Transcript (application/x-ole

PROFESSIONAL DISEASES OF
RESPIRATORY ORGANS,
CONDITIONED BY DUST
IMPACT
(BLACK-LUNG DISEASE,
PNEUMOCONIOSIS)
BLACK-LUNG DISEASE
is a respiratory disorder,
a type of pneumoconiosis caused
by repeated inhalation of coal
dust over a period of years and
dust depositing in lungs,
and is also characterized by the
development of diffusion fibrosis
The modern classification of
pneumoconiosis (2002):
1.
Silicosis
2.
Silicatosis
3.
Metalloconiosis
4.
Carboconiosis
5.
Hypersensitivity pneumonitis
The classification of dust
aggresivity:
1. Dust diseases developing from a dust with high- and
medium-fibrogenious influence (containing Si02 or asbest
more than 10 %) – a silicosis, silicoantracosis,
silicosilicatosis, silicosis derosis, asbestosis
2. Dust diseases developing from a dust with mild-fibrogenious influence (with the contents free silicon dioxid less then
10%, bonded Si02 or without Si02) – silicosilicatosis
(kaolinosis, talcosis); carboconiosis (anthracosis, grafitosis,
pneumoconiosis of coal dust, diamond pneumoconiosis);
metalloconiosis
(siderosis,
kaolinosis,
baritosis,
manganoconiosis, aluminosis); a dust disease of the electric
welders, polishing, grinding
Hypersensitivity dust diseases from a
dust (aerosolum) with toxico-allergic
influence – berylliosis, pneumonites from
influence of chrom, nickel, platinum and
others rare-earth metals and alloys;
pneumonites from a dust of plastic,
polymeric pitches, drugs (toxicofibrogenious alveolites); a byssinosis,
bagassosis, papricosis, exogenous allergic
alveolitis, woodworkers
Radiological Characteristics of Pneumoconiosis
Code
Characteristics of shadows Spreading, density and
(form and size)
territory of shadows
Absence of
0
pneumoconiosis Control
Small nodular (small
rounded shadows)
p
q
r
Nodules, up to 1.5 mm in
size
Stage
Double
0-1
Small number of shadows
I, II
Nodules, from 1.5 to 3.0
Moderate number of
mm
shadows
Nodules, from 3 to 10 mm
Numerous shadows
Radiological Characteristics of Pneumoconiosis
Code
s
Characteristics of shadows Spreading, density and
(form and size)
territory of shadows
Interstitial (small shadows)
Double, diffusive
Linearly and cellulary
Blurry outlines
Stage
I, II
changes
t
Pulled changes
Clear outlines (lung
picture is clear)
u
Sharply expressed pulled Numerous shadows (lung
changes
picture is not defined)
III
Radiological Characteristics of Pneumoconiosis
Code
Characteristics of shadows Spreading, density and
(form and size)
territory of shadows
Big nodular (big rounded
Double or one-sided
shadows on nodular or
interstitial background)
A
B
Small nodular — diameter
Territory of spreading is
of nodules from 1 to 5 cm
not more than 5 cm 2
Big nodular — diameter of Territory of spreading is
nodules from 5 to 10 cm
not more than 1/3 of the
lung field
C
Massive — diameters of Territory is over 1/3 of the
nodules is over 10 cm
lung
Stage
Clinical Characteristics of Pneumoconiosis
Clinical and functional
Disease progress
Complications
Bronchitis
Fast progressing
Tuberculosis:
Bronchiolitis
Slowly progressing
characteristics
a)
with separating forms of
tuberculosis (according to
Lung emphysema, stage
I, II, III
Lung failure, stage I, II,
and III
Regressing
the classification)
b)
without noting the form of
TB
(small
nodular,
nodular and massive TB-
silicon)
Pneumonia
Cor pulmonale,
compensated,
decompensated, stage I,
II and III
big
Brochnoectatic disease
Bronchial asthma
Pneumothorax
Atrophic arthritis
Neoplasm
SILICOSIS
Silicosis is pneumoconiosis, caused by
inhaling dust with free silicon dioxide (Si02).
This
is
the
most
spread
form
of
pneumoconiosis, the progress of which is
particularly complicated
SILICOSIS met:
1. in metal mining industry
2. fireproof and ceramic materials
3. tunnel boring, sand grinding, quartz,
granite and other ores
PATHOGENESIS
1. Colloid-adsorbing theory
2. Immune theory
PATHOLOGIC ANATOMIA
• subtrophic, and later atrophic and sclerotic
changes
• precolagen and collagen fibers, silicotic
nodules.
•
emphysema of lungs
•
hyalinized fascicles
CLINICS OF STAGE I
•
•
•
•
•
dyspnea (much physical activity)
pain in the chest
variable dry coughing
basal emphysema
stiff, in some places vesicular breathing
X-ray: deformation of lung picture, small nodular
from 1 to 2 mm in size, located mostly in lower and
mid lung
CLINICS OF STAGE II
1.
2.
3.
4.
5.
6.
7.
8.
Intensification of dyspnea
Pain in the chest
Cough
Limitation of the motion of the lower end of
lungs
Intensification and deformation of lung picture
Number of nodular shadows from 3 to 10 mm
Lung roots are expanded, carnified and start
looking «cut»
The pleura thickened and deformed
CLINICS OF STAGE III
1.
2.
3.
4.
5.
Dyspnea in rest
Intensive pain in the chest
Coughing
Box sound with dull
X-ray – disseminated miliary tuberculosis ("snow
storm"), massive shadowings, pleurodiaphragm
and pleurocardial commissures, buliosnic
emphysema
6. Increase of minute volume
DIFFERENTIAL DIAGNOSTICS
1. disseminated tuberculosis
2. silicotuberculosis
3. sarcoidosis
4. syndrome of Haman-Rich
Complications of silicosis
silicotuberculosis
pneumonia
bronchiatic disease
bronchial asthma
atrophic arthritis
spontaneous pneumothorax
coniotic cavity
TREATMENT
•
Inhalation of mineral waters
•
Glucocorticoids: prednisolone 20 to 25 mg/day for 10
to 12 days
•
Oxygen therapy
•
Stimulators of activity the respiratory center (Cordiamin)
•
Expectoration drugs (3 % of potassium iodide solution or
the tincture of termopsis herb)
•
Alcohol extract of eleuteroke
•
Ultrasound, electrophoresis
•
Сardiac glycosides (strophanthin 0.5 ml of 0.05%
solution), aminophylline (5-7 ml of 2.4% solution), diuretic
(furosemide and hydrochlorothiazide)
•
Anabolic steroids (metanedrostenolon – 0.005 g 1 to 2
times a day before meals, retabolil – 1 ml of 5% oil solution
intramuscularly, total 8-10 injections)
Verification of work ability
Stage I: rational job.
Stage II: Invalidism Group (mostly Group III,
+ tuberculosis and respiratory insufficiency –
Group II).
Stage III: occupational disablement of group II or I.
SILICATOSES
Silicatoses are pneumoconiosis, which develop in
the result of inhaling of silicate dust
ASBESTOSIS
Asbestosis is silicatosis, which is caused by
inhaling asbestos dust
Clinics of asbestosis
Chronic bronchitis symptoms +
lung emphysema + pneumosclerosis
• dyspnea
• dry rales
• coughing
• pain in the chest
• headaches, general weakness and undue
fatiguability
• losing weight
• dry disseminated crepitations
TALCOSIS
Talcosis is silicatosis, which appears due to the
talc dust action (magnesia silicate).
(rubber, textile, paper, perfume industries)
not earlier than after 10 years of work
dyspnea at physical activity, pain in the chest,
coughing, mostly dry with some mucus, weight
losses, box sound
ANTHRACOSIS
miners (mining coal), ore-dressing plants
professional rout 15 to 20 years
(2% of silicon dioxide)
Clinics of anthracosis
Stage I: fast fatiguability, dyspnea at physical
activity, coughing and pain in the chest.
X-ray: small nuclear shadows, bigger shadows of
lung roots.
Stage II: dyspnea, emphysema and bronchitis.
Stage III: general weakness, dyspnea, coughing,
pain in the chest.
X-ray: massive homogenous shadows.
Berylliosis
is metaloconiosis, caused by inhaling beryllium
(silvery-gray light metal)
beryllium oxide, beryllium sulfate, beryllium
chloride, beryllium fluoride
X-ray tubes, luminescent lamps, atomic
energy, ceramic production
Treatment of silicatoses
•
solux, ultraviolet radiation,
respiratory exercises
•
bronchological, antihistamine and inflammatory
drugs (P, ascorbic acid and nicotinic acid)
•
antibiotics and sulfanamides (pneumonia)
•
cardiac glucosides (strophanthin, corglucon)
•
diuretics (lasix, hydrochlorothiazide)
oxygen
therapy,
Thank You
Good Luck