GBZ 58-2002 Diagnostic criteria for acute occupational sulfur dioxide poisoning

GBZ 58-2002 Occupational acute sulfur dioxide poisoning diagnostic standard GBZ58-2002 standard download decompression password: www.bzxz.net

ICS13.100
National Occupational Health Standard of the People's Republic of China GBZ58—2002
Diagnostic Criteria of Occupational Acute Sulfur Dioxide 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 the original standard GB16378-1996 is inconsistent with this standard, this standard shall prevail. Acute poisoning can be caused in occupational activities involving exposure to sulfur dioxide. In order to protect the health of the contactors and effectively prevent and treat acute sulfur dioxide poisoning, GB16378-1996 was issued. The revised standard highlights the characteristics of acute sulfur dioxide poisoning. The main target organ of its toxic effect is the respiratory system. According to the degree of respiratory damage caused by sulfur dioxide, the diagnostic classification has been modified. According to the requirements of "Occupational Diagnostic Standard Drafting and Expression Rules Part 1: Basic Provisions of Occupational Disease Diagnostic Standards", the text and structure are changed and the diagnosis system is connected with GBZ73 to make the diagnosis clearer and more reasonable and convenient for application. Appendix A of this standard is an informative appendix.
This standard is proposed and managed by the Ministry of Health of the People's Republic of China. This standard is drafted by the Beijing Chemical Occupational Disease Prevention and Control Institute and the Occupational Disease Prevention and Control Institute of Nanjing Chemical Industry (Group) Company. This standard is interpreted by the Ministry of Health of the People's Republic of China. ..com Occupational Acute Sulfur Dioxide Poisoning Diagnostic Standard GBZ58-2002
Occupational acute sulfur dioxide poisoning is a systemic disease caused by short-term exposure to high-concentration sulfur dioxide gas during production labor or other occupational activities, with acute respiratory system damage as the main cause. 1 Scope
This standard specifies the diagnostic criteria and treatment principles for occupational acute sulfur dioxide poisoning. This standard applies to acute poisoning caused by occupational exposure to sulfur dioxide. Acute poisoning caused by sulfur trioxide has similar manifestations and this standard can also be used.
2 Normative referencesbZxz.net
The clauses in the following documents become clauses of this standard through reference in this standard. For all referenced documents with dates, all subsequent amendments (excluding errata) or revisions are not applicable to this standard. However, parties that reach 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 apply to this standard.
GB/T16180
3 Diagnostic principles
Identification of the degree of disability caused by work-related injuries and occupational diseases of employees Diagnostic criteria for occupational acute chemical poisoning respiratory diseases Based on the occupational history of exposure to high concentrations of sulfur dioxide in a short period of time and typical clinical manifestations, combined with on-site labor hygiene investigations, comprehensive analysis, and exclusion of other similar diseases; diagnosis can be made. 4 Irritation reaction
Symptoms of eye and upper respiratory tract irritation occur, but they can return to normal in a short period of time (1 to 2 days), and there are no abnormalities in chest physical examination and X-ray signs.
5 Diagnosis and classification standards
5.1 Mild poisoning
In addition to the aggravation of the above symptoms, there are also systemic symptoms such as headache, nausea, vomiting, and fatigue: congestion and edema of the conjunctiva, nasal mucosa and throat, and obvious dry rales or wheezing in the lungs: chest X-rays may only show enhanced lung texture. 5.2 Moderate poisoning
In addition to the aggravation of the clinical manifestations of mild poisoning, there are also chest tightness, severe cough, sputum, and difficulty breathing; there are also signs such as shortness of breath, mild purple, and obvious wet rales in both lungs; chest X-ray signs show that the transparency of the lung field is reduced, and fine reticular and/or scattered patchy shadows appear, which are consistent with signs of pulmonary interstitial edema or chemical pneumonia. 5.3 Severe poisoning
In addition to the clinical manifestations of moderate poisoning, if one of the following conditions occurs, severe poisoning can be diagnosed. Alveolar pulmonary edema;
Sudden shortness of breath, respiratory rate>28 times/min, blood gas analysis PaO2<8kPa, when inhaling low-concentration oxygen (concentration b)
less than 50%), arterial oxygen partial pressure still cannot maintain 8kPa, and there is a continuous downward trend:..com6
Complications such as severe pneumothorax and mediastinal emphysema; ventricular asphyxia or coma
Treatment principles
Treatment principles
6.1.1 Immediately leave the poisoning scene, lie still, keep warm, and inhale oxygen. Inhale sodium bicarbonate, amino tea, dexamethasone, and antibiotics by nebulization. Rinse the conjunctival sac thoroughly with saline or water. 6.1.2 After inhaling high concentrations of sulfur dioxide, those who have obvious irritation reactions despite no objective signs should be observed for 48 hours and receive symptomatic treatment.
6.1.3 Pay attention to the prevention and treatment of pulmonary edema, and use glucocorticoids in an early, adequate and short-term manner. Perform tracheotomy if necessary. 6.1.4 Oxygen therapy, infection prevention and treatment, reasonable infusion, correction of electrolyte disorders and anti-shock are all the same as the principles of medical treatment. 6.2 Other treatments
Patients with acute mild and moderate poisoning can resume work after recovery. Patients with severe poisoning or those with persistent and obvious respiratory symptoms after poisoning should be transferred away from irritating gas operations. Those who need to undergo labor capacity assessment should be treated in accordance with GB/T16180. Instructions for the correct use of this standard
See Appendix A (Informative Appendix).
..comAppendix A
(Informative Appendix)
Instructions for the correct use of this standard
A.1 The clinical manifestations of acute poisoning caused by exposure to high concentrations of sulfur trioxide gas are similar, and this standard can be applied for diagnosis and treatment.
A.2 This standard is not applicable to other clinical diseases caused by long-term exposure to low concentrations of sulfur dioxide. 3 This disease is mainly characterized by respiratory system lesions, so the diagnostic criteria are mainly based on respiratory system symptoms, signs and chest X-ray manifestationsA.3
The main diagnostic indicators. Others such as peripheral blood picture, electrocardiogram, etc. should be checked, but they may not be consistent with the degree of poisoning and cannot be used as a diagnostic basis.
The clinical manifestations may not be parallel to the chest X-ray manifestations. The diagnosis classification should be combined with the actual situation and decided after comprehensive analysisA.4
5 Pulmonary function tests are only listed in the health examination requirements, but they should be checked as much as possible when the condition of the poisoned patient permits. A.5
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