Introduction of GBZ112 —— 2017 General Principles of Radioactive Disease Diagnosis.

Directory 1 Pinyin 2 English Reference 3 Basic Information 4 Foreword 5 Standard Text 5. 1 1 Scope 5.2 2 Terminology and Definition 5.3 3 Basic Principles of Radioactive Disease Diagnosis 5.3. 1 3. 1. Principles for disease identification 5.3.2 3.2 Principles for determining hazard factors 5. 3. 3. 1. 3. Principles for determining causality in 5.3.3.3. 1 chronological principle 5.3.3.2 3. 3。 2 principle of biological rationality 5.3.3.3 3. 3。 3 biological gradient principle 5. 3。 . 43。 4 diagnostic basis 5. 3。 5 3。 Principle of dose assessment 5. 4 4 Principles of Treatment of Radioactive Diseases 6 Reference 7 Standard Full Text 1 Pinyin GBZ12-2017 zhyyxng fà ng shyxgbngzh

2 English reference general guide for diagnosis of radiation-induced diseases

3 basic information ics 13.5438+000

C 60

China people * * * People's Republic of China (PRC) national occupational health standard GBZ1/KLOC-0-2017 replaced GBZ112-2002 General Guide to Radiological Disease Diagnosis. Promulgated by the National Health and Family Planning Commission of the People's Republic of China on May 6, 2065438, and implemented as of October 0, 2065438.

4 Foreword Chapter 3 of this standard is mandatory, and other standards are recommended.

This standard is formulated according to the Law of People's Republic of China (PRC) on the Prevention and Control of Occupational Diseases.

This standard was drafted according to the provisions in GB/T1.1-2009.

This standard replaces GBZ 1 12—2002 General Diagnostic Standard for Radioactive Diseases. Compared with GBZ 1 12—2002, the main technical changes are as follows:

—— Deleted normative reference documents;

—— Delete emergency irradiation, personal dosimeter, biological dosimeter, workplace monitoring and biological sample analysis from the terminology, change radiation workers to radiation workers, personal detection to personal dose monitoring, and medical follow-up observation to medical follow-up, and increase deterministic effect and random effect;

—— Chapter 3-4 mainly refers to the format of General Rules for Occupational Disease Diagnosis, mainly including basic principles (disease identification and hazard factors).

The principle of determining causality and causality by elements, adding diagnostic basis and dose evaluation principle) and treatment principle;

-the requirements for diagnostic institutions and diagnostic personnel of radiation diseases have been deleted;

-Deleted the appendix.

Drafting units of this standard: Institute of Radiation Medicine of China Academy of Medical Sciences, Henan Institute of Occupational Disease Prevention and Control, Hunan Institute of Occupational Disease Prevention and Control, Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, and Tianjin Bohai Chemical Group Co., Ltd. Institute of Labor Health.

The main drafters of this standard are Xing Zhiwei, Jiang Enhai, Fu, Zeng, Wu, Yu Chengcheng, Zhao and Jiang Meiling.

General rules for diagnosis of radioactive diseases in standard text 5

5. 1 1 Scope This standard specifies the basic principles of diagnosis and treatment of radioactive diseases.

This standard is applicable to the diagnosis and treatment of radiation diseases of radiation workers.

5.2 2 Terms and Definitions The following terms and definitions apply to this document.

2. 1

Radioactive disease? Radiation-induced diseases

The general term for injury or disease caused by ionizing radiation.

2.2

Occupational exposure? occupational exposure

All radiation received by staff in the course of work, except radiation excluded by national regulations and standards and radiation generated by practices or sources exempted by regulations.

2.3

Radiation workers? Radiation workers

Persons exposed to ionizing radiation in radiation work units engaged in radiation occupational activities.

2.4

Personal dose monitoring? Personal monitoring

Use the dosimeter worn by the staff to measure, or measure the types and activities of radionuclides in the body and excreta.

2.5

Deterministic effect? Decisive effect

Organizational reaction? Harmful tissue reaction

Effects of radiation on health. There is usually a threshold dose level, beyond which the severity of the effect increases with the increase of radiation dose.

2.6

Random effect? Random effect

Effects of radiation on health. The probability of its occurrence increases with the increase of radiation dose, and the severity of the impact (if it occurs) has nothing to do with radiation dose. Random effects may be somatic effects or genetic effects, and there is generally no threshold dose level. Include various solid cancers and leukemia.

2.7

Long-term radiation effect and late radiation effect

Long-term harmful effects after repeated exposure to large or small doses, such as leukemia, cataracts and other cancers.

2.8

Medical follow-up? Medical follow-up observation

In order to find out the long-term and late health effects of ionizing radiation, long-term systematic medical follow-up observation was carried out for those who were subjected to excessive dose limitation and accidental radiation accidents.

5.3 3 Basic principles of diagnosis of radioactive diseases 5.3. 1.3. 1 principle of disease identification 3. 1. 1 disease refers to a series of abnormal states that are caused by the disorder of internal balance and lead to changes in metabolism, function or structure of the body. Its clinical manifestations and corresponding auxiliary examinations are the main basis for judging whether there is a disease and its severity.

3. 1.2 Diagnosis and differential diagnosis should be made according to the requirements of evidence-based medicine.

5.3.2 3.2 Determination principle of hazard factors 3.2. 1 Should have a history of occupational exposure.

3.2.2 Its cumulative radiation dose (including dose rate) meets the dose requirements given in various diagnostic standards for radioactive diseases, especially those with definite effects.

3.2.3 The diagnosis of radioactive diseases should be based on its corresponding diagnostic criteria; When there is no corresponding diagnostic standard, refer to this standard.

5.3.3.3's principle of causality determination 5.3.3. 1 3.3. 1 time sequence principle Radioactive diseases must occur after exposure to ionizing radiation, which conforms to the objective law of biological incubation period of radioactive diseases.

5.3.3.2 3.3.2 Principle of Biological Rationality There is biological rationality between ionizing radiation and the occurrence of radiation diseases, that is, the physical characteristics and toxicological data of ionizing radiation confirm that ionizing radiation can cause corresponding diseases, and the manifestations of diseases are consistent with the biological effects of ionizing radiation.

5.3.3.3 3.3.3 There is a dose-effect relationship between the deterministic effect of biological gradient principle and ionizing radiation exposure, that is, ionizing radiation exposure should reach the dose threshold of corresponding diseases to cause radiation diseases; The greater the cumulative absorbed dose, the more serious the radiation disease will be. There is a connection between random effect and ionizing radiation exposure. The greater the cumulative absorbed dose, the higher the probability of occurrence, and the severity has nothing to do with the exposure dose.

5.3.4 3.4 Diagnostic Basis 3.4. 1 The diagnosis of radioactive diseases should follow the catalogue of radioactive diseases in the Classification and Catalogue of Occupational Diseases.

3.4.2 The diagnosis of radioactive diseases should be based on the exposure history of ionizing radiation (including radiation types), exposure dose (including dose rate), clinical manifestations, corresponding auxiliary examination results and special laboratory examination results related to radiation effects, and comprehensive analysis should be made according to the requirements of evidence-based medicine, and the diagnosis conclusion should be made with reference to previous health conditions to exclude other related diseases.

5.3.5 3.5 Dose Evaluation Principle 3.5. 1 Dose Determination of Short-term (Relatively) High-dose Radiation: According to personal dosimeter, dose estimation (including biological dose and physical dose) can be carried out for the irradiated people who are not wearing personal dosimeter, and articles and biological samples used for dose estimation can be kept in time; The lower limit of irradiation dose can be preliminarily determined by early clinical manifestations and the lowest absolute value of lymphocytes after irradiation.

3.5.2 Dose data of low-dose occupational exposure can come from personal dose monitoring files and other dose data provided by radiation protection departments.

3.5.3 Make a comprehensive analysis of radiation exposure, and use the dose data collected from various aspects to evaluate the dose of the irradiated person and determine the illness, so as to take effective treatment measures.

5.4 4 Principles for Treatment of Radioactive Diseases 4. 1 Correct on-site rescue should be carried out in time, especially for life-threatening injuries, and every effort should be made to save lives.

4.2 Get the exposed person away from the radioactive source as soon as possible, remove radioactive pollution, and take measures to block the absorption of radionuclides or promote the discharge of radionuclides.

4.3 Take comprehensive symptomatic treatment and supportive therapy in time.

4.4 Psychological intervention should be carried out as soon as possible.

4.5 Take effective protective measures for workers exposed to ionizing radiation to prevent or delay the occurrence of radioactive diseases; Workers suffering from radiation-induced diseases can get better and be cured through active treatment after leaving their original workplaces.

4.6 Patients with radiation diseases will be included in the medical follow-up plan.

6 refer to [1] gbz/t265 "general rules for occupational disease diagnosis"

[2] GBZ/T163 Medical Follow-up Specification for Long-term Effects of Acute Radiation Diseases Caused by External Irradiation

[3] Medical Terminology Examination Committee, Radiology and Protection Terminology Examination Subcommittee. Terminology of radiology and protection [m]. Science press, 20 14.

7 standard full text