GBZ 32-2015Diagnosis of occupational chloroprene poisoning (English PDF)

Foreword

According to the "People's Republic of China Occupational Disease Prevention Law" to develop this standard.

Chapter 6 of this standard is recommended and the remainder is mandatory.

This standard is drafted in accordance with the rules given in GB/T 1.1-2009.

This standard replaces GBZ 32-2002 "diagnostic criteria for occupational chloroprene poisoning".

Compared with GBZ 32-2002, the main modifications are as follows.

- "diagnostic principle" is divided into "acute poisoning" and "chronic poisoning" in two parts;

The principle of chronic poisoning diagnoses the minimum time limit for long-term close contact with chlorobutadiene;

--- increase the "contact response" and its related content;

--- delete the "observation object" and its related content;

--- will be diagnosed by mild, severe poisoning secondary to mild, moderate, severe poisoning three;

- other processing, an increase of "labor ability identification" of the treatment;

- Appendix A adds a description of the relevant information on the diagnosis of chlorampheneolated toxic liver disease.

This standard is responsible for drafting units. Shanghai Chemical Industry Occupational Disease Prevention and Control Institute.

The standard to participate in the drafting unit. China Center for Disease Control and Prevention Occupational Health and Poison Control, Tongji University, Shanghai pulmonary medicine Hospital, Chongqing Municipal Occupational Disease Prevention and Control Hospital, Fujian Province Occupational Disease Prevention and Control Hospital, Wuxi City People's Hospital.

1 Scope

This standard specifies the principles of diagnosis and treatment of occupational chloroprene poisoning.

This standard applies to the diagnosis and treatment of occupational chloroprene poisoning.

2 Normative reference documents

The following documents are indispensable for the application of this document. For dated references, only the dated edition applies to this article Pieces. For undated references, the latest edition (including all modifications) applies to this document.

GB/T 16180 Labor capacity - Identification of workers' injury and occupational disease Diagnostic criteria for occupational toxic liver disease GBZ 73 Occupational acute chemicals - Criteria for the diagnosis of toxic respiratory diseases GBZ 76 Occupational acute chemical poisoning Nervous system disease diagnostic criteria

3 Diagnostic principles

4 Contact reaction

Short-term exposure to higher concentrations of chloroprene, the emergence of dizziness, headache, or tears, throat pain, cough, chest tightness, shortness of breath, nausea and other symptoms, no positive signs, no abnormal chest X-ray, and 72 hours from the contact with the symptoms were significantly reduced or disappeared.

5 Diagnostic grading

6 Principles of handling

7 Correctly use the instructions in this standard

See Appendix A.

Appendix A

(Informative)

Correctly use the instructions in this standard A.1 Chlorobutadiene (2-chloro-1,3-butadiene) is a liquid monomer for the production of chloroprene rubber and can be copolymerized with styrene, acrylonitrile, isoprene, Production of various synthetic rubber; also other chloroprene products, such as neoprene latex and neoprene asphalt monomer. Where engaged in the production of neoprene Diene and a variety of chloroprene monomer containing chloroprene rubber and latex, adhesive and other production and processing, are likely to occur chloroprene Poisoning.

A.2 acute chloroprene poisoning clinical manifestations of the central nervous system and acute respiratory tract and respiratory damage. Since chloroprene has hemp Drunk, after inhalation can make patients quickly paralyzed into a coma, from the scene after most of the 5min ~ 10min sober. Higher concentration Inhalation can quickly inhibit the respiratory center, can occur early in the onset of breathing difficulties or respiratory arrest.

A.3 chronic chloroprene poisoning first appeared in the performance of neurasthenic syndrome, followed by liver damage. Neurasthenic syndrome is nonspecific Sexual, objectivity is poor, it is not listed as a separate classification index, but because of its high incidence and as a prerequisite for the diagnosis of chronic poisoning.

A.4 hair loss is the clinical characteristics of chronic poisoning of chloroprene, not all contacts can occur. The degree of hair loss is divided into.

a) mild hand gently wipe the head, that is, more hair off;

b) moderate hair loss to obvious sparse degree;

c) severe hair basic stripping, may be associated with eyebrows, armpit hair, pubic hair off.

From the contact after the gradual recovery of their own.

A.5 nail color change often in contact with chloroprene 15d ~ 30d appear. From the root of the nail began to appear purple brown, often involving the bilateral or one Side of the thumb nails. 3 weeks after the operation, the stain fades, with the nail growth, purple brown to the distal propulsion, a root and normal nails color. If the contact is nail color, but also repeated, so nail color can be used as contact with chlorinated butadiene.

A.6 serum protein electrophoresis beta-globulin ratio is one of the characteristics of chloroprene toxic liver disease. beta globulin ratio before and after their own More than 20% lower than the determination of poisoning diagnostic limit. Their own contrast methods are.

a) exposure to chlorobutadiene before and after operation of beta globulin ratio of their own comparison;

b) out of contact with chloroprene operation after 1 to 2 months, the beta globulin ratio of their own comparison. From the contact of chloroprene after the beta-ball Protein ratio can return to normal, re-contact and rapid decline.

A.7 chloroprene toxic liver disease and other chronic liver disease clinical manifestations are not exactly the same. First of all, the former early onset of gastrointestinal symptoms can be not obvious, and often accompanied by neurasthenic syndrome and the occurrence of varying degrees of hair loss and nail color and other characteristics; and other liver disease early digestive tract Symptoms and abnormal liver function. Second, serum protein electrophoresis test results are inconsistent, the former showed an increase in albumin ratio, beta globulin the ratio of alpha and gamma globulin did not change significantly; other liver disease on the contrary, the serum protein electrophoresis showed a decrease in albumin ratio, white (A/G) decreased or inverted, gamma-globulin ratio increased.