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GBZ93-2010 English PDF

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GBZ93-2010: Diagnostic criteria of occupational aeropathy
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GBZ 93-2010259 Add to Cart 3 days Diagnostic criteria of occupational aeropathy Valid
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Basic data

Standard ID: GBZ 93-2010 (GBZ93-2010)
Description (Translated English): Diagnostic criteria of occupational aeropathy
Sector / Industry: National Standard
Classification of Chinese Standard: C60
Classification of International Standard: 13.100
Word Count Estimation: 11,166
Date of Issue: 2010-03-10
Date of Implementation: 2010-10-01
Older Standard (superseded by this standard): GBZ 93-2002
Quoted Standard: GBZ 24; GBZ 49; GB/T 16180
Regulation (derived from): ?Health-Communication (2010) 6
Issuing agency(ies): Ministry of Health of the People's Republic of China
Summary: This standard specifies the aviation otitis media, principles of diagnosis and treatment, such as five kinds bruised lung aviation occupational disease, transformer vertigo, , altitude decompression sickness aviation sinusitis. This standard applies to the diagnosis and treatment of occupational diseases aviation. Diagnosis and treatment of other changes in air pressure caused by the environment may refer to similar diseases.

GBZ 93-2002: Diagnostic Criteria of Occupational Aeropathy

---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 Aeropathy ICS 13.100 C60 GBZ People's Republic of China National Occupational Health Standards Diagnostic criteria for occupational diseases Released in.2002-04-08 2002-06-01 Implementation Issued by the Ministry of Health of the People's Republic of China

Foreword

The principles of treatment of the five types of aviation diseases in this standard and Appendix A are recommended and the rest are mandatory. According to the "People's Republic of China Occupational Disease Prevention Law" to develop this standard. Airborne air pressure changes in the environment can cause aerial otitis media, aviation sinusitis, varicose dizziness, high-altitude decompression sickness, Lung injury and other five kinds of aviation disease. In order to protect the physical and mental health of contacts, effective prevention and treatment of aviation disease, according to recent clinical and laboratory research Progress, the development of this standard. Appendix A of this standard is an informative appendix, Appendix B, and C is a normative appendix. This standard is proposed and centralized by the Ministry of Health of the People's Republic of China. This standard by the Chinese People's Liberation Army Air Force General Hospital of the whole army clinical aviation medicine center drafted. This standard is interpreted by the Ministry of Health of the People's Republic of China. Diagnostic criteria for occupational diseases Occupational aviation disease is due to changes in air pressure in the airborne environment, caused by aviation otitis media, aviation sinusitis, Varicose dizziness, high-altitude decompression sickness, lung injury five kinds of diseases.

1 Scope

This standard specifies the diagnostic criteria and principles of treatment of five diseases in occupational aviation diseases. This standard applies to the diagnosis and treatment of occupational aviation diseases

2 normative reference documents

The terms of the following documents are hereby incorporated by reference into this standard. Whichever is the reference to the date of the document Some amendments (excluding corrigenda) or revisions do not apply to this standard, however, the parties that have agreed under this standard are encouraged To study whether to use the latest version of these files. For undated references, the latest edition applies to this standard. Diagnostic criteria for occupational hearing impairment Diagnostic criteria for occupational decompression sickness

3 diagnostic principles

According to the exact history of low pressure exposure, combined with clinical manifestations and the corresponding laboratory data, a comprehensive analysis to make a diagnosis.

4 observation object

Exposure to aviation personnel (including pilots and other crew members) and low-pressure cabin crews in the aeronautical environment, Hearing loss, sinus pain, eye pain, dizziness, muscle joint pain, chest pain, cough, headache, difficulty breathing and other symptoms should be Close observation, if necessary, take appropriate measures.

5 Diagnostic and grading criteria

5.1 Aerial otitis media In the flight down or low-pressure chamber during the process of falling ear tenderness and other symptoms, check the tympanic membrane congestion. a) mild. tympanic membrane II ° congestion; b) moderate. tympanic membrane III ° congestion; c) severe. tympanic membrane rupture or mixed deafness. 5.2 Air sinusitis During the fall of the flight or during the descent of the low-pressure chamber, symptoms such as pain in the sinus area occur, before and after the low-pressure compartment examination (see Appendix B) Ray or CT found sinus changes. a) mild. sinus pain can be tolerated, X-ray examination of nasal sinus appear fuzzy shadow; b) severe. sinus pain is unbearable and there are tears and blurred vision, X-ray or CT examination showed sinus hematoma. 5.3 varicose dizziness A transient dizziness during flight or low pressure exposure, low pressure compartment examination (see Appendix B) to reproduce vertigo symptoms. a) mild. not accompanied by neurological deafness; b) severe. with neurological deafness. 5.4 high-altitude decompression sickness Symptoms of high-altitude decompression sickness (see Appendix A). a) mild. skin itching, erythema, joint pain, descent height or return to ground symptoms disappear; b) moderate. limb disease; c) Severe. one of the following manifestations. 1) paralyzed; 2) coma; 3) shock; 4) qi choking disease; 5) sudden death. 5.5 lung injury a) mild. chest discomfort, chest pain, cough and other respiratory symptoms, after a few hours or days can be self-healing; b) Severe. one of the following. 1) hemoptysis; 2) difficulty breathing; 3) loss of consciousness; 4) pulmonary hemorrhage, pulmonary interstitial emphysema or pneumothorax.

6 Principles of handling

6.1 Principles of treatment of aerial otitis media 6.1.1 Principles of treatment The basic treatment is to balance the pressure inside and outside the middle ear. Mild. a) active treatment of primary disease; b) with blood vessels to shrink the nose, the Eustachian tube blowing. Moderate. In addition to the above measures, the tympanic effusion is not easy to discharge, for tympanic membrane puncture or tympanic membrane incision. Severe. tympanic membrane rupture, prevention of middle ear infection; neuropathic deafness symptomatic treatment. 6.1.2 Other processing a) when the occurrence of acute air pressure injury, temporary grounded, the treatment of ear pressure can return to normal and then participate in the flight; b) suffering from aerial otitis media repeated treatment ineffective, termination of flight. 6.2 Principles of Airborne Sinusitis 6.2.1 Principles of Treatment a) Mild. 1) primary disease treatment; 2) nasal ventilation and drainage, local physiotherapy; 3) anti-infective treatment. b) severe. In addition to the above measures, the feasible surgical treatment. 6.2.2 Other processing a) when the emergence of acute air pressure injury, temporary grounded, after treatment of sinus air pressure function returned to normal and then participate in the flight; b) the flight officer repeated sinus injury and the treatment effect is poor, the termination of flight. 6.3 Principles of treatment of varicose dizziness 5.3.1 Principles of treatment The medical treatment is mainly based on prevention; on the eustachian tube dysfunction, left vertigo or inner ear injury, given symptomatic treatment. 6.3.2 Other processing a) flight attendants have varicose dizziness, to terminate their flight; b) on-the-job flight personnel appear varicose dizziness to be hospitalized for treatment, after treatment by the low-pressure compartment can no longer induce the disease, Rated as flight qualified; can not eliminate the symptoms, the termination of flight. 6.4 Principles of treatment of high pressure decompression sickness 6.4.1 Principles of treatment a) occurred after high altitude decompression sick, immediately dropped to a height of 8000 meters below, and return to the ground as soon as possible; b) mild high-altitude decompression sickness dropped to the ground after the symptoms disappeared, with mask breathing pure oxygen observed 2 hours, asymptomatic or signs appear, Continue to be observed under oxygen conditions 24 hours after the resumption of general work; c) moderate and severe high-altitude decompression sickness, or high-altitude decompression sickness during the recurrence of symptoms, were immediately sent hyperbaric oxygen chamber pressure treatment. in Transport process to absorb pure oxygen, the shock should be given anti-shock treatment; d) symptomatic treatment. according to the specific condition can also be given rehydration expansion, improve microcirculation, respiratory stimulants, tonic, sedatives, Corticosteroids and other drug treatment. 6.4.2 Other processing a) For high-altitude exposure personnel who may have high-altitude exposure, to carry out low-altitude high-altitude endurance examination (see Appendix C), for susceptible persons, to prohibit participation Empty flight b) at least 48 hours between the two low-pressure tanks; c) Equipment that is not equipped with a sealed pressurized cockpit or less cabin with less pressure. Before, should be carried out oxygen row of nitrogen; d) the occurrence of high-altitude decompression sickness, the treatment of symptoms disappeared, the resumption of general work at least 48 hours after the resumption of flight or body Physical activity; severe high-altitude decompression disease after treatment sequelae, or low pressure exposure repeated high-altitude decompression sickness, termination of flight. 6.5 lung injury 6.5.1 Principles of treatment a) rapid decompression, immediately down to a height of 8000 meters below, and return to the ground as soon as possible; b) mild. to give symptomatic treatment, after a few days or weeks after the self-healing and complete recovery; c) severe. according to different conditions to give the appropriate treatment; d) with concomitant decompression, immediately send hyperbaric oxygen chamber pressure treatment. 6.5.2 Other processing a) lung injury after healing lung function is normal, you can continue to engage in flight career; b) lung injury after suffering from residual lung dysfunction, termination of flight.

7 Correctly use the instructions in this standard

See Appendix A (informative), Appendix B, C (normative).

Appendix A

(Informative) Correctly use the instructions in this standard A.1 The scope of application of this standard. a) This standard applies to flight personnel (including pilots and crew) exposed to airborne flight conditions. Low pressure cabin workers With reference to this standard; b) This standard is a diagnostic standard for occupational diseases, so it is not included in this standard such as the economy class syndrome of passengers; c) other illnesses associated with aerial flight factors (eg occupational injury caused by aircraft noise GBZ 49, caused by flight accidents Of bone and organ damage, etc.), the diagnosis and treatment with reference to the relevant standards. A.2 Specific laboratory tests are. a) Low-pressure ventilator pressure and nasal sinus air pressure test for aerial otitis media, air sinusitis and varicose dizziness Off b) low-pressure cabin up the high-altitude endurance examination, used to find high-altitude decompression sick susceptible personnel. A.3 should pay attention to the following when diagnosing aviation diseases. a) can not be separated from the basic conditions of the aviation environment; b) the diagnosis of aviation otitis media should pay attention to and secretory otitis media phase distinction, and pay attention to whether there is a cold and decline too fast so lure Due to, in addition to pay attention to the early identification of nasopharyngeal carcinoma; diagnosis of aviation sinusitis and chronic sinusitis should pay attention to the difference. Aviation Otitis media and aerautic sinusitis must be differentiated from aviation toothache; c) diagnosis of aerial otitis media, otoscopy examination of tympanic membrane injury index. I ° visible tympanic membrane retraction, hammer bone and relaxation of congestion; II ° In addition to the above performance, the tympanic membrane is also congested around; III ° tympanic membrane was diffuse congestion, near the tympanic membrane around the external auditory canal skin can also be Redness, tympanic membrane surface may have blood scab, and sometimes visible tympanum effusion or blood; IV ° tympanic membrane rupture; d) high-altitude decompression disease should be excluded from hypoxia, hyperventilation, high-altitude flatulence, lung injury and other factors caused by similar diseases; e) the incidence of high-altitude decompression disease has a certain threshold height, the vast majority are up to 8,000 meters above the high-altitude stay for 5 minutes Disease f) the main symptoms of high-altitude decompression sickness. 1) skin symptoms. itching, rash, pimples or marble-like markings. 2) limb disease. the performance of muscle, joint pain, occurred in the upper and lower limb joints; pain is acid, swelling, tear, acupuncture Or knife-like pain, located in the deep, limb to maintain flexion can reduce pain; local no red, swollen, hot, Pain relief. 3) neurological symptoms. spinal cord injury caused by paraplegia, sensory disturbances, incontinence or retention; brain damage caused by headaches, Abnormal numbness, numbness, dyskinesia, hemiplegia, hemiplegia, language disorders, memory loss, ataxia, mood disorders or body temperature Elevated, severe can be coma, death; vestibular system damage caused by dizziness, tinnitus, hearing loss; visual system involvement can cause complex Vision, strabismus, blurred vision, temporary blindness, ipsilateral flash hemianopia, lack of vision or reduction. 4) circulatory system symptoms. cyanosis, pulse breakdown, cold limbs, precordial sense of depression; severe hypovolemic shock, broadcast Scattered intravascular coagulation, sudden death. 5) respiratory symptoms. extensive pulmonary vascular aneurysm may be associated with pulmonary interstitial edema and bronchial spasm, causing chest compression, sternum After burning, can not suppress the paroxysmal cough, difficulty breathing, called the gas choking 6) abdominal organ involvement. can cause nausea, vomiting, abdominal cramps and diarrhea. 7) fatigue. decompression sickness of the bubble can be involved in various parts of the body, and can be displaced with the circulation of blood, the symptoms can occur in a short time Variety. The above symptoms, signs of skin itching and limb pain more, earlier, followed by neurological symptoms. g) Aseptic osteonecrosis in the low-pressure cabin staff can be performed with reference to GBZ 24.

Appendix B

(Normative appendix) Low pressure chamber ear pressure and nasal sinus air pressure function check B.1 Check the methods and procedures B.1.1 Subjects sitting in a low-pressure compartment, the chamber was evacuated and "raised" at a speed of 20-30 m/s to 4000 m for 5 Clock, and then a certain rate of decline (according to the aircraft's cockpit pressure system, and according to the height of the adjustment) "down." Under "the next Drop "in the process, the subjects take the initiative to do swallowing or pinching the nose swallowing or exercise soft palate or movement of the mandibular balance of middle ear pressure action, and pass The microphone reports the subjective symptoms to the examiner. B.1.2 If the ear pressure test can be carried out, pay attention to observe whether the subject has no ear tenderness and its degree, "down" to the ground after the cabin with Otoscopy to check the tympanic membrane, parallel tone and acoustic guidance test. B.1.3 If the nasal air pressure function check, pay attention to observe whether the subjects with sinus pain and the extent of "down" to the ground out Cabin after the nose and ostium check, parallel nasal X-ray film examination. B.1.4 If the low pressure chamber simulates a variable pressure dizziness check, observe whether the subject has vertigo and nystagmus and its degree. B.2 observation and judgment B.2.1 Aeronautic otitis media. When the subject has a significant ear tenderness during the "descent" process, the otoscopy has a tympanic membrane that charges up to 2 ° And more than 2 °, acoustic impedance test showed Eustachian tube dysfunction, can be diagnosed. B.2.2 Aircraft sinusitis. When the subjects in the "decline" in the process of significant sinus pain, sinus X-ray film show sinus Cavity blur, do the diagnosis. B.2.3 Variation dizziness. When the subject in the "drop" during the dizziness and nystagmus, can be diagnosed. B.3 Precautions B.3.1 to be prepared before the ear pressure machine to ask whether the first test whether the cold parallel acoustic impedance test, suffering from colds or eustachian tube dysfunction Suspension of low pressure chamber inspection. B.3.2 It is recommended to ask whether the patient has a cold and parallel nasal sinus X-ray before the nasal sinus function test. X-ray filming showed sinus cavity with inflammation when the suspension of low-pressure cabin. B.3.3 During low-pressure compartment examination, such as unacceptable ear tenderness, nasal sinus pain, dizziness, and vestibular autonomic nerves Response, it should rise to the height of symptoms, slightly stay at a slower rate of "down" to the ground, so as not to cause the subject hurt. Appendix C. (Normative appendix) Low - pressure chamber up - altitude tolerance test method C.1 Check the method and procedure Preparations for C.1.1 a) physical examination of the subject, excluding those who are not suitable for the rise of the low-pressure compartment, such as. colds, indigestion, poor sleep, Eustachian tube dysfunction, respiratory and cardiovascular disease. b) the subjects before the inspection for two consecutive days of high-altitude diet, prohibit the consumption of easy-made food, such as. leek, celery, radish, beans, oil Fried foods, spicy spicy food, a lot of milk, and gas drinks, beer and so on. c) asked the subject again before the examination of the physical condition of the subjects to explain the significance of the inspection, precautions, low-pressure equipment to use the method, As well as the rise of the process of dealing with adverse circumstances. d) physiological signal monitoring preparation, such as. electrocardiogram, blood pressure, breathing, oxygen saturation, EEG, body surface precordial ultrasound Doppler Wait. e) cardiopulmonary resuscitation and other emergency rescue items preparation, hyperbaric chamber and vehicle protection. C.1.2 Rising methods and procedures Subjects emptying urine, remove the watch, pen, etc., the amount of drinking water, wearing a mask and check the air tightness, the ground oxygen row of nitrogen 30 min, oxygen concentration greater than 99%. And then into the cabin, the cabin began to smoke, to 30 ~ 40 m/s speed "rise" to 5000 meters, stay 5 min. Ask the subjects subjective feeling, check the mask air tightness, check the oxygen situation, observe the physiological signal changes; if the situation is good, then To 40 ~ 50 m/s speed "up" to 10,000 meters, stay 5 min. If the situation is still good, then the same speed "rise" To 12000 meters, stay 20 min, pay attention to observe the subjects subjective response, physiological signal changes. Stay at the end of the "drop" "Down" speed. 5000 meters above 30 ~ 40m/s, 5000 meters below 10 ~ 20m/s, with the height reduction, speed Gradually slow down. To 4000 meters when you can remove the oxygen mask, to remind the subjects to pay attention to the Eustachian tube ventilation action. If there is an ear pressure Pain, then slow down or first "rise" 500 ~ 1000 meters, until the symptoms disappeared and then slowly "down" to the ground. If "up" The process of high-altitude decompression sickness symptoms, immediately to 40 ~ 60 m/s speed "down" to 7,000 meters, and then 10 ~ 20 m/s speed Level down to the ground; if there is high-altitude flatulence, then suspend the "rise" or "drop" height, until the symptoms ease and then "on L "; if the subjects appear collapse, severe arrhythmia, disturb......
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