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GBZ70-2015: Diagnosis of occupational pneumoconiosis
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Diagnosis of occupational pneumoconiosis
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Diagnostic criteria of pneumoconiosis
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Diagnostic Criteria of Pneumoconioses
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PDF similar to GBZ70-2015
Basic data | Standard ID | GBZ 70-2015 (GBZ70-2015) | | Description (Translated English) | Diagnosis of occupational pneumoconiosis | | Sector / Industry | National Standard | | Classification of Chinese Standard | C60 | | Classification of International Standard | 13.1 | | Word Count Estimation | 17,133 | | Date of Issue | 2015-12-15 | | Date of Implementation | 2016-05-01 | | Older Standard (superseded by this standard) | GBZ 70-2009 | | Quoted Standard | GB/T 16180 | | Regulation (derived from) | State-Health-Communication (2015)22 | | Issuing agency(ies) | National Health and Family Planning Commission | | Summary | This standard specifies the occupational pneumoconiosis (hereinafter referred to as pneumoconiosis) diagnostic principles, pneumoconiosis, chest X-ray diagnostic staging and treatment principles. This standard is applicable to the diagnosis of pneumoconiosis, coal worker's pneumoconiosis, graphite pneumoconiosis, carbon black pneumoconiosis, asbestosis lung, talc pneumoconiosis, cement pneumoconiosis, mica pneumoconiosis, pneumoconiosis, Pottery workers pneumoconiosis, aluminum pneumoconiosis, welders pneumoconiosis, pneumoconiosis and other pneumoconiosis workers. | GBZ70-2002: Diagnostic Criteria of Pneumoconioses---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 for pneumoconiosis)
ICS 13.100
C60
GBZ
People's Republic of China National Occupational Health Standards
Diagnostic criteria for pneumoconiosis
Diagnostic Criteria of Pnemoconioses
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. Since the implementation of this standard date, the original standard GB 5906-
1997 and this standard is inconsistent with this standard shall prevail.
Pneumoconiosis is the most important occupational disease in China, not only the number of patients, but also the harm is serious, resulting in reduced ability to work
Residual and affect the life of the disease, but also national and corporate compensation for the main occupational disease. Therefore, pneumoconiosis diagnosis is a very strong policy workers
For.
The "Pneumatic X-ray Diagnosis" (GB 5906-1986), promulgated in 1986, is the first edition of this standard. Standard implementation for more than 10 years
To play an important role in the prevention and treatment of pneumoconiosis in China, but there are some obvious shortcomings, such as some stages of the higher baseline; some images
With the development of X-ray imaging technology, the application of new technology on the past X-ray film some of the images have
New knowledge; especially on the standard piece of knowledge has been greatly improved, 86 years of diagnostic standards developed in the content is not enough
Indeed, the technology has lagged behind the internationally widely used high-kVA technology. June 17,.1997 published GB 5906-1997 version
This was revised only in Annexes B and D of the 1986 edition, and appendix C was deleted. There is no comprehensive revision of the standard. because
This amendment is made in accordance with the provisions of the relevant standards.
The main contents of the revision are.
a) the standard name to "pneumoconiosis diagnostic criteria"
b) Intensive classification and ILO classification, using four and twelve grade (Appendix B);
c) a method of determining the overall intensity in Appendix B;
d) Appendix B adds a small shadow shape and size of the recording method;
e) that "patch strips", "whitish areas"
f) more clearly defined in Appendix B for pleural plaques;
g) Added Appendix E (Normative Appendix) < < Pneumoconiosis Diagnostic Reading Requirements >>;
h) developed a pneumoconiosis diagnosis of high-kVA standard tablets, increased the expression of small shadow standard density of the combination of tablets.
Appendix A to this standard is an informative appendix, Appendix B, C, D, E, F 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 China Center for Disease Control and Prevention of Occupational Health and poisoning control is responsible for drafting, to participate in the drafting of the Shanghai municipal
Industrial Hospital, Liaoning Province Institute of Occupational Health and Occupational Diseases, Anshan Iron and Steel Company Labor Hygiene Research Institute, Shanghai Yangpu District Center for Medical
Hospital, Guangdong Province Occupational Disease Prevention and Control Hospital, Guangzhou City Occupational Disease Prevention and Control Hospital, Beijing Hospital, Beijing Center for Disease Control and Prevention, Beijing
Learn the third hospital.
This standard is interpreted by the Ministry of Health of the People's Republic of China.
Diagnostic criteria for pneumoconiosis
Pneumoconiosis is due to occupational activities in the long-term inhalation of productive dust and retention in the lungs caused by diffuse lung fibers
The main body of the disease.
1 Scope
This standard specifies the principles of pneumoconiosis diagnosis and pneumoconiosis X-ray staging
This standard applies to the state of the current list of occupational diseases in a variety of pneumoconiosis.
2 normative reference documents
The terms of the following documents are hereby incorporated by reference into this standard. Whichever is the date of the reference file, which subsequently
All amendments (excluding corrigenda) or revisions do not apply to this standard, however, encouragement of compliance with this standard
All parties discuss whether the latest versions of these documents can be used. For undated references, the latest edition of this document applies
standard.
Identification of Occupational Injury and Occupational Disease Disability in Staff and Workers GB/T 16180
3 diagnostic principles
According to the reliable history of productive dust exposure, on-site labor hygiene survey data to the technical quality of qualified X-ray after the former
Chest X-ray performance as the main basis, reference to dynamic observation data and pneumoconiosis epidemiological survey, combined with clinical manifestations and laboratory tests
Check, exclude other lung-like disease, the control pneumoconiosis diagnostic criteria for pneumoconiosis diagnosis and X-ray staging.
4 X-ray chest X-ray performance staging
4.1 pneumoconiosis (O)
a) O. X-ray chest radiographs.
b) O. chest X-ray performance is not enough to diagnose the I.
4.2 Phase pneumoconiosis (I)
a) I. a small shadow with a total intensity of 1, the distribution range of at least two lung areas.
b) I. small shadows with a total intensity level of 1, with a range of more than 4 lungs or small shadows with a total density of 2
Cloth reached four lung areas.
4.3 Phase II pneumoconiosis (II)
a) II. a small shadow with a total intensity of 2 levels, the distribution of more than four lung areas; or a total density of 3 small shadows,
Distribution range to four lung areas.
b) II. a small shadow with a total intensity of 3 levels, the distribution of more than four lung areas; or small shadow aggregation; or a large yin
Shadow, but not enough to diagnose the Ⅲ.
4.4 Phase III pneumoconiosis (III)
a) III. a large shadow appears, its long diameter of not less than 20mm, short diameter of not less than 10mm.
b) III. the area of a single large shadows or the sum of multiple large shaded areas exceeds the area of the upper right lung area.
5 Principles of handling
5.1 Principles of treatment
Pneumoconiosis patients should be promptly transferred from the dust operation, and according to the needs of the disease comprehensive treatment, and actively prevent and treat tuberculosis and its
It complications, in order to alleviate the symptoms, delay the progression of the disease, improve patient life, improve patient quality of life.
5.2 Other processing
According to the pneumoconiosis X-ray staging and pulmonary function compensation, the need for disability identification in accordance with GB/T 16180 treatment.
6 Correct use of the description of this standard
See Appendix A (informative), see appendix B, C, D, E, F (normative)
Appendix A
(Informative)
Correctly use the instructions in this standard
A.1 The scope of application of this standard
This standard applies to the November 5, 1987 Wei defense word No. 60 < < occupational disease and occupational disease treatment methods >>
Listed 12 kinds of pneumoconiosis, that is, silicosis, coal workers pneumoconiosis, graphite pneumoconiosis, carbon black pneumoconiosis, asbestos lung, talc pneumoconiosis, cement pneumoconiosis, cloud
Pneumoconiosis, pottery pneumoconiosis, aluminum pneumoconiosis, welders pneumoconiosis, casting pneumoconiosis.
A.2 Diagnostic principles
Pneumoconiosis is a prerequisite for the diagnosis of occupational exposure to occupational dust.
Pneumoconiosis patients may have varying degrees of respiratory symptoms and signs and some laboratory tests of abnormal, but do not have a clear
Specificity, and therefore can only be used as a reference for pneumoconiosis diagnosis. Clinical examinations and laboratory tests focus on excluding other lung diseases such as pulmonary tuberculosis
Nuclear, lung cancer and other diffuse pulmonary fibrosis, sarcoidosis, hemeemia and so on.
A.3 pneumoconiosis X-ray staging
According to the degree of X-ray radiography changes, the pneumoconiosis is divided into. a pneumoconiosis (I), two pneumoconiosis (II), three pneumoconiosis
(III), "0" is pneumoconiosis. During each period, 0, I, II, III were added only for better dynamic observation and health monitoring
Care, not a separate period.
A.4 Determination of small shadow intensity
The overall intensity of the small shadows in the pneumoconiosis X-ray staging specified in this standard is determined in the small area
Based on an overall determination of the density of whole lung small shadows. The method of determination is based on the density of the highest lung area as the overall intensity,
Expressed in four major grades.
According to the need, the lung area small shadow intensity determination can be used when the four major grades or 12 small grading.
A.5 on the dynamic observation of chest radiographs
Pneumatic X-ray imaging changes are a gradual process, with a dynamic series of chest radiographs that provide a more reliable basis for diagnosis
This provision is only one chest X-ray should not be diagnosed. But in special circumstances, if it is sure to exclude other diseases, or pathological examination
Check the results, may also consider making a diagnosis.
Appendix B
(Normative appendix)
Criterion and judgment method of pneumoconiosis diagnosis
B.1 Classification of lung areas
The vertical distance from the tip of the lung to the top of the diaphragm is divided into three, with the equilateral points of the horizontal line to each side of the lung field are divided into upper, middle and lower three lungs
Area.
B.2 Small shadows
Refers to the lung field diameter or width of not more than 10mm shadow.
B.2.1 Morphology and size
Small shadows can be divided into two types of circular and irregular shape, according to their size is divided into three. The shape and size of small shadows are marked
The quasi-show is acceptable.
B.2.1.1 Circle small shadows are represented by the letters p, q, r.
p. the maximum diameter of not more than 1.5mm;
q. diameter greater than 1.5mm, no more than 3mm;
r. diameter greater than 3mm, no more than 10mm.
B.2.1.2 Irregular shape Small shadows are represented by the letters s, t, u.
s. the maximum width of not more than 1.5mm;
t. width greater than 1.5mm, no more than 3mm;
u. width greater than 3mm, no more than 10mm.
B.2.1.3 Recording method
When reading chest radiographs should record the shape and size of small shadows. The small shadow on the chest is almost all the same for the same shape and size
The letter symbols are written on the slash above and below, for example. p/p, s/s, etc .; chest appeared on the form of two or more small and small
Shadows, the main small letters of the letter written on the slash above the secondary and a considerable number of another write in the slash
Surface, for example. p/q, s/p, q/t and so on.
B.2.2 Intensity
Refers to the number of small shadows within a certain range. The determination of the degree of small shadow should be based on the standard film, the text part only from the description
use. Reading the first time to determine the intensity of each lung area, and then determine the overall density of the whole lung.
B.2.2.1 Four levels of hierarchical density can be simply divided into four levels. 0, 1, 2, 3 levels.
0 level. no small shadow or little, less than the lower limit of 1.
Level 1. There is a certain amount of small shadows.
Level 2. There are a lot of small shadows.
Level 3. There are a lot of small shadows.
B.2.2.2 12 small grading
Small shadow intensity is a continuous process of gradual change, in order to objectively reflect this change, in the four major levels on the basis of each
1/0,1/1,1/2; 2/1,2/2,2/3; 3/2, 3/2, 3,3 /, the purpose is to provide more information, more detailed
To reflect the lesion, epidemiological studies and medical care. Reading and recording methods are as follows. the chest and standard tablets compared,
According to the provisions of the four major levels to determine the classification, if the small shadow density and standard tablets are basically the same, first recorded as 1/1,2/2,3/3. If its small yin
Shadow intensity and standard comparison, that a higher level or lower level should also be seriously considered, then recorded at the same time, such as 2/1 or 2/3,
The former means that the degree of density is 2, but 1 should also be seriously considered; the latter means that the degree of density is 2, but 3 should also be carefully examined
consider.
B.2.2.3 Distribution range and method of determining the overall intensity
a) determine the density of the lungs require a small shadow distribution of at least two-thirds of the area;
b) The distribution of small shadows refers to the number of lung regions with small shades of 1 level or more (including grade 1).
c) The overall intensity is the density of the lungs with the highest intrahepatic density.
B.3 big shadow
Refers to the lung field diameter or width greater than 10mm above the shadow.
B.4 Small shadows gathered
Refers to the local small shadow significantly increased aggregation, but has not yet formed a large shadow.
B.5 pleural plaques
Long-term exposure to asbestos dust can cause pleural changes, such as diffuse pleural thickening, localized pleural plaques. Pleural patella refers to the tip of the lungs and
Thoracic diaphragm angle outside the thickness of greater than 5mm of the limitations of pleural thickening, or localized calcified pleural plaques.
Exposure to asbestos dust, chest X-ray performance of 0, such as the emergence of pleural plaques, can be diagnosed as I; chest X-ray performance for those who, such as pleural plaques have tired
And part of the heart or the diaphragm surface, can be diagnosed as stage II; chest X-ray performance for the II, such as single or bilateral pleural plaque length and more than one side
A half of the length of the chest wall, or involving the heart to make it part of the show disheveled, can be diagnosed as III.
B.6 Additional symbols
a) bu lung bullae
b) ca lung cancer and pleural mesothelioma
c) small shadow calcification
d) cp pulmonary heart disease
e) cv empty
f) ef pleural effusion
g) em emphysema
h) es lymphoid eggshell calcification
i) ho honeycomb lungs
j) pc pleural calcification
k) pt pleural thickening
l) px pneumothorax
m) rp Rheumatic pneumoconiosis
n) tb active tuberculosis
Appendix C.
(Normative appendix)
Quality and quality assessment of chest radiograph
C.1 chest mass quality
C.1.1 Basic requirements
a) must include both sides of the tip of the lungs and eccentric phrenic angle, thoracolumbar joints are basically symmetrical, scapula shadow does not overlap with the lung field;
b) the number, date and other signs should be placed above the shoulders, arranged neatly, clearly visible, not with the lung field overlap;
c) photo without artifacts, light leakage, pollution, scratches, water collapse and in vitro images.
C.1.2 Anatomical indications are displayed
a) Both sides of the lung texture clear, sharp edges, and extended to the lung field.
b) heart and diaphragm surface imaging sharp.
c) Both sides of the chest wall from the tip of the lungs to the pleural angle showed good.
d) trachea, carina and both sides of the main bronchial contour visible, and can show the thoracic contour.
e) Posterior area lung texture can be displayed.
f) The right side of the diaphragm top is generally located at the tenth posterior level.
C.1.3 Optical density
a) the highest density of the upper lung field should be between 1.45-1.75;
b) The optical density of the subphrine is less than 0.28;
c) The direct exposure area has an optical density greater than 2.50.
C.2 chest mass quality grading
C.2.1 First grade (excellent)
Complete symbol chest radiograph quality requirements.
C.2.2 two tablets (good film)
Not fully meet the chest quality requirements, but not yet reduced to three tablets.
C.2.3 Three-stage film
One of the following conditions for the three tablets, can not be used for pneumoconiosis newly diagnosed.
a) does not fully meet the basic requirements of chest X-ray, the defects affect the diagnosis area and the sum of the lungs to a lung area between the lungs.
b) both sides of the lung texture is not clear and sharp, or local lung texture blur, which affects the area of the diagnosis area in half a lung area to a
Between the lungs.
c) Both sides of the lung tip to the pleural angle of the side of the chest wall showed poor, blurred tracheal contour, heart area after the lung texture is difficult to identify.
d) lack of inspiration, the right side of the diaphragm is located in the eighth posterior rib level.
e) the photo is dark, the upper lung area in the highest optical density between 1.85-1.90; or photo white, upper lung area in the highest optical density in the
1.30-1.40; or fog high, sub-diaphragm optical density between 0.40-0.50; or direct exposure area optical density in the
2.20-2.30 between.
C.2.4 four tablets (waste film)
Chest mass quality of less than three tablets were four tablets, can not be used for pneumoconiosis diagnosis.
Appendix D
(Normative appendix)
Pneumoconiosis X - ray diagnostic standard tablets
D.1 The relationship between standard tablets and standard provisions
Standard tablets are part of the standard of pneumoconiosis diagnosis, mainly to express X-ray imaging changes that are difficult to express in words. So dust
Lungs X-ray imaging changes in the determination of the standard should prevail, the text part is only instructions.
D.2 Preparation of standard tablets
The principle of standard tablet preparation is small shadow density and shape expression is accurate, easy to use.
D.3 The composition and content of standard tablets
Standard piece consists of two parts, one combination of a total of eight films, the main expression of different forms, the size of the small shadow of the intensity, small Yin
The intensity of the shadow is compiled at the midpoint of the intensity of each level, ie 0/0,1/1,2/2,3/3. Second, a total of 15 large lungs, the main demonstration dust
The relationship between the intensity of small shadows and the distribution range of lungs.
D.4 application of standard tablets
When reading X-ray chest radiographs for pneumoconiosis and staging, especially when determining the shape and intensity of small shadows,
The corresponding combination of standard tablets control.
Each phase of the pneumoconiosis lung slice is a reference for the diagnosis of staging.
D.5 standard film copyright
Standard film copyright owned by the state.
D.6 copy and issue of standard tablets
Standard copy and distribution commissioned by the National Center for Occupational Health and Occupational Disease Prevention and Control Center, the National Occupational Disease Diagnosis and Appraisal Committee
Pneumoconiosis diagnosis and identification group review, number, stamped with the seal and the standard sheet instructions issued together.
Appendix E
(Normative appendix)
Chest X-ray inspection of the technical requirements
Pneumoconiosis X-ray examination must use high-kVA photography techniques. Those who do not meet the following equipment and technical requirements can not be pneumoconiosis X
Ray inspection.
E.1 Photographic equipment
E.1.1 X-ray machine
The highest tube voltage output value of not less than 125KV, power is not less than 20KW.
E.1.2 X-ray tube and window filter
a) rotating the anode;
b) the focus is not greater than 1.2mm;
c) Total window filtering 2.5-3.5 mm aluminum equivalent.
E.1.3 Filter grid
a) the gate density is not less than 40 lines/cm;
b) the grid ratio is not less than 10. 1;
c) gate focal length 1.8m;
d) specifications match the film.
E.1.4 Sensing screen, cartridge
a) the general use of medium speed screen;
Sensitization screen without stains;
b) Sensing screen resolution of not less than 5-6 pairs of pairs/mm;
c) sensitization screen and film contact closely;
d) The cartridge does not leak.
E.1.5 X-ray film
a) the general use of general-purpose (hand show, machine) film, to promote the application of special film for chest photography;
b) blue film base;
c) Background fog Dmin < 0.20;
d) d) specifications. 356 mm x 356 mm (14 '' x 14 '') or 356 mm x 432 mm (14 '' x 17 '').
E.1.6 Power supply
a) The power supply shall comply with the X-ray machine's rated requirements;
b) X-ray machine to be independent power supply, not with power appliances share power;
c) Power supply voltage fluctuation range ± 10%.
E.2 photography technology
E.2.1 Preparation and position requirements
a) should be checked by the chest wall close to the camera frame, feet naturally separated, the rotation within the arms so that the scapula as far as possible and lung weight
Stack;
b) coke - sheet distance 1.80 m;
c) adjust the location of the ball, the center line in the sixth thoracic level;
d) exposure should be fully inspiratory after the exhaust state;
e) after the former chest X-ray for the routine examination, for the diagnosis and differential diagnosis of the need to add side, oblique, body photography
Or CT examination.
E.2.2 Photographic conditions
a) according to the specific circumstances of the X-ray machine using 120-140KV for chest photography;
b) According to the chest thickness to determine the exposure, the general use of 2-8mAs, exposure time of not more than 0.1 seconds.
c) Photography should refer to the past chest X-ray adjustment of photography conditions.
E.3 darkroom technology
E.3.1 The darkroom must meet the requirements of the work
E.3.2 Manual hand wash
a) in principle requires constant temperature timing, liquid temperature should be controlled between 20-25 ° C; development time 3-5 minutes;
b) the fuser should be full, the water rinse thoroughly;
c) must use a qualified special safety light;
d) timely replacement, fixing solution.
E.4 automatic washing machine
In order to ensure the quality of chest X-ray, conditional should be used as far as possible automatic washing machine, and in strict accordance with the requirements of the automatic washing machine operating procedures
get on.
Appendix F
(Normative appendix)
Pneumoconiosis diagnostic reading requirements
F.1 in the pneumoconiosis X-ray diagnostic personnel must pass the country on the diagnosis of pneumoconiosis examination and obtain a certificate.
F.2 Principles of collective diagnosis of pneumoconiosis diagnosis. The relevant procedures according to the national < < occupational disease diagnosis and management approach >>.
F.3 readers to correct visual acuity should be within the normal range. Read the film should take the seat, view the location of the lamp to be appropriate, generally placed in the reader eye
Before the 25cm (conducive to observe the small shadow) to 50cm (conducive to observe the chest) at the Department.
F.4 reading film should be based on the time sequence of chest radiographs to observe the dynamic changes in imaging, only one chest radiograph should not be diagnosed.
F.5 read the film should refer to the standard film, the general should be diagnosed chest radiograph on the center of the light box, both sides of the commonly used standard tablets.
F.6 watch light at least 3 light boxes, preferably 5. View the minimum brightness of light not less than 3000CD, brightness uniformity (brightness
Poor) less than 15%.
F.7 Reading room should be quiet, no direct other light exposure to the concept of light, reading speed according to personal habits, but should be in each
1 to 1.5 hours to rest once, in order to keep the reader's vision and brain have a good ability to distinguish.
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