GB 16378-1996 Diagnostic criteria and treatment principles for occupational acute sulfur dioxide poisoning

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 symptoms and this standard can also be used. GB 16378-1996 Diagnostic criteria and treatment principles for occupational acute sulfur dioxide poisoning GB16378-1996 standard download decompression password: www.bzxz.net

National Standard of the People's Republic of China
Occupational acute sulfur dioxide poisoning
Diagnostic criteria and principles of management ofoccupational acute sulfur dioxide poisoningGB 16378-1996
Occupational acute sulfur dioxide poisoning is a systemic disease characterized by acute respiratory damage caused by short-term exposure to high-concentration sulfur dioxide gas during production labor or other occupational activities. 1 Subject content and scope of applicationwww.bzxz.net
This standard specifies the diagnostic criteria and management principles of occupational acute sulfur dioxide poisoning. This standard is applicable 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 Diagnostic principles
Diagnostic can be made based on the occupational history of short-term exposure to high-concentration sulfur dioxide and typical clinical manifestations, combined with on-site labor hygiene investigation, comprehensive analysis, and exclusion of other similar diseases. 3 Diagnosis and classification standards
3.1. 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. 3.2 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, obvious dry rales or wheezing in the body, and chest X-ray may only show enhanced lung texture. 3.3 Moderate poisoning
In addition to the aggravation of the clinical manifestations of mild poisoning, there are also signs such as chest tightness, severe cough, sputum, and difficulty breathing, as well 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 charcoal.
3.4 ​​Severe poisoning
In addition to the clinical manifestations of moderate poisoning, if any of the following conditions occur, severe poisoning can be diagnosed. a. Alveolar pulmonary edema,
b. Sudden onset of rapid breathing, respiratory rate 28 times/min, blood gas analysis PaOz <8kPa, when inhaling low concentration oxygen (concentration less than 50%), arterial oxygen partial pressure still cannot maintain 8kPa, and there is a continuous downward trend; c. Complications such as severe pneumothorax and mediastinal emphysema; d. Asphyxia or coma.
Approved by the State Administration of Technical Supervision on May 23, 1996 304
Implemented on December 1, 1996
4 Treatment principles
GB16378-1996
4.1 Immediately leave the poisoning site, lie still, keep warm, and inhale oxygen. Inhale with sodium bicarbonate, amino tea, dexamethasone, antibiotics. Rinse the conjunctival sac thoroughly with saline or water.
4. 2 After inhaling high concentrations of sulfur dioxide, although there are no objective signs, there is an obvious irritation reaction. Observe for 48 hours and treat symptomatically. 4.3 Pay attention to the prevention and treatment of pulmonary edema, and use glucocorticoids in an early, sufficient, and short-term manner. Perform tracheotomy if necessary. 4. 4 Oxygen therapy, prevention and treatment of infection, reasonable infusion, correction of electrolyte disorders and anti-shock are the same as the principles of internal medicine treatment. 5 Labor capacity assessment
Work can be resumed after recovery. If there are obvious respiratory system symptoms after poisoning, the irritant gas operation should be transferred. 6 Health examination requirements
All personnel engaged in sulfur dioxide operations should undergo a pre-employment physical examination and a physical examination every two years after employment. The physical examination should include internal medicine, ENT, chest X-ray and other examinations. Pulmonary function tests can be performed if conditions permit. 7 Occupational poisoning contraindications
Obvious respiratory diseases,
Obvious cardiovascular diseases.
GB 16378-1996
Appendix A
Instructions for the correct use of the standard
(reference)
A1 Acute poisoning caused by exposure to high concentrations of sulfur trioxide gas has similar clinical manifestations, and this standard can be applied for diagnosis and treatment. A2 This standard is not applicable to other clinical diseases caused by long-term exposure to low concentrations of sulfur dioxide. A3 This disease is mainly characterized by respiratory tract lesions, so the diagnostic standard uses respiratory system symptoms, signs and chest X-ray manifestations as the main diagnostic indicators. Others such as peripheral blood picture and electrocardiogram should be checked, but they may not be consistent with the degree of poisoning and are not used as diagnostic criteria. A4 Clinical manifestations and chest X-ray manifestations may not be parallel. The diagnosis and classification should be combined with the actual situation and decided after comprehensive analysis. A5 Pulmonary function test is only listed in the health examination requirements, but it should be checked as much as possible when the condition of the poisoned patient allows. Additional Notes:
This standard was proposed by the Ministry of Health of the People's Republic of China. This standard was drafted by the Beijing Chemical Industry Occupational Disease Prevention and Control Institute and the Occupational Disease Prevention and Control Institute of Nanjing Chemical Industry (Group) Company. This standard was interpreted by the Institute of Labor Hygiene and Occupational Diseases of the Chinese Academy of Preventive Medicine, the technical unit entrusted by the Ministry of Health.
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