GBZ 36-2002 Diagnostic criteria for occupational acute tetraethyl lead poisoning

This standard specifies the diagnostic criteria and treatment principles for occupational acute tetraethyl lead poisoning. This standard applies to acute poisoning caused by exposure to tetraethyl lead, ethyl liquid or high-concentration ethyl gasoline in occupational activities. It can also be used as a reference for acute poisoning caused by exposure to tetraethyl lead, ethyl liquid and high-concentration ethyl gasoline in non-occupational activities. GBZ 36-2002 Occupational acute tetraethyl lead poisoning diagnostic criteria GBZ36-2002 standard download decompression password: www.bzxz.net

1CS13.100
National Occupational Health Standard of the People's Republic of China GBZ36-2002
Diagnostic Criteria of Occupational Acute Tetraethyl Lead PoisoningPublished on April 8, 2002
Implemented on June 1, 2002
Ministry of Health of the People's Republic of China
Article 6.1 of this standard is recommended, and the rest are mandatory. This standard is formulated in accordance with the "Law of the People's Republic of China on the Prevention and Control of Occupational Diseases". From the date of implementation of this standard, if there is any inconsistency between the original standard GB11503-1989 and this standard, this standard shall prevail. Tetraethyl lead is a gasoline additive that can cause acute poisoning in contact persons due to accidents during occupational activities. It has been nearly ten years since the original acute poisoning diagnostic standard was implemented. During this period, other related standards have been promulgated and implemented. In order to more effectively prevent and control acute tetraethyl lead poisoning, the original standard has been revised in accordance with national regulations. Based on the original standard, this standard mainly supplements and modifies the diagnostic indicators of acute mild poisoning and severe poisoning, the treatment principles of severe poisoning, and the "Instructions for the correct use of this standard", and adds "Basal body temperature, blood pressure, pulse measurement methods and standards" in the appendix of this standard to make the diagnostic standards clearer, more reasonable and easier to use. Appendix A of this standard is an informative appendix, and Appendix B is a normative appendix. This standard is proposed and managed by the Ministry of Health of the People's Republic of China. This standard is drafted by Jinzhou Occupational Disease Prevention and Control Institute and Jinxi Chemical General Plant Occupational Disease Prevention Institute. Dalian Labor Health Research Institute, Liaoning Provincial Occupational Disease Prevention and Control Institute, Jinzhou Petrochemical Company Hospital, and Jinxi Refining and Chemical General Plant Staff Hospital participated in the drafting. This standard is interpreted by the Ministry of Health of the People's Republic of China. Occupational Acute Tetraethyl Lead Poisoning Diagnostic Standard GBZ36-2002
Occupational acute tetraethyl lead poisoning is a systemic disease with acute toxic encephalopathy and mental disorders as the main symptoms caused by short-term and large-scale exposure to tetraethyl lead in occupational activities. 1 Scope
This standard specifies the diagnostic criteria and treatment principles for occupational acute tetraethyl lead poisoning. This standard applies to acute poisoning caused by exposure to tetraethyl lead, ethyl liquid or high-concentration ethyl gasoline in occupational activities. Acute poisoning caused by exposure to tetraethyl lead, ethyl liquid and high-concentration ethyl gasoline in non-occupational activities can also be used as a reference. 2 Normative references
The clauses in the following documents become clauses of this standard through reference in this standard. For all dated referenced documents, all subsequent amendments (excluding errata) or revisions are not applicable to this standard. However, parties to an agreement based on this standard are encouraged to study whether the latest versions of these documents can be used. For all undated referenced documents, the latest versions shall apply to this standard.
GB/T16180
3 Diagnostic principles
Identification of the degree of disability caused by work-related injuries and occupational diseases Diagnostic criteria for occupational acute chemical toxicity of nervous system diseases Based on the occupational history of short-term exposure to large amounts of tetraethyl lead, the appearance of clinical symptoms and signs mainly characterized by acute encephalopathy and mental disorders, combined with the occupational hygiene survey data of the workplace, comprehensive analysis is conducted, and other diseases with similar manifestations are excluded before diagnosis can be made.
4 Contact reaction
Neurotic symptoms such as insomnia, nightmares, headaches, loss of appetite, nausea, etc. appear and disappear in a short time. 5 Diagnosis and classification standards
5.1 Mild poisoning
The above symptoms worsen, and severe insomnia, nightmares, severe headaches, dizziness and other symptoms appear, and one of the following is present: a) Mild mental disorders such as excitability, impatience, irritability, anxiety, etc.; b) Addiction-type neurotic manifestations;
c) Decreased basal body temperature, blood pressure or pulse, see Appendix B (Normative Appendix). 5.2 Severe poisoning
One of the following conditions:
a) Psychomotor excitement;
b) Impairment of consciousness in a spectrum or coma
C) Epileptic seizure or status epilepticus
Treatment principles
6.1 Treatment principles
6.1.1 On-site treatment:
Leave the poisoning site immediately, take off contaminated clothes, shoes and hats, and thoroughly wash contaminated skin, nails, hair, etc. with soapy water or clean water, and pay attention to heat preservation
6.1.2 Contact reaction
Closely observe neurological and mental changes, and give necessary examinations and symptomatic treatment. 6.1.3 Mild poisoning
Closely observe changes in the condition and treat symptomatically. 6.1.4 Severe poisoning
In addition to supportive and symptomatic treatment, actively prevent and treat cerebral edema. When psychomotor excitement or epileptic seizures occur, tranquilizers or anti-epileptic drugs should be given to prevent exhaustion due to overexcitement, and nursing care should be strengthened to prevent accidents. 6.2 Other treatmentswww.bzxz.net
6.2.1 After treatment of mild poisoning, the original work can be arranged after a short rest. 6.2.2 Severe poisoning should be transferred away from toxic operations, and rest or appropriate work should be decided based on the recovery of the disease. 6.2.3 If labor capacity assessment is required after severe poisoning, the relevant provisions of GB/T16180 shall be followed. 7 Instructions for the correct use of this standard
See Appendix A (Informative Appendix) and Appendix B (Normative Appendix). Appendix A
(Informative Appendix)
Instructions for the correct use of this standard
A.1 This standard applies to workers who work with tetraethyl lead, as well as workers who work with ethyl liquid and high-concentration ethyl gasoline. A.2 When using this standard, a clear history of occupational exposure and special conditions that cause acute poisoning, such as the mode, degree, time, and protective conditions of exposure, must be available. The results of the on-site determination of tetraethyl lead concentration in the air are of reference significance, and the possibility of percutaneous absorption of tetraethyl lead should not be ignored.
A.3 Except for a very small number of patients who develop symptoms immediately after exposure to tetraethyl lead and gradually worsen, symptoms and signs will only appear after a certain incubation period. The incubation period varies in length, with the shortest being 30 minutes and the longest being up to 27 days, and most often 1 to 10 days, and generally not exceeding 20 days. Therefore, during this period, those who have excessive exposure to tetraethyl lead should be tracked and observed. A.4 Patients with acute tetraethyl lead poisoning have more prominent mental disorders. Mild poisoning is characterized by excitability, impatience, irritability, anxiety and addiction-type neurosis, while severe poisoning is characterized by psychomotor excitement such as restlessness, mental confusion, hallucinations, fantasies, personality changes, and even violent behavior. The above symptoms should be examined according to the methods of psychiatry and neurology, and the relevant units and personnel should be investigated when necessary. A.5 Patients with acute tetraethyl lead poisoning often show autonomic dysfunction, which can be manifested as the "three lows" sign. The "three lows" sign refers to the decrease in basal body temperature, blood pressure, and pulse, which can be seen in some patients with acute tetraethyl lead poisoning, but the "three lows" do not necessarily exist at the same time. It is often "one low" or "two lows". Those without the "three lows" cannot deny the possibility of poisoning.
Other autonomic nerve function tests (skin scratches, eye heart reflex, erector piloerection reflex, supine reflex, supine reflex, inverted blood pressure, two-measurement skin temperature difference, etc.) are not used as diagnostic indicators for the time being because the methods are not standardized. They can be used as references for diagnosis. A.6 Differential diagnosis: This disease should be differentiated from acute gasoline poisoning, mental illness, central nervous system infection, alcohol poisoning, and neurosis.
Acute severe tetraethyl lead poisoning, if not fully recovered, should be treated according to GB/T16180. A.7
Appendix B
(Normative Appendix)
Measuring methods and standards for basal body temperature, blood pressure, and pulse Basal body temperature, blood pressure, and pulse refer to the body temperature, blood pressure, and pulse of the subject when he is awake in the morning, not getting up to move, and not eating.
B.1 Temperature
B.1.1 Gum measurement method: wipe the sweat off the gum socket, put the thermometer deep in the gum socket, clamp the thermometer with the upper arm, and read the value after 10 minutes. The measured value below 36℃ is hypothermia. B.1.2 Oral measurement method: place the sterilized thermometer under the tongue, close the lips tightly, do not breathe through the mouth, read the value after 5 minutes, and the measured value below 36.3℃ is hypothermia. B.1.3 Anal measurement method: lie on your side, apply lubricant to the head of the anal thermometer, slowly insert it into the anus, until it reaches half the length of the thermometer, and read the value after 5 minutes. The measured value below 36.5℃ is hypothermia. B.2 Blood pressure
Use the cuff pressurization method (i.e. sphygmomanometer measurement method). Generally, the right upper limb is used. A measured value below 12.0/8.0kPa (90/60mmHg) is considered hypotension. Since the systolic blood pressure of people over 45 years old increases with age (increases by 1.33kPa for every 10 years of age), and the diastolic blood pressure has a downward trend except for those over 60 years old, it does not change much in those under 60 years old, so a comprehensive analysis should be made during diagnosis. B.3 Pulse
Use the palpation method of the radial artery (under special circumstances, the radial artery, carotid artery, brachial artery, etc. can also be checked). If necessary, both sides need to be palpated and measured for comparison. Each measurement should be more than 1 minute. A measurement value of less than 60 beats/minute is a low pulse rate. The above three measurements need to be measured once a day for two consecutive days.
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