| MINISTRY OF HEALTH | SOCIALIST REPUBLIC OF VIETNAM |
| No.: 167-BYT/QD | Hanoi, February 04, 1997 |
ON ADDITIONAL ISSUANCE OF OCCUPATIONAL DISEASES IN THE LIST OF COVERED OCCUPATIONAL DISEASES
MINISTER OF HEALTH
Pursuant to Article 106 of the Labor Code on the issuance of the list of occupational diseases;
Pursuant to Decree No. 68 dated October 11,1993 of the Government stipulating functions, duties and powers of the organizational structure of the Ministry of Health;
Pursuant to official dispatch No. 334/LDTBXH-BHLD dated January 29, 1997 of the Ministry of Labour - Invalids and Social Affairs authorizing the Ministry of Health to sign the decision on addition of 5 occupational diseases to the list of covered occupational diseases 1997;
After obtaining the consent of Vietnam General Federation of Labor in the official dispatch No.1592/TLD dated December 31, 1996;
DECIDES
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1. Occupational arsenic and arsenic compound intoxication disease (Annex 1).
2. Occupational nicotine intoxication disease (Annex 2).
3. Occupational pesticide intoxication disease (Annex 3).
4. Occupational caisson disease (Annex 4).
5. Occupational chronic bronchitis (Annex 5).
Article 3. This Decision takes effect from its signing date.
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Nguyen Van Thuong
(Signed)
OCCUPATIONAL ARSENIC AND ARSENIC COMPOUND INTOXICATION DISEASE
(Issued together with Decision No. 167 dated February 04, 1997)
I. MAIN OCCUPATIONS AND JOBS MAY CAUSE DISEASE
All jobs with exposure to or breath of arsenic dust or vapor and arsenic compounds.
- Arsenic ore processing.
- Production and use of arsenic chemical pesticides.
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- Use of arsenic compounds and inorganic substance in leather processing, production of glass, electronic parts…
II. DIAGNOSIS INSTRUCTION:
1. Diagnosed subject:
Diagnosed subject are laborers working in the environment with arsenic dust, vapor or arsenic inorganic compounds.
2. Exposure time:
Determined by the concentration of exposure and disease;
. Acute disease: typically short duration of exposure with high concentrations.
. Chronic disease: with concentration lower than the permit standard but long duration of exposure may also be affected.
3. Sub-clinical signs:
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Eating fish and sea food shall increase the urinary arsenic amount. Thus, the subjects diagnosed must avoid eating sea food at least for 2 days before collecting urine for determination of arsenic amount .
4. Clinical signs and symptoms:
4.1. Acute intoxication:
- Nausea and diarrhea
- Severe abdominal pain
- Little urination
- Reduction in body temperature and blood pressure
- Cramp and convulsion.
For acute intoxication due to AsH3, there are signs as follows:
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- Jaundice and thrombolysis
- Plasma proteins in nephritis
- Central nervous system toxicity (coma)
4.2. Chronic intoxication:
. Initial symptoms: irritability, abdominal pain, itching, pain in joints and asthenia.
. Signs: Diarrhea or constipation, rash, gauntness, swelling of lower eyelid, mucosal lesion, gingivitis, pharyngitis, upper respiratory inflammation (runny nose, hoarseness, cough ...) and combined membrane inflammation.
. Neurological symptoms: Feeling of numbness, skin burning, tingling or itching accompanied with tremor, muscle twitching, muscle atrophy, limb paralysis. Inflammation of many nerves is a primary sign.
. Skin and mucous membrane lesion: Inflammation, ulcer, palmoplantar keratodermas
. Skin darkening and hair loss
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. Nephritis and kidney failure
4.3. Cancer: Cancer of the skin, lungs, ethmoid bone, malignant warts.
III. INSPECTION INSTRUCTION
Lesion – Sequelae after treatment
Guarantee time
Rate of loss of working capacity (%)
Note
I. Arsen and arsenic organic compounds
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1. Skin and mucous membrane lesion:
a. Contact dermatitis causing chronic ulcer
1 month
5-10
Still recurring after over 03 times of treatment
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11-15
b. Skin ulcer successfully treated, stable scar
As above
1-5
c. Perforation of the nasal septum
As above
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...
d. Chronic conjunctivitis and blepharitis
As above
11-15
Keratitis with remaining scar affecting vision
Assessed by central vision table
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e. Skin darkening (depending on region and area):
3 months
- Less than 50% of face and neck area
11-15
- More than 50% of face and neck area
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...
16-20
- Less than 50% of arm and leg area
6-10
- More than 50% of arm and leg area
11-15
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g. Palmoplantar keratodermas
as above
5-10
2. Neuromuscular lesion
6 months
a Neuromuscular dermatitis affecting movement
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- Mild degree (less affecting movement)
21-25
- Moderate degree (Movement with difficulty)
26-31
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- Heavy degree (Movement with extreme difficulty)
31-40
³2 limbs =41%
b. Flaccid paralysis and muscular atrophy:
6 months
* With limbs:
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. Mild degree (working with limitation)
21-25
. Moderate degree (working with difficulty)
35-40
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. Heavy degree (loss of working capacity)
61-65
* Flaccid paralysis and muscular atrophy not in limbs
16-20
c. Sequelae of lesion to the central nerve
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Rating by Sequelae VII of neuropathy group of classification standard of loss of working capacity (Table 2)
3. Forms of cancer due to arsen:
30 years
- Primary carcinoma
61-65
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- Liver sarcoma
81-95
- Primary lung cancer
81-95
II. Asen hydro hay Arsin (AsH3) Arsenic hydrogen or Arsin (AsH3)
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1. Jaundice and thrombolysis after acute intoxication
a. Erythrocyte E 3 T. HST E 11 g%
31-35
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b. Erythrocyte E 2.5 T. HST E 10 g%
41-45
Temporarily classified and re-inspected after 01 year
2 Hepatic impairment
a. Liver function changed little (test after treatment)
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...
31-35
b. Liver function changed much
41-45
Temporarily classified and re-inspected after 01 year
3. Plasma proteins in nephritis
60 days
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a. Blood urea E 0.6 g / l
31-35
b. Regular blood urea from 0.6 to 1 g / l
41-45
c. Regular blood urea ³ 1 g/l
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51-55
4. Irreversible chronic renal failure (ascites, HC <2,000,000 blood urea> 1.5 g / l creatinine> 100 mmol / 1)
61-70
If there are serious complications such as paralysis and blindness
81-85
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Note:
When being intoxicated with arsen and acute arsenic compounds, first aid and treatment must be performed until stable, if any new Sequelae occurs, it should be inspected by the Medical Evaluation Board.
. When the disease recurs, it must be treated until stable and then re-inspected.
Persons suffering from diseases mentioned above (defined in recruitment dossier) shall not have medical inspection to determine occupational diseases.
OCCUPATIONAL NICOTINE INTOXICATION DISEASE
(Issued together with Decision No. 167 dated February 04, 1997)
I. MAIN OCCUPATIONS AND JOBS MAY CAUSE DISEASE
All jobs with exposure to or breath of cigarette and nicotine dust such as:
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. Tobacco harvesting, packing, shipping ...
II. DIAGNOSIS INSTRUCTION:
1. Diagnosed subjects: are persons working in environment with cigarette and nicotine dust.
2. Exposure time:
Determined by the concentration of exposure and disease;
. Acute disease: typically short duration of exposure with high concentrations.
. Chronic disease: with concentration lower than the permit standard but long duration of exposure may also be affected.
3. Sub-clinical signs:
Urinary nicotine amount:
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- For smokers: the urinary nicotine amount is more than 0.3 mg/l.
4. Clinical signs and symptoms:
4.1. Acute intoxication:
- Severe dizziness and headache, pale face.
- Nausea, vomiting, abdominal pain and diarrhea.
- Saliva secretion and cold sweat streaming
- Rapid heartbeat, increased blood pressure, pain in the heart
- Visual and hearing disturbances
- Eyelid vibration, hand tremor and muscle cramp.
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- Mucosa: with phenomenon of irritability, dry gular and nasal mucosa, stomatitis, conjunctivitis (watery eyes, eye pain, vision loss).
- Skin and nails: atopic dermatitis, thin and brittle nails;
- Cardiovascular: heart attack, heartbeat change, premature ventricular beat, blood pressure change.
- Nerve: headache, poor sleep, decreased memory, easy to forget, decreased hearing and vision, tremor.
- Digestion: nausea, loss of appetite, indigestion, diarrhea, heartburn, epigastric pain.
- Respiration: chronic bronchitis, alveolar expansion, decreased pulmonary ventilation.
III. INSPECTION INSTRUCTION
Lesion – Sequelae after treatment
Guarantee time
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Note
1. Skin and mucosa
3 months
a. Chronic conjunctivitis
5-10
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- Inflamed area ³ 20% of parts (limbs, face, neck…)
21-25
- Inflamed area E 20%
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...
2. Circulatory apparatus dysfunction
3 months
a. Hypotension (systolic blood pressure E 90 mmHg; diastolic blood pressure E 60 mmHg)
16-20
Table 3
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16-20
-as above-
c. Premature ventricular arrhythmias
- Infrequent ³ 12 beats / min
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- Fast (antiarrhythmic drugs must be used regularly)
25-30
d. Slow beat (less than 55 times / min)
21-25
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35-40
- There is atrioventricular block grade 3 with faint, successful treatment
45-50
- There is atrioventricular block grade 3 with faint, unsuccessful treatment
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Temporary rating,re-inspection after 1 year
e. Lesions to the coronary arteries and heart muscle
35-40
3. Neurasthenia syndrome
3 months
25-30
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Note:
. When being intoxicated with nicotine, first aid and treatment must be performed until stable, if any new Sequelae occurs, it should be inspected by the Medical Evaluation Board.
When the disease recurs, it must be stably treated and then re-inspected.
Persons suffering from diseases mentioned above (defined in recruitment dossier) shall not have medical inspection to determine occupational diseases.
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I. MAIN OCCUPATIONS AND JOBS MAY CAUSE DISEASE
All jobs with exposure to chemical pesticdes:
- Industrial production.
- Packaging
- Transport
- Storage
- Mingling, mixing, spraying, sprinkling, steaming ...
II. DIAGNOSIS INSTRUCTION
1. Diagnosed subjects:
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2. Exposure time:
Determined by the concentration of exposure and disease;
. Acute disease: typically short duration of exposure with high concentrations.
. Chronic disease: with concentration lower than the permit standard but long duration of exposure may also be affected.
3. Sub-clinical signs:
Amount of Acetylcholinesteraza enzyme activity (AChE): The amount of AChE enzyme activity decreases over 25% compared to that before exposure or the constant of AChE enzyme activity in normal person.
4. Clinical signs and symptoms:
4.1. Acute intoxication:
- Vomiting and abdominal pain
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- Miosis
- Pulmonary edema
- Muscle twitching and cramping
- Paralysis, coma.
4.2. Chronic intoxication:
- Headache, dizziness
- Fatigue
- Poor sleep
- Loss of appetite
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- Eyeball twitching
- Light paralysis
- Skin manifestations: rash, eczema ...
- Neurovegetative dysfunction
III. INSPECTION INSTRUCTION
Lesion – Sequelae after treatment
Guarantee time
Rate of loss of working capacity (%)
Note
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30 days
5-10
2. Neurological sequelae
90 days
a. Nystagmus may affect vision
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- One eye
5-10
- Two eyes
11-15
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5-10
c. Paralysis (depending on paralyzed muscular group, in one or more limbs, in any area of the body and degree of paralysis)
- Mild degree (working with limitation)
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- Moderate degree (working with difficulty)
35-40
- Heavy degree (paralyzing entire limb and loss of working capacity)
61-65
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9 days
25-30
3. Chronical intoxication of chemical pesticide with organochlorine
180 days
a. Hepatic impairment, decreased liver function lasting months
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- Mild degree
31-35
- Moderate and severe degree
45-58
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61-70
b. Chronic nephritis and increased blood urea
Determination of renal tubular lesion, rate of loss of working capacity according to the similar plasma urea toxicated with AsH3
c. Anemia marrow (After poisoning of Chlordan and Lindan)
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- HC 3,000,000, HST E11 g%
31-35
- HC E 2,500,000, HST E 10 g%
41-45
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61-65
Note:
When being intoxicated with chemical pesticide, first aid and treatment must be performed until stable, if any new sequela occurs, it should be inspected by the Medical Evaluation Board.
When the disease recurs, it must be stably treated and then re-inspected.
Persons suffering from diseases mentioned above (defined in recruitment dossier) shall not have medical inspection to determine occupational diseases.
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I. MAIN OCCUPATIONS AND JOBS MAY CAUSE DISEASE
All jobs carried out under conditions of pressure high than atmospheric pressure: divers, working in the sank cage ...
II. DIAGNOSIS INSTRUCTION:
1. Diagnosed subjects:
Diagnosed subjects are persons working in conditions of high pressure or compressed air (divers and person working in sank cage).
2. Exposure time:
Exposure time may vary with disease: acute or chronic.
. Time of apprearance of acute disease may be right after pressure reduction.
. For chronic disease, the exposure time is usually 01 year.
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3.1. Acute caisson disease:
- Pain in limbs
- Vomiting, epigastric pain
- Dizziness
- Tingling and numbness in limb tip
- Shortness of breath
- Headache
- Visual disturbances, dazzling or scotoma
- Heart attacks, coronary artery disorder, irregular heartbeat.
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3.2. Chronic caisson disease:
- Limb fatigue and pain
- Difficult movement: stiffness, less or much limitation of movement.
- Muscle atrophy
- Hearing loss.
4. Sub-clinical signs (chronic decompression)
4.1. X-ray signs: detection of bone changes:
- Calcium disorders: mineral loss
- Bone structure: bone cavity
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- Periosteal reaction (spine, thick bone)
Change of bone found in the limb root: shoulders, groin. As seen in the upper and lower end of femur, tibia, in the upper end and shaf of humerus bone.
4.2. Audiometry: to identify hearing loss
III. INSPECTION INSTRUCTION
Lesion – Sequelae after treatment
Guarantee time
Rate of loss of working capacity (%)
Note
1. Vestibular syndrome (dizziness, loss of balance) determined by experimental method of labyrinth
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- Mild degree
15-20
- Moderate degree (working with limitation)
31-35
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- Heavy degree (working with difficulty)
45-50
2. Chronic inflammation of the middle ear, perforated eardrum
3 months
- One ear
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10-15
- Two ear
25-31
3. Occupational hearing loss, with or without labyrinth disorder, no progress after stopping work in high pressure, determined by complete audiometry from 3-6 months after stopping work in high pressure .
12 months
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- Mild hearing loss of both ears
15-20
- Moderate hearing loss of both ears
26-31
- Heavy hearing loss of both ears
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41-51
- Totally deaf of both ears
61-70
Table 5
4. Local myocardial ischemia
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a. Infrequent and mild heart attacks (type 2 according to NYHA)
35-40
Table 3
b. Fast heart attacks affecting activities (type 3 according to NYHA)
51-60
-as above-
c. Enlarged heart, heart failure, with old myocardial infarction.
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71-80
5. Osteonecrosis (determined by X-ray)
20 years
- In 01 joint or 1 bone
21-30
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- In 01 joint or 2 bones
31-40
- More than 02 joints or 2 bones
45-60
6. Paralysis of limbs
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Rating by Sequelae VII of neuropathy group of classification standard of loss of working capacity (Table 2)
Note:
The working complications in high-pressure must have first aid and treatment until stable, if any new Sequelae occurs, it should be inspected by the Medical Evaluation Board.
When the disease recurs, it must be stably treated and then re-inspected.
Persons suffering from diseases mentioned above (defined in recruitment dossier) shall not have medical inspection to determine occupational diseases.
OCCUPATIONAL CHRONIC BRONCHITIS
(Issued together with Decision No. 167 dated February 04, 1997)
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All jobs with exposure to organic and inorganic dust or toxic gas such as CO, SO2, H2S, C1, HCL etc. ..
II. DIAGNOSIS INSTRUCTION:
1. Diagnosed subjects
Diagnosed subjects are persons who are exposed to some kinds of dust or toxic gas such as SO2, H2S etc. ..
2. Exposure time: The prescribed exposure time is 3 years.
3. Clinical signs and symptoms:
Coughing and spitting sputum for over 2 months in a year and over 2 consecutive years.
4. Sub-clinical signs:
Measurement of respiratory function: maximum expiratory volume / second (FEV1) declines.
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Lesion – Sequelae after treatment
Guarantee time
Rate of loss of working capacity (%)
Note
1. Common chronic bronchitis does not affect heart
12 months
Irreversible decline in FEV1:
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- Degree I
15-20
- DegreeII
21-30
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- Degree III
31-40
2. Chronic bronchitis with spasm and allergy
12 months
Irreversible decline in FEV1:
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- Degree I
31-35
- DegreeII
41-45
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- Degree III
51-55
3. Chronic bronchitis with respiratory failure and heart failure (right sided heart failure)
- Stage I
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41-50
- Stage II
51-60
- Stage III
61-75
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- Stage VI
81-90
Note:
The persons who are given inspection of occupational chronic bronchitis must have the result of measurement of respiratory function in normal physiological limit at least 3 years before
TABLE 1
TABLE OF PERCENTAGE OF LOSS OF WORKING CAPACITY DUE TO VISION LOSS BECAUSE OF LESION OF VISUAL ORGAN
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9/10 8/10
7/10 6/10
5/10
4/10
3/10
2/10
1/10
1/20
Below 1/20
...
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...
9/10 8/10
0
5
8
11
14
17
21
20
25
...
...
...
41
7/10 6/10
5
8
11
14
17
21
20
25
...
...
...
35
45
5/10
8
11
14
17
21
20
25
...
...
...
35
41
40
51
50
4/10
11
14
17
21
20
25
...
...
...
35
41
40
45
55
3/10
14
17
21
20
25
...
...
...
35
41
40
45
51
50
61
2/10
17
21
20
25
...
...
...
35
41
40
45
51
50
55
65
1/10
21
20
25
...
...
...
35
41
40
45
51
50
55
61
60
71
70
1/20
25
...
...
...
35
41
40
45
51
50
55
61
60
71
70
81
Below 1/20
...
...
...
35
41
40
45
51
50
55
61
60
71
70
81
80
85
...
...
...
41
45
51
50
55
61
65
71
70
81
85
...
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...
TABLE 2
VI. GROUP OF NEUROPATHY
No.
Name of disease – Type of disease
Percentage of loss of working capacity (%)
(1)
(2)
(3)
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Sequelae of hemiplegia or simply two legs (from any cause whatever)
a. Sequelae of hemiplegia:
- Mild degree: almost normal movement
41-45
...
...
...
If without teres disorder
55-60
If with teres disorder
65-70
- Heavy degree: unable to move (with or without teres disorder)
...
...
...
b. Sequelae of paralysis of both legs
- Mild degree: without teres disorder
50-55
- Moderate degree: movement with difficulty, with or without teres disorder
65-70
...
...
...
- Heavy degree
81-85
2
Sequelae of paralysis of one arm and one leg
- Mild degree
30-35
...
...
...
35-40
- Heavy degree
55-60
3
Sequelae of lesion of one or many sensory nerves due to inflammation or pain
- Mild degree
...
...
...
- Moderate degree
35-40
- Heavy degree
41-45
4
Cerebellar syndrome
...
...
...
- Mild degree
25-30
- Moderate degree
55-60
- Heavy degree
61-65
...
...
...
81-85
5
Parkinson's syndrome
. Mild degree: still able to work
41-45
. Moderate degree: unable to work, still serve oneself
...
...
...
. Heavy degree: unable to serve oneself
81-85
6
Lateral sclerosis, muscular dystrophy:
- Mild degree
41-45
...
...
...
- Moderate degree
61-65
- Heavy degree
81
7
Other diseases and syndromes of the central nervous system
...
...
...
. Occurring 1-2 times/year
10-15
. Occurring 1-2 times/ month
21-25
. Weekly occurring affecting work
...
...
...
* Local epilepsy
. Occurring at times
20-25
. 1-2 times/month
21-25
...
...
...
. Regularly occurring
35-40
* Total epilepsy
. Rare crisis
25-30
...
...
...
35-40
. Fast crisis
61-65
. Dementia (if any)
81-85
* State equivalent to epilepsy or mental absence
...
...
...
. Occurring 1-3 crises/year
10-15
. Occurring 1-2 crises/month
25-30
. Weekly occurring
35-40
...
...
...
. Daily occurring
45-50
* Mental epilepsy
- Mild degree
40-45
...
...
...
50-55
- Heavy degree
70-75
* Sweating limbs
. Little effect on activity and working
...
...
...
. Significant effect on activity and working
30-35
TABLE 3
CARDIOVASCULAR CLASSIFICATION ACCORDING TO NYHA
(NEW YORK HEART ASSOCIATION)
(Currently applied by the World Health Organization)
Type I: No symptom (shortness of breath, chest pain, palpitation) at rest or exertion.
Type II: No symptom (as above) at rest, but symptoms do appear upon performance of daily work.
Type III: No symptoms at rest, but symptoms do appear upon performance of a lighter job than the daily one.
...
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TABLE 4
CLASSIFICATION OF DEGREE OF HYPERTENSION DISEASE
(According to WHO)
I. CLASSIFICATION
Stage I:
Patient has no objective signs of any physical injury (see below).
Stage II:
Patient has at least one of signs of physical injury as follows:
+ Left ventricular hypertrophy can been seen upon clinical examination or electric ray, ECG, ultrasound cardiogram etc. ..
...
...
...
+ Proteinuria and / or serum creatinine increasing slightly.
Stage III:
Hypertension disease has caused injury to various organs, represented by the functional symptoms and physical signs as follows:
+ Heart: left ventricular failure.
+ In the brain: Hemorrhage of cerebrum, cerebellum or brainstem, hypertensive cecaphalopathy
+ Ocular fundus: retinal hemorrhages and exudation, with or without papilledema. These signs represent the progressive malignant stage.
Also in stage III hypertension or even other unclear signs which are the direct result of hypertension with these above signs, such as:
+ Heart: angina pectoris and myocardial infarction.
+ Brain: intracranial arterial thrombosis
...
...
...
+ Kidney: renal failure
II. SEVERITY CLASSIFICATION OF HYPERTENSION NUMBER
(Measuring 03 times for every 02 weeks)
Classification
Systolic blood pressure
(mm Hg)
Diastolic blood pressure
(mm Hg)
1. Limited hypertension
140 - 159
90 - 94
...
...
...
160 - 189
95 - 104
3. Moderate hypertension
190 - 219
105 - 114
4. Heavy hypertension
220 or more
115 or more
File gốc của Decision No. 167-BYT/QD of February 04, 1997, to add five occupational diseases to the list of insured occupational diseases đang được cập nhật.
Decision No. 167-BYT/QD of February 04, 1997, to add five occupational diseases to the list of insured occupational diseases
Tóm tắt
| Cơ quan ban hành | Bộ Y tế |
| Số hiệu | 167-BYT/QD |
| Loại văn bản | Quyết định |
| Người ký | Nguyễn Văn Thưởng |
| Ngày ban hành | 1997-02-04 |
| Ngày hiệu lực | 1997-02-04 |
| Lĩnh vực | Bảo hiểm |
| Tình trạng | Hết hiệu lực |