GB 8786-1988 Diagnostic criteria and treatment principles for occupational acute nickel carbonyl poisoning

GB 8786-1988 Occupational acute carbonyl nickel poisoning diagnostic criteria and treatment principles GB8786-1988 standard download decompression password: www.bzxz.net

National Standard of the People's Republic of China
Occupational Acute Carbonyl Nickel Poisoning
Diagnostic Criteria and Principles of Management
Diaghostir eriterie and principles of management ofoccupatinnal atcute nickel carbonyl proisoningUDC 616-057: 616
-07/-08 : 613
GH 8786 -88
Occupational acute carbonyl nickel poisoning is a systemic disease with acute respiratory and nervous system damage as the main manifestation caused by inhalation of high concentrations of carbonyl nickel in a short period of time in a production environment. Its clinical manifestations are characterized by early irritation symptoms, a latent period of one epidemic period, and chemical pneumonia and toxic pulmonary edema. 1 Diagnostic principles
Based on a clear history of exposure to nickel at commercial concentrations within two weeks (such as production accidents, toxic spills, accident handling, equipment maintenance, etc.), clinical manifestations of acute damage to the respiratory and nervous systems, combined with urine tests, and the exclusion of other diseases with similar manifestations, a diagnosis can be made.
2 Diagnosis and grading standards
Mild poisoning
Mild poisoning can be diagnosed based on a comprehensive analysis of the following typical clinical manifestations. There are symptoms of dizziness, headache, fatigue, blurred vision, nausea, loss of appetite, as well as swallowing, chest tightness, and chest pain. Physical examination shows mild congestion of the conjunctiva and pharynx, and no other positive signs. Chest X-ray examination may be normal or show enhanced texture of both lungs. 2.2 Moderate poisoning
The above respiratory and nervous system symptoms suddenly intensify after 8-72 hours, accompanied by cough, sputum, and increased breathing. There may be chills, fever (not exceeding 39℃), confusion, drowsiness or excitement and multi-talk. Physical examination chest auscultation can hear coarse breath sounds and dry rales. Tachycardia, sometimes arrhythmia. Chest X-ray shows enhanced texture and blurred edges of both lungs, or decreased transparency of the lung field or scattered patchy shadows. The total number of peripheral white blood cells increases.
2.3 Severe poisoning
The above symptoms progress, with high fever, palpitations, coma, obvious cyanosis and difficulty breathing, and bloody foamy sputum. Physical examination shows abnormal breathing, widespread rales in the lungs, and tachycardia. It may be accompanied by arrhythmia or even gallop rhythm. The liver may be enlarged. Chest X-ray shows blurred and enlarged shadows of the hilum. The lung field is blurred, with fine reticular and cord-like shadows, or widespread infiltrative shadows of spots and flakes, which merge into adult flakes. Electrocardiogram may show arrhythmia and myocardial damage. The total number of peripheral blood cells is significantly increased, and the nucleus is left-shaped.
Acute mild, moderate, and severe urinary nickel content can be significantly increased. 3 Treatment principles
Quickly leave the poisoning site, take off contaminated clothes, and wash contaminated skin and hair. Keep quiet and rest in bed. Inhale mice and conduct clinical observation of sudden excision within 72 hours. To prevent and treat pulmonary edema, glucocorticoids should be applied early, in sufficient quantities, and for a short period of time (3 to 5 days). If urine potassium is elevated, sodium dithiocarb (dithlocarb) can be taken orally, 0.5g each time, once every hour, and an equal amount of sodium bicarbonate can be taken at the same time. Approved by the Ministry of Health of the People's Republic of China on February 22, 1988, and implemented on September 1, 1988
GB 878688
The number of days for medication is determined according to the condition and the amount of urinary nickel content. Generally, it can be taken continuously for 3 to 7 days: atomization inhalation can also be used. Other emergency education and symptomatic treatment measures are the same as those for internal medicine. :
Labor capacity assessment
After mild poisoning is cured, the original work can be resumed. After treatment, those with obvious symptoms of moderate and severe poisoning should be arranged to rest as appropriate, and should not work with carbonyl nickel.
Requirements for health examination
People engaged in carbonyl nickel operations should undergo regular physical examinations before employment and every two years. The examination items include internal medicine, chest radiography, electroencephalogram, and pulmonary ventilation function measurement. Occupational contraindicationsbZxz.net
Obvious neurological diseases;
Obvious heart, lung, liver, kidney diseases,
Severe or persistent skin diseases
GB8786--88
Appendix A
Instructions for the correct use of the standard
(reference)
A.1 This standard is mainly applicable to acute carbonyl nickel poisoning. Acute poisoning of other carbonyl metals such as carbonyl iron and carbonyl cobalt can be used as a reference. A.2 The clinical manifestations of acute carbonyl poisoning are mainly respiratory and nervous systems. The diagnosis is mainly based on clinical symptoms, signs and chest X-ray examination. Urine nickel content determination can be used as a reference. A.3 The symptoms of respiratory damage caused by acute carbonyl nickel poisoning include two categories, namely initial symptoms and delayed symptoms. The latter is usually more serious, and often appears 24 hours or more after the initial symptoms disappear, so it is emphasized that poisoned patients should rest in bed early and receive close clinical observation within 72 hours.
Additional remarks:
This standard was proposed by the National Health Standard Technical Committee Occupational Disease Diagnosis Standard Committee. This standard was drafted by the Third Hospital of Beijing Medical University, the Institute of Labor Hygiene and Occupational Disease Prevention and Control of Sichuan Academy of Medical Sciences, the Institute of Radiation Protection of the Ministry of Nuclear Industry, the Chengdu Health and Epidemic Prevention Station and the Employees' Hospital of Southwest Metal Products Factory of the Ministry of Nuclear Industry. This standard was entrusted by the Ministry of Health to the Institute of Labor Hygiene and Occupational Diseases of the Chinese Academy of Preventive Medicine for interpretation.
Tip: This standard content only shows part of the intercepted content of the complete standard. If you need the complete standard, please go to the top to download the complete standard document for free.