GBZ37-2024 English PDF

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GBZ37-2024: Diagnostic standard for occupational lead and its inorganic compounds poisoning
Status: Valid

GBZ37: Historical versions

Standard ID	USD	BUY PDF	Lead-Days	Standard Title (Description)	Status
GBZ 37-2024	159	Add to Cart	3 days	Diagnostic standard for occupational lead and its inorganic compounds poisoning	Valid
GBZ 37-2015	189	Add to Cart	3 days	Diagnosis of occupational chronic lead poisoning	Valid
GBZ 37-2002	199	Add to Cart	3 days	Diagnostic Criteria of Occupational Chronic Lead Poisoning	Obsolete

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Basic data

Standard ID: GBZ 37-2024 (GBZ37-2024)
Description (Translated English): Diagnostic standard for occupational lead and its inorganic compounds poisoning
Sector / Industry: National Standard
Classification of Chinese Standard: C60
Classification of International Standard: 13.100
Word Count Estimation: 7,775
Date of Issue: 2024-05-09
Date of Implementation: 2025-05-01
Issuing agency(ies): State Administration for Market Regulation, China National Standardization Administration
Summary: This standard specifies the diagnostic principles and diagnostic classification of occupational lead and its inorganic compound poisoning. This standard applies to the diagnosis of poisoning caused by occupational exposure to smoke, dust and vapor of lead and its inorganic compounds.

GBZ37-2002: Diagnostic Criteria of Occupational Chronic Lead 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 Chronic Lead Poisoning ICS 13.100 C60 GBZ People's Republic of China National Occupational Health Standards Occupational diagnostic criteria for chronic lead 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. The original standard GB 11504-1989 and this standard does not Consistent with this standard shall prevail. According to the nationwide research and research, combined with domestic and foreign literature progress, this revision mainly in the following areas. 1. The original standard in the "lead absorption" a "target". Urine lead index from the original 0.39 μmol/L (0.08mg / L) to 0.34 μmol/L (0.0 7 mg/L) to facilitate the prevention of lead poisoning. 2. According to clinical experience, the starting point of urine lead diagnosis from the original 0.39 μmol/L (0.08 mg/L) adjusted to 0.58 μmol / L (0.12 mg/L) to reduce false positives. 3. According to the survey of 3588 cases, the introduction of occupational exposure limits (acceptable upper limit) and diagnostic lower limit (diagnostic value) And the diagnostic value as the basis for the diagnosis of classification, the original standard in the diagnosis of mild poisoning made a major change in the starting point. Not only reflects the role of individual indicators, but also highlights the importance of a comprehensive diagnosis of multiple indicators, so that more reasonable diagnosis. 4. In the treatment of the principle of adding oral complexing agent two mercapto succinic acid. 5. In the original standard, a variety of measurement methods are listed as standard appendices, and in view of the majority of the standardized methods that are now unanimously approved The same, so thin. 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 by the Xi'an Central Hospital is responsible for drafting, to participate in the drafting unit. China Center for Disease Control and Prevention Occupational Health and Poisoning control, Shanghai Yangpu District Central Hospital, Jiangxi Province, the Institute of Labor and Health Occupational Diseases, Shenyang City, occupational health Institute of Occupational Disease Prevention and Control, Institute of Occupational Disease Prevention and Control, Hunan Medical University, Sichuan Province, Sichuan Province, China , The Shanghai Municipal Center for Disease Control and Prevention, Zhuzhou smelter workers hospital, Shaoxing City epidemic prevention station, Gansu Province, silver company labor Institute of Health, Shanghai Sixth People's Hospital, Jingdezhen City, occupational health and disease prevention and control, Zhenjiang City Health and Epidemic Prevention Station, Zhejiang Center for Disease Control and Prevention, China Center for Disease Control and Prevention. This standard is interpreted by the Ministry of Health of the People's Republic of China. Diagnostic criteria for occupational chronic lead poisoning Occupational chronic lead poisoning is due to exposure to lead smoke or lead dust caused by nerve, digestion, hematopoietic system-based Body disease.

1 Scope

This standard specifies the diagnostic criteria and principles of occupational chronic lead poisoning. This standard applies to the diagnosis and treatment of occupational chronic lead poisoning. The diagnosis and treatment of non-occupational chronic lead poisoning may also be Refer to use.

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. Identification of Occupational Injury and Occupational Disease Disability in Staff and Workers GB/T 16180

3 diagnostic principles

According to the exact occupational history and the nerve, digestive, hematopoietic system-based clinical manifestations and related laboratory tests, Test work environment survey, a comprehensive analysis, excluding other causes of similar diseases, can be diagnosed.

4 observation object

Has a close lead exposure history, lead-free poisoning clinical manifestations, with one of the following manifestations. a) urinary lead ≥ 0.34 μmol/L (0.07 mg/L, 70 μg/L) or 0.48 μmol/24h (0. l mg/24h, 100 μg/24h); b) Blood lead ≥1.9 μmol/L (0.4 mg/L, 400 μg/L); c) After urinary lead ≥1.45 μmol/L (0.3 mg/L, 300 μg/L) and < 3.86 μmol / L (0.8 mg/L, 800 μg/L).

5 Diagnostic and grading standards

5.1 mild poisoning 5.1.1 Blood lead ≥2.9 μmol/L (0.6 mg/L, 600 μg/L) or urinary lead ≥0.58 μmol/L (0.12 mg/L, 120 μg/L); and with one of the following manifestations, can be diagnosed with mild poisoning. a) Urine δ-amino-r-ketopentanoic acid ≥ 61.0 μmol/L (8 mg/L, 8000 μg/L); b) red blood cells free protoporphyrin (EP) ≥ 3.56 μmol/L (2 mg/L,.2000 μg/L); c) erythrocyte zinc protoporphyrin (ZPP) ≥2.91 μmol/L (13.0 μg/gHb). d) have abdominal pain, bloating, constipation and other symptoms. 5.1.2 Diagnostic lead lead test, urine lead ≥3.86 μmol/L (0.8 mg/L, 800 μg/L) or 4.82 μmol/24h (1 mg/24h, 1000 μg/24h), can be diagnosed with mild lead poisoning. 5.2 moderate poisoning On the basis of mild poisoning, with one of the following. a) abdominal cramps; b) anemia; c) mildly toxic peripheral neuropathy. 5.3 severe poisoning Have one of the following. a) lead paralysis; b) toxic encephalopathy;

6 Principles of handling

6.1 Principles of treatment Poisoned patients should be based on specific circumstances, the use of metal complexing agent to lead the treatment, such as disodium dihydrate, sodium dimercaptosuccinate Such as injection, or two mercapto succinate oral, supplemented by symptomatic treatment. The subject may also be treated for lead. 6.2 Other treatments 6.2.1 Observe objects Can continue to work the original, 3 to 6 months to review once or conduct lead test to determine whether the light lead poisoning. 6.2.2 mild, moderate poisoning After healing can be restored to the original work, do not have to remove the lead operation. 6.2.3 severe poisoning Must be transferred from the lead operation, and according to the condition given treatment and rest. For the identification of labor capacity by GB/T 16180 Department Reason.

7 Correctly use the instructions in this standard

See Appendix A (informative).

Appendix A

(Informative) Correctly use the instructions in this standard A.1 This standard applies to chronic poisoning caused by exposure to lead or lead dust in production. Non-occupational adult chronic lead poisoning also Can refer to. A.2 lead poisoning laboratory indicators are more, a variety of indicators of detection methods are often a variety of. Due to method, instrument, area And other factors, the previous normal reference value is also different. Occupational exposure limits, diagnostic values are in a uniform way, strict quality Under the conditions of the national survey through the 3188 people, in accordance with the original standard by the collective discussion of lead absorption group, poisoning group, lead normal group. Which is processed by statistics and presented by field verification. That is, lead between the normal group and lead absorption group between the boundaries of occupation Exposure limit, lead absorption group and lead poisoning group between the diagnostic points for the diagnostic value. And this value of the promotion and application also requires testing Consistent approach, strict quality control, a number of indicators with each other. Avoid the conclusion of a test result with a single item. Check urine Lead has a chemical method, instrumental method, but as long as strict quality control, the determination of the results should be consistent. In order to facilitate the operation, check urine lead It is recommended to use a wide range of polyethylene plastic bottles to collect a morning urine about 100ml, but should pay special attention to urine lead, blood lead in the sampling and testing The process of pollution problems. A.3 The basic standard of the original standard is correct, the basic adoption of this revision, but some of the lead poisoning laboratory indicators data, This revision is based on the occupational exposure limit and the diagnostic value is adjusted. The specific values are shown in the table below. A.4 The typical performance of lead colic has been known to the grassroots doctors. Need to combine career history, the scene situation, in the exclusion of other reasons Causing similar symptoms of the disease can be diagnosed later. A.5 Diagnostic lead lead test is mainly used for some long-term work in the lead environment of lead workers, there are clinical symptoms and lead Laboratory test indicators are still below the occupational exposure limit (see table below), or the object of observation. Drugs can be used as calcium disodium acid 1.0g, subcutaneous intramuscular injection or intravenous infusion or intravenous infusion. It is recommended to collect 24 hours urine lead test The urine lead value of the diagnostic lead test should be determined by reference to this standard and the specific circumstances. A.6 drive lead treatment commonly used sodium edetate sodium, sodium dimercaptosuccinate injection and two mercapto succinate capsules (DMSA) orally. Generally 3 to 4 days for a course of treatment, two treatment interval interval 3 to 4 days. Dosage and treatment should be based on the specific circumstances of patients with drugs Of the variety, depending on the dose. Mild lead poisoning treatment recommendations generally do not exceed 3-5 courses. A.7 lead laboratory test indicators in the table below. Table A.1 Lead laboratory test index values Index Occupational exposure limit diagnostic value Blood zinc protoporphyrin (ZPP) μmol/L (μg/g Hb) Hematoporphyrin (EP) μmol/L (μg/L) Blood lead (PbB) μmol/L (μg/L) Urine lead (PbB) μmol/L (μg/L) Urine δ-amino-r-ketoacetic acid (ALA) μmol/L (μg/L) 1.9 (400) 0.34 (70) 2.91 (13.0) 3.56 (2000) 2.9 (600) 0.58 (120) 61.0 (8000) ......

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