GBZ 38-2002 Diagnostic criteria for occupational acute trichloroethylene poisoning

This standard specifies the diagnostic criteria and treatment principles for occupational acute trichloroethylene poisoning. This standard applies to acute poisoning caused by exposure to trichloroethylene in occupational activities. Acute poisoning caused by exposure to trichloroethylene in non-occupational activities can also refer to this standard. GBZ 38-2002 Occupational acute trichloroethylene poisoning diagnostic criteria GBZ38-2002 standard download decompression password: www.bzxz.net

1CS13.100
National Occupational Health Standard of the People's Republic of China GBZ38—2002
Diagnostic Criteria of Occupational Acute Trichloroethylene 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 GB11505-1989 is inconsistent with this standard, this standard shall prevail. Acute trichloroethylene poisoning may be caused in occupational activities involving exposure to trichloroethylene. This standard is formulated to protect the health of the exposed, standardize the diagnosis of acute trichloroethylene poisoning, and effectively prevent and treat trichloroethylene poisoning. In light of the research progress in recent years, the diagnostic criteria highlight the effects of trichloroethylene on the nervous system, and the original standard GB11505-1989 has been revised in terms of the clauses. At the same time, supplementary explanations are given for allergic skin damage that has occurred in recent years. 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 Institute of Occupational Health and Poison Control of the Chinese Center for Disease Control and Prevention and the Shenzhen Municipal Health and Epidemic Prevention Station. The participating units include the West China Occupational Hospital of Sichuan University, Xi'an Central Hospital and Guangdong Provincial Institute of Occupational Disease Prevention and Control. This standard is interpreted by the Ministry of Health of the People's Republic of China. Occupational acute trichloroethylene poisoning diagnostic standard GBZ38-2002
Occupational acute trichloroethylene poisoning refers to a systemic disease with central nervous system damage as the main manifestation caused by short-term exposure to a large amount of trichloroethylene in occupational activities. A small number of contacts develop severe allergic skin diseases 1 Scope
This standard specifies the diagnostic criteria and treatment principles for occupational acute trichloroethylene poisoning. This standard applies to acute poisoning caused by exposure to trichloroethylene in occupational activities. Acute poisoning caused by exposure to trichloroethylene in non-occupational activities can also refer to this standard. 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 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 are applicable to this standard.
GB/T16180
WS/T64
3 Diagnostic principles
Diagnostic standards for occupational skin diseases (general principles) Identification of the degree of disability caused by work-related injuries and occupational diseases Diagnostic standards for occupational toxic liver diseases
Diagnostic standards for occupational acute chemical poisoning heart disease Diagnostic standards for occupational acute chemical poisoning nervous system diseases Spectrophotometric determination of trichloroacetic acid in urine Based on the occupational history of short-term exposure to a large amount of trichloroethylene, clinical manifestations mainly of nervous system damage, combined with on-site labor hygiene investigation, reference to the determination of urinary trichloroacetic acid content, comprehensive analysis, and exclusion of similar diseases caused by other causes before diagnosis can be made.
Contact reaction
Short-term exposure to high concentrations of trichloroethylene may cause dizziness, headache, weakness, facial flushing, eye and upper respiratory tract irritation symptoms, etc., which can generally return to normal within 24 hours after the contact is broken. 5 Diagnosis and classification standards
5.1 Mild poisoning
In addition to the aggravation of the above symptoms, there may be palpitations, chest tightness, nausea, vomiting, loss of appetite, etc., and one of the following conditions a) Mild consciousness disorder (confusion, drowsiness or haziness); b) trigeminal nerve damage;
Mild liver or kidney damage.
2 Severe poisoning
In addition to the aggravation of the above symptoms, there is one of the following conditions: a)bzxz.net
Severe consciousness disorder (delirium or coma) with damage to more than two pairs of cranial nerves;
Severe liver or kidney damage.
Treatment principles
Treatment principles
6.1.1 Leave the scene quickly, wash the contaminated skin, change the contaminated clothes, lie in bed and rest quietly; observe the condition closely. Those who have contact reactions should be observed for at least 24 hours and treated symptomatically according to the situation. 6.1.2
There is no specific antidote, and treatment is mainly symptomatic and supportive. 6.1.3
2 Other treatments
Patients with mild poisoning can resume their original work after recovery; patients with severe poisoning should be transferred away from trichloroethylene operations. If labor capacity assessment is required, it shall be handled in accordance with GB/T16180.
Instructions for the correct use of this standard
See Appendix A (Informative Appendix).
Appendix A
(Informative Appendix)
Instructions for the correct use of this standard
A.1 This standard is applicable to the diagnosis of acute poisoning cases caused by contact with trichloroethylene gas or liquid. Trichloroethylene is often used to clean oil stains on metal surfaces, dry cleaning, or as a solvent or extractant, and as a product of trichloroethylene production factories. A.2 Acute trichloroethylene poisoning is mainly manifested by damage to the central nervous system. Liver, kidney, and heart damage are sometimes seen. A diagnosis can be made based on the contact situation, clinical manifestations, combined with on-site investigation and comprehensive analysis. It should be differentiated from consciousness disorders, cranial nerves, heart, liver, and kidney diseases caused by other reasons. A.3 Since trichloroethylene poisoning sometimes has a long incubation period, once a contact reaction occurs, it must be closely observed and treated in time to avoid progression of the disease.
A.4 The trigeminal nerve is a mixed nerve. Its motor branch innervates the masticatory muscles and the masticatory muscles, and its sensory branch is responsible for the sensation of the face and cornea. When the trigeminal nerve is damaged, the main manifestations are the disappearance of the corneal reflex, the facial sensory loss of the trigeminal nerve peripheral or nuclear distribution, and the weakness of the masticatory muscles.
A.5 Severe poisoning can be diagnosed with coma or damage to two or more pairs of cranial nerves on the basis of mild consciousness disorder. Severe poisoning is often accompanied by obvious liver, kidney, and heart damage. For consciousness disorders, see GBZ76, and for liver and heart diseases, see GBZ59 and GBZ74.
A.6 Exposure to high concentrations and large doses of trichloroethylene may affect the cardiac conduction system and cause arrhythmias. In severe cases, ventricular fibrillation may occur, leading to sudden death.
A.7 In acute poisoning, the urinary trichloroacetic acid content increases, which is a good exposure indicator. It can be used as a reference indicator for diagnosis or differential diagnosis. For the determination method, please refer to WS/T64. A.8 Some people who are exposed to trichloroethylene develop severe allergic skin lesions, which may develop after a latent period of 8-30 days (mostly two weeks) and have no obvious dose-effect relationship. Most of them are sporadic single onset. There are three main types of skin lesions: severe erythema multiforme type; exfoliative dermatitis type; bullous epidermal necrolysis type. It is often accompanied by liver damage, and some have kidney damage. The mortality rate is high and should be taken seriously. The pathogenesis of skin damage needs further study. It is currently believed that it is not poisoning, but an allergic disease. Because it is an occupational exposure, it belongs to the category of occupational diseases. When skin lesions occur, their diagnosis is handled according to GBZ18. A.9 There is no specific antidote for acute trichloroethylene poisoning. The treatment principles should refer to the relevant diagnostic standards for occupational acute chemical poisoning.
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.