GBZ 5-2016Diagnosis of occupational fluorine and inorganic compound poisoning (English PDF)

Foreword

This standard is formulated in accordance with the Law of the People's Republic Chapter 6 of this standard is recommended and the rest are mandatory.

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

This standard replaces GBZ 5-2002 "Diagnostic Standard for Industrial Fluorosis"; compared with GBZ 5-2002, the main technical changes are as follows.

--- The standard name was changed from "Diagnostic Standard for Industrial Fluorosis" to "Diagnosis of Occupational Fluoride and Its Inorganic Compound Poisoning";

--- Amend the "Diagnostic Principles of Industrial Fluorosis" to "Diagnostic Principles of Chronic Poisoning";

--- Amend the "segmentation of bone X-ray changes" to "chronological diagnosis of chronic poisoning";

--- Deleted the observation object;

--- Increased the diagnosis and treatment of acute fluoride and its inorganic compound poisoning.

1 Scope

This standard specifies the principles for the diagnosis and treatment of occupational fluorine and its inorganic compound poisoning.

This standard applies to the diagnosis and treatment of occupational fluorine and its inorganic compound poisoning.

This standard does not apply to the diagnosis and treatment of acute organofluorine poisoning and endemic fluorosis.

2 Normative references

The following documents are indispensable for the application of this document. For dated references, only the dated version applies to this article.

Pieces. For undated references, the latest edition (including all amendments) applies to this document.

GB/T 16180 Labor ability appraisal employee injury and occupational disease disability level GBZ 51 diagnostic criteria for occupational chemical skin burns GBZ 73 Occupational acute chemical toxicity diagnostic criteria for respiratory diseases GBZ 74 Diagnostic criteria for occupational acute chemical toxicity heart disease GBZ/T 228 diagnostic criteria for sequelae of occupational acute chemical poisoning WS/T 30 method for determination of ion selective electrode in urine WS/T 212 Determination of fluoride in serum - Ion selective electrode method

3 Diagnostic principles

4 Contact reaction

After short-term exposure to a large amount of fluorine and its inorganic compounds, one of the following manifestations occurred and was significantly reduced or disappeared within 72 hours of disengagement.

a) eye pain, tearing, photophobia, cough, sore throat, chest tightness and dizziness, fatigue, palpitations and other symptoms;

b) Blood calcium is reduced but has no clinical manifestations.

5 Diagnostic rating

6 Processing principles

7 Instructions for the correct use of this standard

See Appendix A.

Appendix A

(informative appendix) Instructions for the correct use of this standard A. 1 Acute fluorosis A. 1.1 The most common fluorides causing occupational acute fluoride and its inorganic compounds poisoning are hydrogen fluoride and hydrofluoric acid, followed by elemental fluorine, three Boron fluoride, silicon tetrafluoride, fluorosilicic acid, oxygen difluoride, nitrogen trifluoride, sulfur pentafluoride, sulfur hexafluoride, sulfur hexafluoride and uranium hexafluoride.

A. 1.2 Fluoride mainly invades the human body through the skin mucosa and respiratory tract, leading to poisoning. The clinical manifestations of fluorosis caused by different invasive pathways are endless.

the same.

a) Inhalation poisoning in the respiratory tract alone. Most of them are caused by inhalation of hydrogen fluoride or hydrofluoric acid mist, and the clinical manifestations are acute respiratory damage.

Mainly harmful. Immediately after inhalation, there are irritation such as cough, sore throat, and shortness of breath. Severe cases have a lot of foam, and both lungs can smell wet.

Arpeggio, chest X-ray images of bronchitis, chemical pneumonia or pulmonary edema, severe acute respiratory distress Combined.

b) Simple burns the skin to absorb poisoning. Mostly caused by hydrofluoric acid burns, clinical manifestations of acute cardiovascular system caused by hypocalcemia Damage is dominant. Some may have repeated convulsions. Mild symptoms can increase myocardial enzyme activity index or muscle calcium egg within 48 hours after injury White positive. Electrocardiogram mainly shows QT interval prolongation and ST-T abnormal changes; severe cytotoxicity due to fluoride ion and hypocalcemia, electrocardiogram showed T wave low level and conduction block, frequent premature beats, severe ventricular tachycardia, ventricular fibrillation and other arrhythmias, or epilepsy-like convulsions, or even sudden death.

c) Burning skin absorption and inhalation poisoning. Mostly found in hydrofluoric acid burn concentration > 40% and there is a burn in the face and neck. Illness the degree is often severe, and the rate of sudden death is high. Even a small area ( Appendix B (normative appendix) Bone X-ray film requirements B. 1 Using an X-ray diagnostic machine with a frequency of.200 mA or more, the focus size is not more than 2.0 mm × 2.0 mm, preferably a rotating anode bulb.

B. 2 Photographing parts. The basic requirements are pelvic anteroposterior, one side iliac crest, ulnar anteroposterior and ipsilateral iliac crest, tibia positive and lateral radiographs;

Department and lumbar vertebrae.

B. 3 The requirements for the conditions of the investment are shown in Table B. 1.

Table B. 1 Requirements for investment conditions

Film location target distance cm Exposure mAs Tube voltage kV filter Pelvis 100 100~150 Thickness (cm)×2+(30~40) + , ulna 100 25 ~ 30 thickness (cm) × 2+ (30 ~ 40) -, bone 100 30 ~ 40 thickness (cm) × 2+ (30 ~ 40) -Lumbar spine 100 100 ~ 150 thickness (cm) × 2+ (30 ~ 40) + Chest 150 20 ~ 25 thickness (cm) × 2+ (30 ~ 40) -Note. X-ray film is best used with a blue base.

B. 4 Photographic quality requirements. The position of the film is accurate, the contrast is good, the direct exposure area is black, the soft tissue is gray, the layers are distinct, the cortex and the trabecular bones are clearly displayed.