Occupational Diseases / / August 12, 2017
Chronic dust bronchitis are common in people who work in the face of considerable dust (among workers mining, coal, metallurgy, mechanical engineering industries).There are also among agricultural workers.The disease occurs more often in contact with the coarse dust with a relatively low silica content (coal, cement, asbestos, plant, etc..).
nonspecific syndrome, but found that the workers "dust" manufactures bronchitis and emphysema are more common than in other groups of the population, and with the increase in length of service increases the frequency of these diseases.Dust bronchitis develop slowly, with a length of 8-10 years and more.
a result of irritation of the respiratory tract mucosa dust particles developing endobronchitis in violation of the secretory function of the mucous glands.Later formed a nonspecific bronchial obstruction, which considerably complicates the course of the disease, leading to bronchial obstruction, emphysema of the lungs and respiratory failure.Bronchospasm
According to the severity of the disease, there are three stages:
I - stage irritation.Cough for 2-3 years, or dry with scanty sputum;periodically dry wheezing, normal temperature.
exacerbation of the disease are rare and short-lived.During exacerbations enhanced cough, sputum, or appears it increases the number of, sometimes fever.There were no significant radiographic changes were observed.Pulmonary insufficiency is absent or is 0 degree-I (mainly during periods of exacerbations).Changes of peripheral blood there.
II stage (inflammatory) is the result of a combination of irritation with the inflammatory reaction: cough almost constant, shortness of breath during normal operation.During an exacerbation - weakness, malaise, sweating.Breathing hard, or weakened, scattered dry rales.In the period of acute cough and shortness of breath enhanced, increasing the number of allocated sputum, it contains white blood cells, dust cells, sometimes - elements that are typical of asthma.Changing nature of phlegm: it becomes mucopurulent.Low-grade temperature, during an exacerbation - febrile.In addition to dry, can be auscultated crackles.Sometimes, changes are observed in the peripheral blood (leukocytosis with a left shift, increased ESR).X-ray - increased pulmonary pattern blurred (due to the initial effects of peribronchial sclerosis), which becomes more pronounced during exacerbation due to peribronchial infiltration.Pulmonary insufficiency of I or II degree.There may be initial symptoms of pulmonary heart.Exacerbations of the disease are long (2-3 weeks), and their frequency - up to 3 times a year.
III stage - peribronchial (deep bronchitis) - is rare.The process applies to peribronchial tissue.The clinical manifestations can dominate pulmonary symptoms of infection (often leading to secondary chronic pneumonia) or diffuse emphysema with infectious-allergic bronchial asthma.Persistent cough, shortness of breath at rest, chest pain, cyanosis, puffiness of the face, a large number of scattered wheezing, emphysema.X-ray - and a pronounced increase in strain lung pattern with bronchiectasis, emphysema.During an exacerbation may be pockets pneumonic infiltration.Severe pulmonary insufficiency, pulmonary heart in the process of sub- or decompensation.Exacerbations are frequent, unstable remission.
Treatment Treatment depends on the stage of the disease.When the initial phenomena: softening inhalation (warm, moist mixture of alkali and oil aerosols), breathing exercises, physiotherapy, aimed pa increase in the overall reactivity.In more severe forms of the disease -otharkivayuschie, desensitizing and anti-inflammatories.In severe cases, apply additional antibiotics, heart, diuretics, oxygen therapy.
patients with initial forms of bronchitis with appropriate treatment can be a long time not to change their profession.During an exacerbation - transfer to another job.young persons should be encouraged to sustainable employment and retraining.For the period of re-training may be given disability group III of a professional nature.When expressed forms, especially when complications of bronchial asthma and chronic pneumonia, the appearance of pulmonary-cardiac insufficiency of II degree, patients with disabilities (less disability).
For Us of chronic bronchitis with the profession say, high dustiness in the workplace of the patient, significant experience in such conditions, a preliminary examination of evidence about the absence of bronchitis when applying for a job, the gradual development of the disease, early accession of bronchial obstruction, an increased incidence of chronicbronchitis among workers of the production, the absence of a history of frequent indications of acute respiratory infections, pneumonia, especially repeated, long-term smoking and so forth.
equipment inhalers.Individual and collective inhalation of alkaline solutions, ultraviolet irradiation doses suberythermal, hardening of the body (sports, gidroprotsedury etc.).Dynamic observation.