared.

5 Diagnostic and grading standards

5.1 mild poisoning Often chills, fever, headache, fatigue, back pain, and the emergence of soy sauce color urine, sclera skin yellow dye and other acute blood The clinical manifestations of hemolysis in the tube; peripheral blood hemoglobin, urinary occult blood test and other intravascular hemolysis laboratory abnormalities, urine This is normal. Complicated with mildly toxic hemolytic anemia, secondary to mildly toxic nephropathy. 5.2 severe poisoning Rapid onset, chills, fever, obvious back pain or abdominal pain, urine was deep sauce color, oliguria or anuria, sclera Skin was yellow dye, very serious hemolytic skin was bronze or purple black, in line with severe toxic hemolytic anemia, may have cyanosis, Disturbance of consciousness. Peripheral blood hemoglobin was significantly reduced, urinary occult blood test was strong, plasma or urine free hemoglobin was significantly increased. Serum creatinine progressive increase, secondary to moderate to severe toxic kidney disease.

6 Principles of handling

6.1 Principles of treatment 6.1.1 In the event of an accident, all contacts shall be promptly disengaged from the site. 6.1.2 Respondents should be closely observed for 48 hours, rest quietly, encourage drinking water, oral administration of alkaline drugs, and monitor Urine routine and urinary occult blood test. 6.1.3 poisoning patients should be hospitalized, early enough to use short-term glucocorticoid, early rational infusion, the correct application of profits Urine to maintain urine, alkaline urine. Avoid the use of nephrotoxic drugs. For severe poisoning, should be used as soon as possible blood purification Therapy; according to the degree of hemolysis and speed, if necessary, can be used exchange transfusion therapy; and pay attention to maintaining water and electrolyte balance, to ensure that foot Enough calories and other symptomatic supportive care. 6.2 Other treatments Mild poisoning can be restored after the original work; acute renal failure in severe poisoning as a result of disease recovery, should Consider withdrawing from hazardous operations. If you need to do the identification of labor capacity, with reference to GB/T 16180 the relevant provisions of the deal.

7 Correctly use the instructions in this standard

See Appendix A (informative).

Appendix A

(Informative) Correctly use the instructions in this standard A.1 The diagnostic grade of this standard is mainly based on acute intravascular hemolysis and the degree of acute renal impairment caused by it. A.2 contact reaction only fatigue and other symptoms, no urine color changes, scleral skin yellow dye and other common acute intravascular hemolysis clinical Performance, the intravascular hemolysis laboratory tests were normal. A.3 acute intravascular hemolysis for the diagnosis of the starting point, the diagnosis based on clinical manifestations and laboratory tests. Soy sauce color urine (Hemolysis early urine can be red brown), and vomiting, back pain or abdominal pain, scleral skin yellow dye and other intravascular hemolytic Symptomatic clinical manifestations, laboratory tests found that peripheral blood hemoglobin decreased urine urinary test positive, plasma or urine free blood red Protein increases. Soy sauce color urine is a clear reflection of hemoglobinuria, although not the first blood free hemoglobinemia Performance, but earlier appeared after poisoning, is more practical and easy to operate one of the indicators of hemolytic diagnosis starting point. Reticulocytes increased blood Qingbing then bilirubin increased, gallbladder hyperplasia, can be used as a diagnostic reference. A.4 course of disease should pay attention to dynamic observation of peripheral blood hemoglobin, plasma or urine free hemoglobin, urinary occult blood and urine color change To determine the severity of hemolysis and whether to continue hemolysis. Acute renal failure (ARF) is the most severe secondary hemolysis Disease, the pathological changes are characterized by acute tubular necrosis (ATN), patients are oliguria or anuria, so urine can also be used as To determine the degree of renal damage caused by hemolysis and the prognosis of the disease indicators. A.5 the occurrence of the disease more sudden, occult, early clinical manifestations and no specificity, easy to cause mixed diagnosis, misdiagnosis. should And upper respiratory tract infection, acute gastroenteritis, urinary tract stones, acute viral hepatitis, cholecystitis and cholelithiasis and other diseases identified. A.6 acute intravascular hemolysis have self-limiting, hemolytic period is generally not more than 5 days, the peak in the first 3 days or so. Treatment weight Point is early protection of renal function, early reasonable infusion, the correct application of diuretics to maintain urine output, the protection of renal function is very heavy want. Mild poisoning, intravenous infusion of 20% mannitol 125 ml-250 ml, 5 minutes -10 minutes finished, full-time Should not exceed 750 ml; for severe poisoning generally do not advocate the use of mannitol, and furosemide diuretics is appropriate, necessary When combined with dopamine, the effect is better. Such as urine output is not increased, indicating that there have been severe ATN, ineffective treatment of diuretic, Should not be diuretic, need to use blood purification therapy. Blood purification therapy is the most effective way to rescue critically ill patients, should be used as soon as possible. Condition meets any of the following, Are the blood purification therapy indications. (1) the body skin was yellow dye or bronze or purple. (2) oliguria or anuria (3) Scr > 442 μmol/L (5 mg/dl) or daily increase > 44.2 μmol/L (0.5 g) / Dl). Hemodialysis is the most commonly used and effective method, unconditional peritoneal dialysis can also be used as a rescue of severe poisoning one Emergency measures. On the incidence of severe, particularly serious degree of hematoxia severe poisoning, can also be used to exchange transfusion therapy, emphasizing the exchange time to early, Should not exceed 48h after poisoning, the total amount of blood transfusion is generally more than 50% of the total body blood. A.7 mercapto complexing agent can not prevent the disease progression, generally not used. A.8 is currently clinical serum haemagglutinin and glomerular filtration rate as acute intravascular hemolysis and early diagnosis of ARF Of the specific and sensitive indicators, so the conditions can be selected as the above indicators for the future revision of the standard to provide data.

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