[Study on the implementation assessment of GBZ 5-2016 "Diagnosis of Occupational Fluorine and Inorganic Compound...

Objective: To assess the implementation effectiveness of GBZ 5-2016 "Diagnosis of Occupational Fluorine and Inorganic Compound Poisoning", summarize the existing issues, and provide data support and suggestions for the revision and improvement of the standard. Methods: From April to July 2024, by using the judgment sampling method, professional health personnel from occupational disease prevention and control hospitals (institutes), medical institutions, and disease prevention and control centers at all levels were selected as the survey subjects. Questionnaires were used to collect information such as the basic situation of the survey subjects, the application of the GBZ 5-2016 standard, cases of poisoning by fluorine and its inorganic compounds, and revision suggestions. Results: The survey involved 71 professionals from 19 provinces in China. Among them, 51 individuals (accounting for 71.8%) had practical application experience of the GBZ 5-2016 standard, mainly in occupational health examination and occupational disease diagnosis, with 37 individuals (accounting for 72.5%) and 35 individuals (accounting for 68.6%) respectively. Among the cases of acute occupational poisoning by fluorine and its inorganic compounds diagnosed by 41.2% (21 individuals) of the standard users, the majority showed elevated blood fluoride or urine fluoride levels. For 31.4% (16 individuals) of the cases diagnosed by the standard users, the majority had decreased blood calcium levels. 39 individuals (76.5%) of the standard users suggested adding bone density tests in the diagnosis of chronic poisoning. 43 individuals (84.3%) of the standard users believed that the GBZ 5-2016 standard needed further improvement, including adding quantitative biomarker indicators, standardizing imaging diagnostic indicators, supplementing auxiliary examination items, and adding content related to damage to other organs. Conclusion: The GBZ 5-2016 standard is widely applied in occupational health examinations and occupational disease diagnoses. However, the current provisions have problems such as insufficient quantification of biomarkers and the lack of a unified standard for imaging diagnoses. Most users suggest that the quantitative assessment requirements for bone mineral density and periosseous changes be supplemented as soon as possible, and the auxiliary examination system for acute and chronic fluorosis be improved to enhance the scientificity and operability of the standards.