GBZ74-2009 English PDF

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GBZ74-2009: Diagnostic criteria of occupational acute toxic cardiopathy caused by chemicals
Status: Valid

GBZ74: Historical versions

Standard ID	USD	BUY PDF	Lead-Days	Standard Title (Description)	Status
GBZ 74-2009	189	Add to Cart	3 days	Diagnostic criteria of occupational acute toxic cardiopathy caused by chemicals	Valid
GBZ 74-2002	239	Add to Cart	3 days	Diagnostic criteria of occupational aeropathy	Obsolete

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Basic data

Standard ID: GBZ 74-2009 (GBZ74-2009)
Description (Translated English): Diagnostic criteria of occupational acute toxic cardiopathy caused by chemicals
Sector / Industry: National Standard
Classification of Chinese Standard: C60
Classification of International Standard: 13.100
Word Count Estimation: 8,873
Date of Issue: 2009-03-16
Date of Implementation: 2009-11-01
Older Standard (superseded by this standard): GBZ 74-2002
Quoted Standard: GBZ 71; GB/T 16180
Regulation (derived from): ?Health-Communication [2009] 9
Issuing agency(ies): Ministry of Health of the People's Republic of China
Summary: This standard specifies the principles of diagnosis of occupational acute toxic chemicals heart disease, diagnosis and grading standards and principles. This standard is applicable to a variety of occupational acute heart attack caused by chemical poisoning.

GBZ74-2002: 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 acute toxicosis Diagnostic Criteria of Occupational Acute Toxic Cardiopathy Caused by Chemicals 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 17057-1997 inconsistent with this standard, the standard shall prevail. In a variety of professional activities, may be in a short period of time exposure to some high concentrations and high toxicity of chemicals and acute poison. These chemicals can be known varieties, and some are already in the poisoning after a moment is not clear its exact pathogenic varieties, Some species caused by poisoning in the "list of occupational diseases" in the famous, and some have not yet included; some have independent diagnostic criteria, Some have not yet developed a separate diagnostic criteria. But all of the acute poisoning diseases have a common law of incidence, can be developed, It is also necessary to develop rules that should be observed in the diagnosis of acute poisoning. The rules set out in this standard series relate to the diagnosis of occupational acute chemical poisoning, which are used to ensure that The diagnosis system of acute chemical poisoning is unified, whether known or concealed by the cause, and whether it is caused by poisoning. Into which the target organ damage, can be in accordance with the rules of the rules to do the diagnosis. In the "occupational acute chemical poisoning diagnosis" under the heading, including the following 10 parts. Part 1. Diagnostic criteria for occupational acute chemical poisoning (general); Part 2. Occupational acute occult chemical poisoning diagnostic rules; Part 3. Occupational acute chemical toxicity - Multiple diagnostic criteria for multiple organ dysfunction syndrome; Part 4. Diagnostic criteria for occupational acute exogenous death; Part 5. Occupational acute chemical toxicity - Criteria for the diagnosis of neurological diseases; Part 6 Occupational acute chemicals - Criteria for the diagnosis of toxic respiratory diseases; Part 7. Diagnostic criteria for occupational acute toxic liver disease; Part 8. Diagnostic criteria for occupational acute toxic nephropathy; Part 9 Occupational Acute Chemicals - Toxic Cardiac Disease Diagnostic Criteria; Part 10 Occupational Acute Chemicals Toxicity Diagnostic criteria for blood system diseases; Appendix A to this standard is an informative appendix and Appendix B 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 Shanxi Medical College Second Affiliated Hospital is responsible for drafting, Tianjin Occupational Disease Prevention and Treatment Hospital; Xi'an Central Hospital, Shanghai Sixth People's Hospital, Shanghai Zhabei District Central Hospital to participate in the drafting. This standard is interpreted by the Ministry of Health of the People's Republic of China. Diagnostic criteria for occupational acute toxicosis Occupational Acute Chemicals Toxicity Heart disease is a process of poisoning in a variety of occupational acute chemicals. Damage the heart, affect its pump function, self-discipline or conduction caused by the disease.

1 Scope

This standard specifies the general principles and principles of treatment of occupational acute chemical toxic heart disease. This standard applies to a variety of occupational acute chemical poisoning caused by heart disease. For non-occupational acute chemical poisoning The diagnosis of heart disease, can also refer to this standard.

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 71 Occupational Acute Chemical Poisoning Diagnostic Criteria (General) Rules for the diagnosis of occupational acute occult chemical poisoning

3 diagnostic principles

According to the short term there is a higher concentration of chemical poisoning occupational exposure history, clinical manifestations and field investigation, combined with ECG, Myocardial enzymes, X-ray chest X-ray and other test results, consistent with toxic heart disease, and exclude other causes caused by similar diseases Disease, can be diagnosed. Clinically can be divided into acute toxic myocardial damage and arrhythmia two categories, the former to ECG ST-T And myocardial enzymes to change the main basis for diagnosis, the latter ECG can show a variety of arrhythmia, two types of clinical manifestations can also be appear.

4 observation object

In the identification of occupational acute poisoning, one of the following circumstances. a) mild increase in myocardial enzymes; b) ECG QT interval extended; c) occasional premature.

5 Diagnostic and grading standards

5.1 mildly toxic heart disease One of the following conditions. a) myocardial enzymes increased significantly; b) a variety of common arrhythmias, such as frequent premature beat, supraventricular tachycardia; c) degree of atrioventricular block; d) ECG shows ST-T mild abnormal changes. 5.2 Moderate toxic heart disease Where are one of the following. a) heavier arrhythmias, such as atrial fibrillation or flutter, ventricular tachycardia; b) II degree atrioventricular block; c) ECG myocardial injury, ischemia or myocardial infarction-like changes. 5.3 severe toxic heart disease Where one of the following conditions is met. a) Myocardial infarction; b) torsades de pointes, ventricular fibrillation or flutter; c) III degree atrioventricular block; d) cardiogenic shock or congestive heart failure; e) Sudden cardiac death.

6 Principles of handling

6.1 Principles of treatment 6.1.1 According to the principle of treatment in GBZ 71, rescue acute poisoning. 6.1.2 Take specific treatment measures for the cause. 6.1.3 patients should be absolutely bed rest, timely correction of hypoxia, maintenance of water, electrolyte and acid-base balance, reasonable nutrition. 6.1.4 Treatment of myocardial damage a) to give the cardiomyocytes to improve the nutrition and metabolism of drugs, such as potassium myristate magnesium, polarized solution, coenzyme Q10,1,6- Fructose diphosphate (FDP), vitamin C, vitamin B, etc .; b) early use of adequate glucocorticoid; c) improve the coronary circulation drugs, such as nitric acid lipid drugs, calcium antagonists, low molecular weight dextran; d) congestive heart failure, caution with digitalis drugs, diuretics, dopamine. 6.1.5 treatment of arrhythmia a) correct high potassium or hypokalemia; b) tachyarrhythmias, such as atrial fibrillation or flutter, supraventricular tachycardia, optional verapamil; ventricular tachycardia Rapid choice of lidocaine; potassium magnesium mixture on the tip of the torsion type VT has a good effect; with drugs on atrial fibrillation treatment When invalid, consider using defibrillation; c) slow arrhythmia, atrioventricular block, the choice of atropine, ephedrine or isoproterenol, sugar Corticosteroids, use temporary pacemakers if necessary; d) Other treatment principles are the same as internal medicine. 6.2 Other treatments 6.2.1 Observe subjects and mildly toxic heart disease After treatment is fully restored, can return to the original job. 6.2.2 Moderate toxic heart disease After the recovery of treatment, generally can be engaged in normal work. 6.2.3 Severely toxic heart disease After treatment, according to the recovery situation, arrange work or rest.

7 Correctly use the instructions in this standard

See Appendix A (informative).

Appendix A

(Informative) Use this standard correctly A.1 This standard applies to the diagnosis, classification and treatment of heart disease caused by occupational acute chemical poisoning, life acute Poisoning caused by heart disease can refer to the implementation. A.2 common cause a) Asphyxiating gases. carbon monoxide, hydrogen sulfide, cyanide, methane, nitrogen, carbon dioxide. b) Pesticides. lindane, DDT; dexamethasone; fluoroacetamide, sodium fluoride; sodium phosphate, phorate, DDV ,, methamidophos, kaolin, dimethoate, trichlorfon, malathion, phosphamine; pyrethroids Pyrethrins, deltamethrin, etc.); insecticidal; carbamates; c) metal and non-metallic. mercury, arsenic, arsine, lead, antimony, barium, cobalt, thallium, phosphorus and so on. d) Irritant gases. ammonia, chlorine, phosgene, nitrogen dioxide, dimethyl sulfate, methyl chloroformate, organic fluorine, fluorine Acid, phosphine, phosphorus trichloride, chloromethyl ether, monomethylamine, nickel carbonyl. e) Halogenated hydrocarbons. tetrachlorethylene, vinyl chloride, ethyl chloride, trichloroethane, tetrachloroethane, trichloropropane, Alkane, bromoethane, bromopropane, chloroform. f) organic solvents. benzene, toluene, gasoline, carbon tetrachloride, carbon disulfide. g) methemoglobin forming agent. aniline, nitrite. h) other. phenol, fluoroacetic acid, sodium azide, allylamine, ethyl gasoline, borane and so on. A.3 Pathogenesis a) toxic effects on the myocardium and/or conduction system. b) poisoning caused by the body hypoxia, electrolyte imbalance, acid-base balance disorders and other indirect causes. A.4 Occupational acute toxic heart disease clinical features a) have a history of exposure to high concentrations of chemicals in the short term. b) has the clinical manifestation of the chemical poisoning. c) acute and toxic heart disease clinical and ECG changes are nonspecific, and often poisoned by the critical symptoms of the cover Cover, easily overlooked. d) myocardial damage occurred in the poison after l ~ 7 days, and some even occurred in the recovery of poisoning. e) the more poisoning, the more the chance of myocardial damage occurs, the sooner the emergence of the time, the more serious the degree. f) Most patients may return to normal with the improvement of poisoning. A.5 Clinical manifestations of toxic heart disease a) Symptoms. palpitations, shortness of breath, weakness, chest tightness, difficulty breathing sometimes due to critical condition in a coma without any Complained. b) signs. cyanosis, blood pressure, heart enlargement, heart rate increased or slowed, heart sounds low blunt, arrhythmia, severe Who can hear diastolic gallop, two lungs, and so on. c) ECG. common QT interval prolongation, ST-T changes, varying degrees of atrioventricular block, various types of Arrhythmia. d) X-ray chest X-ray. visible cardiac enlargement. Irritating gas poisoning pulmonary edema, visible pulmonary artery protrusion, lung field was significant Shows a little, shadow-like or butterfly-like shadows. e) Other. increased myocardial enzymes, cardiac ultrasound, two-dimensional echocardiography, dynamic ECG, ECT, etc. Often, you can understand the heart size, cardiac hypertrophy, ventricular enlargement, cardiac function and other changes. A.6 Diagnostic steps and methods a) According to the high concentration of chemical contact history, field investigation, clinical and laboratory data, first diagnosed acute Poison and its degree. b) According to the clinical manifestations and signs of myocardial damage. c) patients with acute poisoning, should be routinely done ECG examination, critically ill patients should be continuous dynamic ECG monitoring. d) myocardial enzymes, serum electrolytes and blood gas analysis. e) X-ray chest radiograph. f) echocardiography, two-dimensional echocardiography, dynamic electrocardiogram, cardiac ultrasound, cardiac ECT and other test results. g) Based on the above information, comprehensive analysis, excluding other similar diseases, can make a diagnosis. ECG is poisoning heart The most reliable diagnosis of disease. A.7 Occupational acute toxic heart disease naming and writing format Standardized diagnosis naming format, you can at a glance, is conducive to the accumulation of clinical data, guiding treatment, is conducive to timely treatment And later research. The naming principle is that after the classification of the diagnosis, the name of the type of heart disease is indicated. Its way of expression as follows. a) Acute mild toxic heart disease. 1) acute mild toxic heart disease (myocardial damage); 2) acute mild toxic heart disease (supraventricular tachycardia); 3) acute mild toxic heart disease (myocardial damage with 1 degree atrioventricular block). b) Acute moderate toxic heart disease. 1) acute moderate toxic heart disease (ventricular tachycardia); 2) acute moderate toxic heart disease (Ⅱ degree atrioventricular block); 3) acute moderate toxic heart disease (myocardial ischemic injury with I degree atrioventricular block). c) acute severe toxic heart disease. 1) acute severe toxic heart disease (myocardial infarction with congestive heart failure); 2) acute severe toxic heart disease (Ⅲ degree atrioventricular block with cardiogenic shock). And so on. ......

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