professional diseases of respiratory organs, conditioned by dust impact (black-lung disease,...
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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)
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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
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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
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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
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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
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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
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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
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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
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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
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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
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1. in metal mining industry
SILICOSIS met:
2. fireproof and ceramic materials
3. tunnel boring, sand grinding, quartz, granite and other ores
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PATHOGENESIS
1.Colloid-adsorbing theory
2. Immune theory
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PATHOLOGIC ANATOMIA
•subtrophic, and later atrophic and sclerotic changes
•precolagen and collagen fibers, silicotic nodules.
•emphysema of lungs
•hyalinized fascicles
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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
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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
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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
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DIFFERENTIAL DIAGNOSTICS
1. disseminated tuberculosis
2. silicotuberculosis
3. sarcoidosis
4. syndrome of Haman-Rich
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Complications of silicosissilicotuberculosis
pneumonia
bronchiatic disease
bronchial asthma
atrophic arthritis
spontaneous pneumothorax
coniotic cavity
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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)
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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.
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SILICATOSES
Silicatoses are pneumoconiosis, which develop in the result of inhaling of silicate dust
ASBESTOSISAsbestosis is silicatosis, which is caused by
inhaling asbestos dust
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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
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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
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ANTHRACOSIS
miners (mining coal), ore-dressing plants
professional rout 15 to 20 years(2% of silicon dioxide)
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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.
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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
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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)
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Thank You Good Luck