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GBZ66-2002 English PDF

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GBZ66-2002: Diagnostic Criteria of Occupational Acute Fluoro hydrocarbon Poisoning
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Standard ID	Contents [version]	USD	STEP2	[PDF] delivered in	Standard Title (Description)	Status	PDF
GBZ 66-2002	English	189	Add to Cart	3 days [Need to translate]	Diagnostic Criteria of Occupational Acute Fluoro hydrocarbon Poisoning	Valid	GBZ 66-2002

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Basic data

Standard ID	GBZ 66-2002 (GBZ66-2002)
Description (Translated English)	Diagnostic Criteria of Occupational Acute Fluorohydrocarbon Poisoning
Sector / Industry	National Standard
Classification of Chinese Standard	C60
Classification of International Standard	13.1
Word Count Estimation	7,798
Date of Issue	4/8/2002
Date of Implementation	6/1/2002
Quoted Standard	GBZ 70
Summary	This standard specifies the occupational acute organic fluoride poisoning diagnostic criteria and principles. This standard applies to organic fluorine materials production, processing, use, such as during inhalation tetrafluoroethylene, hexafluoropropylene monomer; two fluorine - chlorine methane pyrolysis gas, residue gas; PTFE, FEP propylene, and other fluoropolymer polytrifluorochloroethylene pyrolysis due to acute poisoning. Acute organophosphorus pesticide poisoning and desflurane fluoride poisoning not fall within the scope of this standard.

GBZ66-2002: Diagnostic Criteria of Occupational Acute Fluoro hydrocarbon Poisoning

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Diagnostic Criteria of Occupational Acute Fluorohydrocarbon Poisoning ICS 13.100 C60 GBZ People's Republic of China National Occupational Health Standards Diagnostic criteria for occupational acute organic fluorosis 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 4867-1996 inconsistent with this standard, the standard shall prevail. In the organic fluorine materials in the production, processing, use and other professional activities in the process of inhalation of organic fluorine monomer, pyrolysis gas, residual Liquid gas and fluoropolymer pyrolysis gas cause acute poisoning. This standard highlights the characteristics of acute organic fluoride poisoning. According to organic fluoride poison The role of the main target organ respiratory system damage was diagnosed hierarchically modified, the toxic myocardial damage included in the moderate Poison, so that the diagnosis of this standard is more clear, reasonable and easy to use. 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 is drafted by Shanghai Chemical Industry Occupational Disease Prevention and Control Institute. This standard is interpreted by the Ministry of Health of the People's Republic of China. Diagnostic criteria for occupational acute organic fluorosis Occupational acute organic fluoride poisoning, refers to the workers in the production environment, short-term inhalation of excess organic fluorine monomer pyrolysis gas, residual Liquid gas or pyrolysis gas, caused by the respiratory system damage-based systemic disease.

1 Scope

This standard specifies the diagnostic criteria and principles of occupational acute organic fluorosis. This standard applies to the production of organic fluorine materials, processing, use and other processes, inhalation of tetrafluoroethylene, hexafluoropropylene and other monomers; Fluoro-methyl chloride and other pyrolysis gases, residual liquid gas; polytetrafluoroethylene, polyfluoroethylene propylene, polychlorotrifluoroethylene and other fluoropolymer heat Gas poisoning caused by acute poisoning. Acute organic fluoride pesticide poisoning and fluoride ether poisoning is not within the scope 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 70 diagnostic criteria for pneumoconiosis

3 diagnostic principles

According to the exact short-term, excessive organic fluorine gas inhalation history, combined with clinical manifestations, X-ray and ECG Check the results, comprehensive analysis, excluding other diseases can be diagnosed later.

4 observation object

Inhalation of organic fluorine gas, the upper respiratory tract infection-like symptoms, observed 72h symptoms gradually improved, no heart and lung injury.

5 Diagnostic and grading standards

5.1 acute poisoning 5.1.1 mild poisoning Headache, dizziness, cough, sore throat, nausea, chest tightness, fatigue and other symptoms, the lungs are scattered dry rales or a small amount of wet Rales X-ray chest see the lungs, lungs and lungs enhanced texture, edge blurred and other signs, in line with acute bronchitis, bronchitis Clinical signs of pericarditis. 5.1.2 moderate poisoning Those who have one of the following conditions can be diagnosed as moderate poisoning. a) mild clinical manifestations of mild poisoning increased chest tightness, chest pain, palpitations, difficulty breathing, irritability and mild Cyanosis, lungs, limited respiratory sounds, lungs have more dry rales or wet rales. X-ray examination of lungs Enhanced, with a wide network of shadows, and scattered in the small dot-like shadow, so that the lungs through the brightness reduction, or see the level of cracked Wide, bronchial cuff sign, occasionally Kerley's B line, consistent with interstitial pulmonary edema clinical signs. b) Symptoms and signs as above, two, lower lung field lungs increased texture, patchy shadow along the distribution of lung texture, more common in the, Within the band, widely intensive when combined into a film, in line with the clinical signs of bronchial pneumonia. 5.1.3 severe poisoning Where any of the following circumstances, can be diagnosed as severe poisoning. a) acute alveolar pulmonary edema; b) acute respiratory distress syndrome (ARDS); c) toxic myocarditis; d) with mediastinal emphysema, subcutaneous emphysema, pneumothorax. 5.2 Fluoropolymer dust heat Inhalation of organic fluoropolymer pyrolysis, the emergence of chills, fever, chills, muscle soreness and other metal fever symptoms, May be associated with cough, chest tight feeling, headache, nausea, vomiting, etc., generally within 24 ~ 48h subsided.

6 Principles of handling

6.1 Principles of treatment 6.1.1 Where there is a clear history of accidental inhalation of organic fluorine gas, with or without symptoms, must immediately leave the scene, absolutely Bed rest, carry out the necessary medical examination and preventive treatment, and observe 72h. 6.1.2 early oxygen, oxygen concentration is generally controlled within 50% to 60%, with caution with pure oxygen and hyperbaric oxygen. Acute respiratory distress Syndrome can be applied when the lower pressure of positive end expiratory pressure (PEEP0.5kPa or so). 6.1.3 Early, adequate, short-range application of glucocorticoid. Stressed that all the observation and poisoning patients in place to give glucocorticoid intravenous and other preventive treatment. Poisoned patients according to Condition severity, in the first day after poisoning may be appropriate to increase the dose, after a sufficient amount of short-term intravenous administration. More moderate poisoning patients, For the prevention and treatment of pulmonary fibrosis, can continue in the acute phase after a small dose of intermittent application of glucocorticoids. 6.1.4 to maintain airway flow, can be given bronchial spasm and other ultrasonic atomization inhalation. A lot of foam sputum should be used early To defoamer dimethyl silicone oil (defoaming net). Difficult to occur after the use of medical treatment is invalid after tracheotomy. 6.1.5 toxic myocarditis and other clinical signs, the treatment principle is generally the same with the internal medicine. 6.1.6 rational use of antibiotics, prevention and treatment of secondary infection. 6.1.7 Fluoropolymer dust heat, generally given symptomatic treatment. Where recurrent disease, should be given the treatment of pulmonary fibrosis. 6.2 Other treatments 6.2.1 Cure standards Acute poisoning caused by the clinical manifestations disappeared, chest X-ray and other related test results returned to normal for the cure. 6.2.2 poisoned patients cured, can restore the original work; such as patients after poisoning left lung, heart failure, should be transferred from the original For post, and regular review.

7 Correctly use the instructions in this standard

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

Appendix A

(Informative) Correctly use the instructions in this standard A.1 The use of this standard, must have a clear occupational exposure to organic fluorine gas accident history. Fluoropolymer itself is non-toxic, Does not cause acute poisoning, but accidental inhalation of organic fluorine monomer, pyrolysis gas, residual liquid gas, fluoropolymer pyrolysis gas, can cause Acute Organic Fluorosis. The organic fluorine monomer refers to a monomer in a fluoropolymer, such as tetrafluoroethylene, difluoro-methyl chloride, chlorotrifluoroethylene, Hexafluoropropylene and so on. Cracking gas refers to the reaction by-product produced when pyrolysis of organic fluorine monomer is prepared at high temperature. Such as difluoro-methyl chloride (F22) Pyrolysis of pyrolysis produced by the preparation of tetrafluoroethylene, which components are tetrachlorethylene, hexafluoropropylene, octafluoroisobutylene, etc. More than 10 kinds of reaction products. Residual gas refers to the case of high temperature pyrolysis of the monomer after the remaining residue, at room temperature for the gaseous compounds, there are very toxic Octafluoroisobutylene and the like. Pyrolysis gas refers to the pyrolysis of fluoropolymers at high temperature pyrolysis, pyrolysis products greater than 400 ° C contain highly toxic fluorophos And hydrogen fluoride. A.2 Some components of organic fluorine gas, such as fluoroalkanes and olefins, have a significant effect on myocardial damage. The patients with ECG Figure shows myocardial damage and various types of arrhythmias, excluding the previous heart after organic disease, even if X-ray Lesions lighter, can still be diagnosed as toxic myocarditis, should be treated by severe poisoning. A.3 organic fluorine gas is a pro-lung highly toxic substances, but the disease can also be a transient liver and kidney dysfunction, the process Degrees are often lighter, generally do not need special treatment can be recovered, the diagnosis should still be based on the clinical manifestations of respiratory system and X-ray As the basis. A.4 on the use of glucocorticoid "early, short, short" principle, all observed and poisoned patients should be on-site prevention Sex medication, optional dexamethasone 10mg + 25% glucose solution 40 mL intravenous slow injection. Although the observation object is not acute Drug category, but in the observation period can still be used hormone preventive treatment 1 ~ 3d. Light, medium and severe poisoning in the first 1 ~ 5d poisoning According to the disease, optional dexamethasone 20 ~ 60mg/d or hydrocortisone 400 ~ 1200mg/d intravenous medication. Mild poisoning anxious Symptoms of the symptoms can be quickly discontinued. Moderate or more poisoning patients after the acute phase, for anti-pulmonary fibrosis, can continue to small doses Oral glucocorticoid 2 to 4 weeks or so. A.5 fluoropolymer dust heat usually occurs in the polytetrafluoroethylene, poly perfluoro-ethylene propylene hot forming process, the sintering temperature in the 350 ~ 380 ℃ or so, the workers inhalation of its pyrolysis caused by the cold-like reaction, the symptoms resemble metal smoke, is a special A clinical type, generally given antipyretic analgesic symptomatic treatment, within 24 ~ 48h more. But repeated onset, the literature can be reported Induced pulmonary fibrosis, it should be given anti-pulmonary fibrosis treatment. A.6 early poisoning symptoms of this disease is not typical, so the organic fluorine monomer, crack, pyrolysis gas (material) occupational exposure history is extremely important, Where listed as the object of observation, should be stressed that the absolute bed rest, reduce oxygen consumption, strict medical observation, early attention should be with the ordinary Cold, acute tonsillitis, acute gastroenteritis phase identification.

Appendix B

(Normative appendix) Bedside chest X-ray film technical requirements and reading notes B.1 Location. As far as possible to take the seat or semi-recumbent front and rear chest radiograph. Chest radiograph must include all thorax and ribs on both sides; Both sides of the sternoclavicular joint symmetry, target - slice distance of 100 cm. B.2 Exposure. No breath when exposed. Lung, bone and soft tissue contrast and good level, the first 1 to 4 thoracic vertebrae clearly visible, Putting the time should be as short as possible, should be 1/10s or less than 1/10s. The centerline is aligned with the fifth thorax and perpendicular to the cartridge. B.3 darkroom. no shoulders above the tissue should be dark black, under the diaphragm was transparent character. B.4 lung blood distribution. standing before the posterior position due to the relationship between lung blood gravity, upper lung lung texture slim, and when lying, On the lungs and lungs texture thickening. B.5 heart shadow increases and tends to horizontal. a. Diaphragm position, so that the heart up and rotation. b. Standing before the posterior position, the heart by the diaphragm support, supine position by the spine, mediastinal and bilateral lung support, heart wall More weak are more likely to change their shape. c. Standing when a large number of blood stuck in the abdominal organs and body sagging parts of the vascular bed; supine when the amount of blood More, so that the mind is significantly increased. d. The distance between the target and the target was shifted from about 180 cm to about 100 cm, and the proportion of the heart was significantly increased. e. Standing before the chest radiograph close to the film, the magnification is smaller; and lying position before and after the chest radiograph heart high film distance increased Large, large magnification, heart shadow is also significantly increased. B.6 mediastinal large blood vessels widened. superior vena cava shadow more obvious. B.7 Aortic ball position shift, close to the level of clavicle. B.8 bilateral shoulder blade and lung field overlap, may also affect the observation of the lesion. When lying down a small amount of pleural effusion can not be displayed. therefore, Need to carefully observe, to avoid the wrong conclusion.

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