PROFESSIONAL DISEASES OF RESPIRATORY ORGANS,CONDITIONED BY DUST

IMPACT

(BLACK-LUNG DISEASE, PNEUMOCONIOSIS)

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

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):

The modern classification of pneumoconiosis (2002):

1. Silicosis

2. Silicatosis

3. Metalloconiosis

4. Carboconiosis

5. Hypersensitivity pneumonitis

1. Silicosis

2. Silicatosis

3. Metalloconiosis

4. Carboconiosis

5. Hypersensitivity pneumonitis

The classification of dust aggresivity:

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-fibrogen- ious 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 (toxico-fibrogenious alveolites); a byssinosis, bagassosis, papricosis, exogenous allergic alveolitis, woodworkers

Radiological Characteristics of Pneumoconiosis

CodeCharacteristics of shadows

(form and size)

Spreading, density and

territory of shadowsStage

Absence of pneumoconiosis

Control0

Small nodular (small rounded

shadows)Double 0-1

p Nodules, up to 1.5 mm in size Small number of shadows I, II

q Nodules, from 1.5 to 3.0 mmModerate number of

shadows

r Nodules, from 3 to 10 mm Numerous shadows

Radiological Characteristics of Pneumoconiosis

CodeCharacteristics of shadows

(form and size)

Spreading, density and

territory of shadowsStage

Interstitial (small shadows) Double, diffusive I, II

s Linearly and cellulary

changes

Blurry outlines

t Pulled changes Clear outlines (lung picture

is clear)

u Sharply expressed pulled

changes

Numerous shadows (lung

picture is not defined)

III

Radiological Characteristics of Pneumoconiosis

CodeCharacteristics of shadows

(form and size)

Spreading, density and

territory of shadowsStage

Big nodular (big rounded

shadows on nodular or

interstitial background)

Double or one-sided

A Small nodular — diameter of

nodules from 1 to 5 cm

Territory of spreading is not

more than 5 cm2

B Big nodular — diameter of

nodules from 5 to 10 cm

Territory of spreading is not

more than 1/3 of the lung

field

C Massive — diameters of

nodules is over 10 cm

Territory is over 1/3 of the

lung

Clinical Characteristics of Pneumoconiosis

Clinical and functional

characteristics

Disease progress Complications

Bronchitis Fast progressing Tuberculosis:

Bronchiolitis Slowly progressing a) with separating forms of

tuberculosis (according to the

classification)

b) without noting the form of TB

(small nodular, big nodular

and massive TB-silicon)

Pneumonia

Brochnoectatic disease Bronchial

asthma Pneumothorax

Atrophic arthritis

Neoplasm

Lung emphysema, stage I,

II, III

Regressing

Lung failure, stage I, II, and

III

Cor pulmonale,

compensated,

decompensated, stage I, II

and III

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

1. in metal mining industry

SILICOSIS met:

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

X-ray: deformation of lung picture, small nodular from 1 to 2 mm in size, located mostly in lower and mid lung

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 I

•dyspnea (much physical activity)•pain in the chest•variable dry coughing•basal emphysema•stiff, in some places vesicular breathing

CLINICS OF STAGE II

1. Intensification of dyspnea2. Pain in the chest3. Cough4. Limitation of the motion of the lower end of

lungs5. Intensification and deformation of lung picture6. Number of nodular shadows from 3 to 10 mm7. Lung roots are expanded, carnified and start

looking «cut»8. The pleura thickened and deformed

CLINICS OF STAGE III

1. Dyspnea in rest2. Intensive pain in the chest3. Coughing4. Box sound with dull5. 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 silicosissilicotuberculosis

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

ASBESTOSISAsbestosis is silicatosis, which is caused by

inhaling asbestos dust

Clinics of asbestosisChronic 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, oxygen therapy, respiratory exercises

• bronchological, antihistamine and inflammatory drugs (P, ascorbic acid and nicotinic acid)

• antibiotics and sulfanamides (pneumonia)

• cardiac glucosides (strophanthin, corglucon)

• diuretics (lasix, hydrochlorothiazide)

Thank You Good Luck