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GBZ81-2002 English PDF

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GBZ81-2002: Diagnostic Criteria of Occupational Phosphorus Poisoning
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Standard ID	Contents [version]	USD	STEP2	[PDF] delivered in	Standard Title (Description)	Status	PDF
GBZ 81-2002	English	189	Add to Cart	3 days [Need to translate]	Diagnostic Criteria of Occupational Phosphorus Poisoning	Valid	GBZ 81-2002

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Basic data

Standard ID	GBZ 81-2002 (GBZ81-2002)
Description (Translated English)	Diagnostic Criteria of Occupational Phosphorus Poisoning
Sector / Industry	National Standard
Classification of Chinese Standard	C60
Classification of International Standard	13.1
Word Count Estimation	7,774
Date of Issue	4/8/2002
Date of Implementation	6/1/2002
Quoted Standard	GBZ 59; GBZ 51
Summary	This standard specifies the diagnostic criteria and principles of occupational pesticide poisoning. This standard applies to professional activities caused due to exposure to phosphorus poisoning, does not apply to red phosphorus, phosphorus purple, black and phosphorus caused by poisoning. Non-occupational activities, phosphorus poisoning caused by contact, also refer to the use of this standard.

GBZ81-2002: Diagnostic Criteria of Occupational Phosphorus Poisoning

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Diagnostic Criteria of Occupational Phosphorus Poisoning ICS 13.100 C60 GBZ People's Republic of China National Occupational Health Standards Diagnostic criteria for occupational phosphorus 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. Since the implementation of this standard date, the original standard GB 17059-1997 inconsistent with this standard, the standard shall prevail. In contact with yellow phosphorus in occupational activities can cause acute or chronic poisoning, both between the two, there are differences in the incidence of regulation Law and clinical manifestations are not the same. To protect the health of contacts, regulate the diagnosis of phosphorus poisoning, effective prevention and treatment of phosphorus poisoning, the system Fixed standard. This standard is based on the unity of the diagnosis of occupational diseases, external disease, the same target organ damage, clinical manifestations are consistent Principle, in the preparation of chemical liver damage as the main clinical manifestations of acute phosphorus poisoning diagnostic criteria cited GBZ 59, GBZ 51 in the diagnostic and grading standards; in the differential diagnosis of acute and chronic liver disease routine functional test part, also refer to the Standard implementation. This standard is based on the occupational hazards of occupational groups have health records and system tracking observation of the industry advantages, do a good job in disease Do not diagnose, especially early clinical manifestations of poisoning and common diseases are difficult to distinguish between the special population to treat a special view To find out the relationship between progressive changes in disease and continuous contact as a guiding ideology for the preparation of chronic phosphorus poisoning classification criteria. 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 Liaoning Provincial Occupational Disease Prevention and Control Hospital, Yantai City, Shandong Province, responsible for the drafting of occupational disease prevention and control. Guangxi Zhuang Autonomous Region Institute of Occupational Disease Prevention and Control, Wuhan Institute of Chemical Industry and Disease Control, Shandong Province, Institute of Occupational Disease Prevention and Control, Zibo City, Zhejiang Province, Occupational Disease Prevention and Prevention Department of Shandong Medical University Department of Oral Department 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 phosphorus poisoning Occupational phosphorus poisoning refers to the workers in occupational activities in contact with yellow phosphorus caused by systemic diseases. Short-term exposure to large doses The amount of yellow phosphorus or yellow phosphorus burns caused by liver and kidney damage as the main manifestation of acute phosphorus poisoning; long-term contact caused by the teeth Teeth and mandible damage as the main manifestation of chronic phosphorus poisoning, may be associated with liver and kidney damage.

1 Scope

This standard specifies the diagnostic criteria and principles of occupational phosphorus poisoning. This standard applies to occupational activities due to exposure to yellow phosphorus caused by poisoning, does not apply to red phosphorus, purple phosphorus, black phosphorus caused by Of poisoning. Non-occupational activities in contact with yellow phosphorus caused by poisoning, 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. Diagnostic criteria for occupational toxic liver disease GBZ 51 Occupational chemical skin burns diagnostic criteria

3 diagnostic principles

3.1 According to a short period of time inhalation of a large number of yellow phosphorus or yellow phosphorus burns occupational history, with acute liver and kidney damage Bed performance, comprehensive analysis and exclude other causes of similar diseases, can be diagnosed with acute phosphorus poisoning. 3.2 According to long-term close contact with yellow phosphorus or yellow phosphorus dust in the occupational history, with progressive periodontal tissue, teeth and the next Jaw damage-based clinical manifestations, but also liver and kidney damage, combined with on-site labor hygiene data comprehensive analysis, excluding Other causes caused by similar diseases, can be diagnosed with chronic phosphorus poisoning.

4 observation object

Long-term close contact with phosphorus vapor or yellow phosphorus dust, the emergence of periodontal atrophy, periodontal pocket deepening, loose teeth, mandible X-ray visible on both sides of the alveolar ridge slightly absorbed, was horizontal.

5 Diagnostic and grading standards

5.1 acute phosphorus poisoning 5.1.1 mild poisoning Inhalation of high concentrations of yellow phosphorus vapor after a few hours or yellow phosphorus burns after 1 to 10 days or so headache, dizziness, fatigue, appetite Sluggish, nausea, liver pain and other symptoms, and liver swelling and tenderness, accompanied by abnormal liver function test, in line with acute mild Toxic liver disease; may have hematuria, proteinuria, tubular urine, in line with acute mild toxic kidney disease. 5.1.2 moderate poisoning The above performance is aggravated and one of the following occurs. a) the liver was swollen and tenderness, liver function was abnormal, in line with acute moderate toxic liver disease; b) renal insufficiency, urea nitrogen and plasma creatinine increased, in line with acute moderate toxic nephropathy. 5.1.3 severe poisoning On the basis of the above clinical manifestations, and one of the following circumstances. a) acute liver failure; b) acute renal failure. 5.2 chronic phosphorus poisoning 5.2.1 mild poisoning Clinical observation of more than a year, the symptomatic treatment, the above symptoms were progressive increase, alveolar bone absorption more than root 1/3, periodontal ligament widening, narrowing or disappearing, thickening of the bone plate, mandibular body visible bone texture thickening or sparse, row Disorder; may have respiratory mucosal irritation and digestive system symptoms. 5.2.2 moderate poisoning The performance of the above, mandibular posterior teeth appear symmetrical bone dense shadow, perimeter unclear, may have mental hole, blurred edges. 5.2.3 severe poisoning In the above clinical manifestations, the mandible jaw necrosis or fistula formation.

6 Principles of handling

6.1 Principles of treatment 6.1.1 Acute Phosphorus Poisoning 6.1.1.1 cause of treatment a) inhalation of high concentrations of yellow phosphorus vapor should quickly leave the scene, moved to fresh air; b) yellow phosphorus burns the skin should immediately rinse with water, extinguish the fire, remove the embedded yellow phosphorus particles in the organization, to prevent the yellow Phosphorus absorption, can be treated with GBZ 51. 6.1.1.2 symptomatic and supportive care a) may be appropriate to use adrenal cortex hormones, oxygen free radical scavenger, calcium channel blockers; b) keep the water, electrolyte and acid and alkali balance; c) the use of liver and nutritional therapy for toxic liver disease and other symptomatic treatment; d) the treatment of toxic nephropathy to prevent blood volume deficiency, improve renal microcirculation and other symptomatic treatment and supportive care, necessary Can be used when the blood purification therapy. 6.1.2 Chronic Phosphorus Poisoning 6.1.2.1 pay attention to oral hygiene, timely treatment of various diseases of the mouth, as soon as possible to repair the teeth; 6.1.2.2 mandibular necrosis or osteomyelitis should be given timely surgical treatment; 6.1.2.3 pay attention to the protection of liver and kidney function, and given symptomatic treatment. 6.2 Other treatments 6.2.1 acute phosphorus poisoning Mild poisoning cure should be temporarily removed from the yellow phosphorus operation, moderate and severe poisoning after the general should not be engaged in yellow phosphorus operation. 6.2.2 chronic phosphorus poisoning 6.2.2.1 mild poisoning can be done after the original work, such as the condition was progressive increase, should be transferred from the yellow phosphorus operation. 6.2.2.2 moderate and severe poisoning should be transferred from the yellow phosphorus operation.

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 This standard applies to occupational acute and chronic poisoning caused by yellow phosphorus. Acute phosphorus poisoning to liver and kidney damage, heavy Sexual abuse can occur when the disturbance of consciousness; chronic phosphorus poisoning to the main teeth and mandible damage, may be associated with liver and kidney damage. in Clinical observation to the overall point of view to observe and evaluate its condition, should pay attention to the yellow phosphorus on the body of multiple organ damage. A.2 acute phosphorus poisoning A.2.1 yellow phosphorus burns commonly used l% ~ 2% copper sulfate cleaning wounds, extinguish the fire, but excessive can cause acute copper poisoning lead to dissolved Blood, so pay special attention to this side effect; is now advocated with 2% to 3% silver nitrate solution to no phosphorus so far. A.2.2 yellow phosphorus burn area can occur when the poisoning, liquid yellow phosphorus burn area of 5% can be lethal, burn 1 to 10 days About liver, kidney and other organ lesions, these conditions should be taken seriously; the grading indicators should be acute toxic liver disease and kidney Disease diagnosis steps and grading standards. A.2.3 acute phosphorus poisoning liver function routine examination items can refer to GBZ 59 for testing. A.2.4 acute phosphorus poisoning renal function test items available urea nitrogen, plasma creatinine, urinary sodium and urine determination. A.2.5 acute phosphorus poisoning can increase blood phosphorus, blood calcium can be reduced, but because the determination of the results by other factors, it is not As a grading indicator. A.2.6 This standard proposed acute phosphorus poisoning caused by the treatment of liver disease principles, can refer to GBZ 59 implementation. A.3 Chronic Phosphorus Poisoning A.3.1 chronic phosphorus poisoning, there is still a lack of sensitive, specific diagnostic indicators, not only a check that is to make a diagnosis, Must be dynamically observed and treated to provide contact with yellow phosphorus after the teeth, jaw and liver changes year after year, a comprehensive, comprehensive clinical Data, self-control, combined with occupational history, the workshop air yellow phosphorus concentration determination results, a comprehensive analysis, and do a good job of identification Diagnosis, can confirm the diagnosis; in the case of oral disease on the basis of liver damage can be dealt with according to GBZ 59 related provisions. A.3.2 chronic phosphorus poisoning periodontal, dental and mandibular lesions, good occurred in bilateral posterior teeth, often multiple teeth, often Symmetrical on both sides of the jaw for more than one year after treatment is still aggravated, and often accompanied by respiratory mucosal irritation symptoms and Digestive system symptoms, which can be differentiated from non-occupational oral disease, due to non-occupational oral disease mostly numb or bite disease, And the site is not fixed, asymmetric, and there are few other system symptoms accompanied. A.3.3 According to domestic and foreign information chronic phosphorus poisoning may have liver and kidney damage, because the case is very small, so temporarily not liver, kidney damage As a diagnostic grading standard. Liver and kidney damage is rare, but can not be ignored, so the yellow phosphorus producers should pay attention to physical examination General health conditions, conditional health monitoring work should be done. A.3.4 chronic mild toxic liver disease liver function test ALT, AST and so often no abnormalities, serum bile acid determination, indole Cyanosis retention test (ICG) is more sensitive; renal function test can be urine, urine protein and urinary sodium determination, root According to the clinical situation to choose the observation project. A.4 phosphorus has four allotropes, namely yellow phosphorus (also known as white phosphorus), red phosphorus (also known as red phosphorus), purple phosphorus, black phosphorus, which yellow Phosphorus toxicity is greatest, the rest of the toxicity is very small, such as impurities containing yellow phosphorus, there is the possibility of causing phosphorus poisoning, so after diagnosis The name of the allotrope containing yellow phosphorus should be indicated by brackets to distinguish between pure yellow phosphorus.

Appendix B

(Normative appendix) Mandibular X - ray examination requires B.1 mandibular sitting (standing) side image B.1.1 Film 5 X 7 Horizontal. B.1.2 Distance 55 ~ 60 cm. B.1.3 position pendulum method. the patient inverted position (stand) in front of the camera, the side of the jaw was close to the camera frame, arms placed in the body Next to the mandible placed on the side of the test was tilted 30 degrees angle frame. The jaw is stretched and the mandibular body will be tested as dark as possible Box parallel, dark front, including mandibular joint, off the assembly line and the lower edge of the lower jaw. B.1.4 The centerline is tilted 30 degrees to the head side and 5 ° C below the contralateral mandibular angle. B.2 mandibular supine side image (no standing frame available this method) B.2.1 Film 5 X 7 Horizontal. B.2.2 Distance 60 cm. B.2.3 position pendulum method. the patient supine on the camera, arms on the side, the head turned to the side of the test, the shoulder with a pillow Head or sandbag pad high. To avoid the overlap of the cervical spine and mandible, jaw extension, will be detected mandibular body flat, try to The cartridge is parallel. Cartridge front, including mandibular joint, off the assembly line with the lower jaw line. B.2.4 The centerline is tilted 30 degrees to the head side and 5 cm below the contralateral mandibular angle. B.3 Darkroom requirements The fixation solution is formulated according to the formulation in the X-ray film instructions used. The development time is 4 ~ 6 min. Liquid The temperature is between 18 and 22 ° C. B.4 Film quality requirements B.4.1 According to the X-ray film in the rinse, the examined mandibular body is clear and can not be deformed (too wide or too narrow) The side of the mandible does not overlap and is detected to show 4-5 teeth. B.4.2 The structure of the teeth, the root weeks and the jaws is clear. B.5 chronic poisoning when the upper and lower jaw can be damaged, but the mandible is more common, such as the diagnosis of illness should be accompanied by the corresponding Department of teeth and maxillary.

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