L.T. Bazeliuk; B.M. Salimbaeva
Sixty-four persons were examined. The examination was undertaken to study the cytomophological parameters of the cells of the nasal mucosa and the buccal epithelium in coal miners. Group 1 consisted of 18 donors without contact with industrial dust; Group 2 comprised 24 apparently healthy miners; Group 3 included 22 workers (drift miners) with Stage 1 anthracosilicosis, grade 1 respiratory failure. The patients with Stage 1 anthracosilicosis had noticeably worse morphofunctional characteristics of the epithelium that displayed extensive fields with pronounced structural changes, such as destruction and desquamation of the integumentary epithelium of the nasal mucosa. Nasal mucosal atrophic changes were observed in 50% of the examined miners. Examination of the buccal epithelium in apparently healthy miners (code 0) and in workers with Stage I anthracosilicosis revealed the increased proportion of microfloral (Streptococcus) contamination by 79% and 3.7 times, respectively.
Exposure to coal rock dust in combination with exercise for 2 months was found to have a negative impact on cellular metabolism in the endocrine system. The early form of anthracosilicosis developed in this period. Cytomorphological study revealed cellular changes in the pituitary, thyroid, parathyroid, and pancreatic glands. The cells of the endocrine organs are functionally tense upon exposure to toxic and physical factors and they are most vulnerable in this period of an experiment.
Ulmer, W T
Some types of pneumoconiosis, such as asbestosis, are characterized by marked restrictive functional patterns. Treatment is begun when definite arterial hypoxemia appears, since the inhalation of oxygen clearly lowers pulmonary artery pressure. It is also important that the onset of concomitant airway obstruction is recognized promptly. From the sociomedical standpoint the most significant pneumoconiosis continues to be the miner's anthracosilicosis. The functional pattern of this pneumoconiosis is clearly airway obstruction, and such anthracosilicotic airway obstruction responds like all other forms of airway obstruction to antiobstructive therapy. The fundamentals of this therapy, which is based on the use of bronchodilators, adrenal cortical hormones and antibiotics, are described.
The out-patient treatment of anthracosilicosis patients was investigated by means of an inquiry among 50 severely disabled patients of the nearly 30 000 miners receiving compensation for disability. Those patients that were able to come to the hospital were also examined clinically in order to objectify the lung function. The airway resistances and intrathoracal gas volumes were measured by body plethysmography, the oxygen partial pressure was determined, and the ECG was analyzed for dextrocardial signs. In the patients visited at their homes, the airway resistances were determined by oscilloresistometry. In all patients, even the clinical examination alone indicated a chronical obstructive bronchitis with shortage of air, at least after slight exercise. Also, more than half of the patients presented with signs of enhanced right ventricular strain. There is no causal therapy to silicosis, so the chronical obstructive bronchitis should be treated by continuous bronchospasmolysis, if necessary supported by glucocorticosteroid administration and antibiotics.
Levitskaia, V L
Flow-volume values and their changes in response to salbutamol and methacin inhalations were studied with the help of a pneumotachograph in 69 patients with anthracosilicosis stage I, and in 70 patients with chronic dust bronchitis stages I and II. Pneumotachography was shown to extend diagnostic potentialities in the detection of ventilation insufficiency in patients with dust pulmonary pathology, making it possible to determine not only a degree but also a site of obstructive disorders. Disorders of the sympathetic and parasympathetic bronchial innervation and associated biochemical mechanisms were important in the mechanism of bronchospasm development. Pneumotachography was recommended in combination with bronchospasmolytic drugs of sympathomimetic and cholinolytic action for elucidation of the mechanism of disorders of the bronchial tone, a choice of adequate therapy and assessment of its efficacy.
Panev, N I; Korotenko, O Iu; Zakharenkov, V V; Korchagina, Iu S; Gafarov, N I
Study covered 426 miners aged 40-54 years with previously diagnosed occupational respiratory diseases due to dust (246 patients with chronic occupational obstructive bronchitis, 98 with anthracosilicosis and 82 with chronic dust nonobstructive bronchitis). 315 (73.9%) examinees out of 426 with lung diseases due to dust demonstrated chronic cor pulnmonale. Considering high share of this complication, the authors used Bayes method to create a method to diagnose predisposition towards chronic cor pulmonale in patients with dust lung diseases through respiratory failure, concomitant coronary heart disease and arterial hypertension, blood groups ABO, MN and P, some structural and functional parameters of heart: myocardium weight index, relative wall thickness index and left ventricle sphericity index, average lung artery pressure. Increasing number of analyzed factors that directly influence chronic cor pulmonale development and selecting additional markers help to improve forecasting of the complication.