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GBZ18-2013 English PDF

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GBZ18-2013: Diagnosis of occupational skin diseases -- General guideline
Status: Valid

GBZ18: Evolution and historical versions

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GBZ 18-2013English279 Add to Cart 3 days [Need to translate] Diagnosis of occupational skin diseases -- General guideline Valid GBZ 18-2013
GBZ 18-2002English319 Add to Cart 3 days [Need to translate] Diagnostic Criteria of Occupational Skin Diseases (General Guideline) Obsolete GBZ 18-2002

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Basic data

Standard ID GBZ 18-2013 (GBZ18-2013)
Description (Translated English) Diagnosis of occupational skin diseases -- General guideline
Sector / Industry National Standard
Classification of Chinese Standard C60
Classification of International Standard 13.100
Word Count Estimation 12,140
Older Standard (superseded by this standard) GBZ 18-2002
Quoted Standard GB/T 16180; GBZ 94; GBZ 185
Regulation (derived from) Health-Communication (2013) 1
Issuing agency(ies) Ministry of Health of the People's Republic of China
Summary This standard specifies the occupational skin disease diagnosis and treatment principles. This standard applies to the professional activities of its subsidiaries is in contact with the skin disease caused by harmful factors.

GBZ18-2002: Diagnostic Criteria of Occupational Skin Diseases (General Guideline)

---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 Skin Diseases (General Guideline) ICS 13.100 C60 GBZ People's Republic of China National Occupational Health Standards Diagnostic criteria for occupational dermatology (general) Diagnostic Criteria of Occupational Skin Diseases (General Guideline) Released in.2002-04-08 2002-06-01 Implementation Issued by the Ministry of Health of the People's Republic of China

Foreword

Article 5.1 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 7804-1987 and this standard is different Due to this standard shall prevail. Occupational dermatosis pathogenic factors, high incidence, involving a wide range of occupational diseases in a large proportion. For protection Occupational exposure to health, effective prevention and treatment of occupational skin diseases, and according to occupational disease diagnostic criteria should reflect the latest clinical progress The requirements of GB 7804-87 made a change. Appendix A to 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 Center for Disease Control and Prevention Occupational Health and Poison Control, Shanghai Dermatology and STD Hospital grass. Shanghai Second Medical University Ruijin Hospital participated in the drafting. This standard is explained by the Ministry of Health of the People's Republic of China. General rules for the diagnosis of occupational dermatosis Occupational skin disease refers to the occupational activities in contact with chemical, physical, biological and other harmful factors caused by skin and Its affiliate disease.

1 Scope

This standard specifies the general principles of diagnostic criteria and principles of occupational dermatosis. This standard applies to occupational activities in contact with harmful factors caused by skin and its appendages of the disease. Non-professional contact Of similar skin diseases can also refer to the use of 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 106 diagnostic criteria for radioactive skin diseases Cosmetic skin diseases - Diagnostic criteria and principles of treatment

3 diagnostic principles

According to a clear history of occupational exposure and clinical manifestations, if necessary, combined with skin patch test or other special examination results, Test the environment of the survey and the same kind of disease, comprehensive analysis, and exclude non-occupational factors caused by similar skin diseases, side Can be diagnosed.

4 clinical type

Occupational skin diseases common clinical types and etiology are as follows. 4.1 Occupational dermatitis 4.1.1 contact dermatitis Direct or indirect contact with irritants and/or allergenic irritant and/or allergic contact dermatitis. 4.1.2 light contact dermatitis Contact with the photosensitive material and subject to sunlight or artificial ultraviolet light exposure caused by phototoxicity or light allergic contact dermatitis. 4.1.3 electro-optical dermatitis Contact with artificial ultraviolet light source (welding, etc.) caused by acute dermatitis. 4.1.4 Radiation dermatitis Ionizing radiation caused by acute and chronic dermatitis and mucosal ulcers (see GBZ 106). 4.1.5 drug rash-like dermatitis Contact with trichlorethylene and other chemicals caused by skin, mucosal inflammatory response, severe with fever and visceral lesions. 4.2 occupational skin pigment changes 4.2.1 Occupational melanosis Long-term contact with coal tar and mineral oil, rubber products and their additives, some Yan (dye) materials and intermediates caused by Chronic skin pigmentation. 4.2.2 Occupational white spot Long-term exposure to phenolic or alkyl phenolic compounds caused by skin pigmentation spots. 4.3 Occupational acne Exposure to coal tar, shale oil, natural oil and its high boiling fractionation products with oil acne caused by asphalt; contact with some Halogenated aromatic hydrocarbons, polychlorophenol and polyvinyl chloride pyrolysis caused by chlorine acne. 4.4 Occupational skin ulcers Contact with hexavalent chromium, soluble beryllium salts and other compounds caused by "bird eye type ulcers." 4.5 Occupational infectious skin diseases Contact with certain bacteria, viruses and other microorganisms caused by skin anthrax, erysipelas, milking pills and other occupational skin damage. 4.6 Occupational warts Long-term exposure to asphalt, coal tar, shale oil and high boiling fraction of mineral oil and other parts of the contact caused by flat warts, looking Often warts and papilloma-like lesions, as well as exposure to asbestos caused by asbestos warts. 4.7 occupational angle of the excessive, chapped Contact with organic solvents and alkaline substances and mechanical friction caused by rough skin, thickening and cracks. 4.8 Occupational prurigo By mites, cercariae and other biological factors caused by papular urticaria-like damage. 4.9 occupational dipping, erosion Long-term immersion caused by skin milky white swelling, wrinkling and erosion. 4.10 Occupational hair changes Mineral oil, asphalt caused by broken hair or hair growth and other hair abnormalities. 4.11 Occupational nail changes Long-term exposure to alkali substances, mineral oil and physical factors caused by the armor, spoon, a stripping and other damage. 4.12 other Other occupational dermatoses that have a clear causal relationship with occupational exposure, such as contact with fiberglass, copper, and a variety of Chemical dust or gas caused by skin itching; contact latex gloves, chlorpromazine, lindane, raw lacquer caused by contact Urticaria; contact with coal tar pitch, coal tar, shale oil, inorganic arsenic and ionizing radiation caused by squamous cell carcinoma, basal Cell carcinoma and other skin tumors.

5 Principles of handling

5.1 Principles of treatment 5.1.1 Avoidance or reduction of exposure to pathogenic factors during treatment. 5.1.2 timely removal of residual pathogens on the skin. 5.1.3 according to the clinical type and condition symptomatic treatment. 5.2 Other processing Occupational skin diseases generally do not lose the ability to work in the enhanced protective conditions can work as usual, special circumstances are handled as follows. 5.2.1 have a serious allergic reaction or recurrent long-term unhealed, should be transferred to the type of work, arrangements do not touch the work of allergens. 5.2.2 dermatitis acute phase, ulcers and certain infectious skin diseases during treatment as appropriate rest or temporary exchange of jobs. 5.2.3 occupational melanosis, occupational leukoplakia and occupational skin cancer should be replaced after the identification of work, from the onset of the environment. 5.2.4 Polymerization or combination of multiple folliculitis, cystic occupational acne, long-term treatment ineffective may consider the exchange of jobs.

6 Correct use of this standard

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

Appendix A

(Informative) Correctly use the instructions in this standard A.1 This standard applies to the diagnosis of occupational dermatosis. Those who meet the clinical standards specified in this standard, are subject to this standard Quasi-principle of diagnosis and treatment. A.2 Occupational dermatology has many pathogenic factors and different clinical types. The same pathogenic factors can cause different clinical manifestations, The same clinical manifestations can be caused by different pathogenic factors. The clinical type specified in this standard is common in occupational skin diseases Bed type, can basically include a variety of causes of occupational dermatosis. A.3 Occupational drug eruption dermatitis refers to contact with trichlorethylene, dimethyl dimethyl carbonate, acrylonitrile, methamidophos or dimethoate and other chemicals Caused by severe erythema multiforme, bullous epidermal necrolysis or exfoliative dermatitis and other types of skin lesions, often involving the mucosa, accompanied by hair Heat, severe liver, kidney or other organ damage. Similar to some drugs through a variety of ways to enter the body after the drug Physical dermatitis. Although the disease is not high incidence, but the condition is often more serious, should pay attention. A.4 This standard will be the original standard of "occupational photosensitive dermatitis" renamed "occupational light contact dermatitis." Professional light Allergic dermatitis is exogenous photosensitive dermatitis category, exogenous photosensitive dermatitis refers to exposure to certain foreign light and light After the reaction occurs, and according to the sensitizer to reach the skin of the different channels are divided into two kinds of light contact dermatitis and actinic drug erosions. Light contact dermatitis refers to the skin exposed to photosensitizers (such as asphalt. Coal tar, anthracene, chlorpromazine and other industrial chemicals), local And after the sun caused by an inflammatory reaction. actinic drug eruption refers to the use of photosensitive drugs (such as promethazine, sulfonamide, naphthyridine Acid, norfloxacin, psoralen, Angelica, etc.), while the skin caused by an inflammatory response after sun, both according to the pathogenesis Can be divided into two kinds of phototoxicity and photoresponse. Due to the exogenous sensitizers derived from the occupational environment of various photosensitizers, in the profession Activities in the way of invading the body is mainly through skin contact, the standard then the original standard in the "occupational photosensitive dermatitis" easy Called "occupational light contact dermatitis". Now, on-site survey data and other comprehensive analysis, in order to make the right judgments. Appendix B of this standard is based on the original standard, Rhithers. Find Results Results Results Rhitherical and Rhithersy composition Results Results (L.) (European Standard) and other international standards and GB 171 49.l-1997 screening allergen series, combined with our country when Before the specific circumstances of the development. Decisions. Decision ON Finds.s. Finded to Decisions.ferencess. Decisions.s.s.s.s.s.s.ithertithers.itherigmaician Rh Examination, hair follicle check, fungal microscopy and culture, if necessary, can be detected chemicals and their metabolites. A.7 Occupational skin diseases should be differentiated from non-occupational skin diseases. Occupational skin lesions of the initial site of the lesion often contact with the Department Consistent with the phase, but its clinical manifestations and often caused by non-occupational factors similar to the majority of non-specific, so the history of occupational diagnosis Decisive. Suspected of occupational dermatitis and diagnosis based on inadequate, generally can be temporarily out of contact, dynamic observation. L.aintithers. Finds.s.s.ithers. Finds.s.s.s.s.s.s.utaintitheromenigmaitheromenigmaither Rhithers. Refunds calling composition views Results calling rounds.itheromen outcome (Rhitheric calling composition swinding access nights calling outcome wanted Rhitheric calling didomenymferencesigma views Find / And Rhithers. Rhithers.s.s.s.s.s.s. Rhithers.s.s.s.s.s.s. Points and Rhithers. Rhithers. Rhithers. and Rh ' poison. This standard does not contain chemicals caused by chemical poisoning. A.9 health inspection requirements in the provisions of the "prone to skin diseases of the type of work, need l ~ 2 years for a physical examination, physical examination should be noted The new skin disease and identify whether the occupational skin disease, "mainly refers to the skin caused by some of the skin caused by the skin Skin damage to be the correct diagnosis and differential diagnosis. Such as. contact with coal tar and petroleum fractionation products, rubber and its additives Of the skin type of skin changes occur; exposure to phenyl phenols and alkyl phenols in the form of white spots; contact with coal tar and high boiling point distillation Acorns and verrucous organisms that occur in the form of petroleum products; the keratosis of the exposure to organic and alkaline substances Excessive and chapped.

Appendix B

(Normative appendix) Skin patch test method B.1 Scope of application This method is only applicable to allergens that are allergic to allergic contact dermatitis and are not suitable for irritation Contact dermatitis. B.2 Test material and spotted allergen concentration B.2.l Test material. A commercially available low-sensitivity tape with good closing properties. B.2.2 Exposure to allergen concentration. should be used on the skin neither stimulation nor induced allergic concentration. Some common work Refer to Appendix C for chemical concentrations. Not included in Appendix C need to do the test of the allergen concentration, refer to the relevant information As the reference, do the animal test to determine its minimum stimulation concentration, and then lower than the concentration of allergens to do skin Skin test, and need to do health control. B.3 Procedure B.3.l Remove the tape from the tape and place the medicine chamber facing up on the test bed. B.3.2 If the test substance is solid or semi-solid, it can be added directly to the drug chamber, adding more than half of the volume of the chamber 0.02g); liquid test material can be wet paper (about 0.02ml) into the drug room. B.3.3 Immediately place the spotted tape with the allergen from the lower part to the normal skin on both sides of the spine, A soft press chamber to get rid of the air and to distribute the test pieces evenly. B.3.4 The test site is marked for observation. B.4 observation and judgment B.4.l observation time 50 hours to remove the tape, with wet soft paper or cotton swab to remove the remaining spots, separated by 30 minutes for the first And observed for the second and third observations at 72 and 96 hours respectively. If necessary, on the 7th day to continue to observe, pay attention With or without delayed response. B.4.2 Determination of the degree of reaction IR stimulus response NT not tested - Negative reaction. No local skin was tested. ± suspicious reaction. localized skin was mild erythema. Ten weak positive reaction. localized skin was erythema, infiltration, may have a small amount of pimples. Ten strong positive reaction. localized skin was erythema, infiltration, pimples, blisters. ++ ten very strong positive reaction. localized skin appear bullae. B.4.3 Explanation of results B.4.3.l patch test results should be repeated several times dynamic observation, comprehensive analysis to judge. B.4.3.2 "+" and "+" above the reaction, in 72 hours or after the observation of the persistence, even intensified, Suggesting that positive allergies. B.4.3.3 In the judgment of patch test results, attention should be paid to the identification of false positives and false negative reactions. B.5 Precautions B.5.l dermatitis acute phase should not be used for patch test. B.5.2 Subjects should not use corticosteroids 2 weeks prior to the trial and during the trial period, 3 days before the trial and during the trial period Anti-histamine drugs should be discontinued. B.5.3 Prior to the examination, the participants should be informed of the meaning and possible response in order to achieve complete cooperation. B.5.4 must be asked the subject, such as the occurrence of a strong reaction should immediately remove the spot. B.5.5 During the spotting should not take a bath, drink and scratch the spot parts, and to avoid intense exercise. B.5.6 In the determination of the degree of response, to avoid false positive or false negative results. B.5.7 should be used as a control for excipients. Necessary fashion to be normal control. Appendix C. (Normative appendix)

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