BYSSINOSIS

From Big Medical Encyclopedia

BYSSINOSIS (byssinosis; grech, byssos cotton + - osis) — the disease of the respiratory device caused by professional contact with cotton dust.

It is described for the first time by Grinau (E. N of Greenhow, 1861) in England. The clinical picture is studied by J. Leach two years later in detail. Incidence to a crust, time is studied insufficiently. It is known that B. is generally widespread among working preparatory workshops of the hlopkoobrabatyvayushchy enterprises, and the persons working with low-grade cotton are ill more often. So, in England in the mid-fifties R. S. F. Schilling with sotr. established that B. are ill apprx. 60% of the chesalshchik working with low-grade cotton and apprx. 20% — with high-grade. In France, according to Verner (G. Page of Werner, 1955), B. is revealed at all chesalshchik working over 30 years; in Sweden, according to L. Belin et al. (1965) — at 68% of the chesalshchik working with low-grade cotton; in the Arab countries, according to Batavi (M. A. E1 of Batavi, 1962, 1964) — at 38 — 52% of working various workshops at the cotton-processing plants and at 26,6% of working combing workshops. Researches of domestic authors confirm the maximum incidence of working preparatory workshops at low grades of cotton. Indicators of incidence, according to various data, vary from 6% to 50% (Yu. A. Vertkin, 1963; V. M. Perelygin, 1965, 1967).

The etiology and a pathogeny

is considered the Etiological factor of B. cotton dust, edges is formed generally at the first stages of production processing of cotton. In cotton dust particles less than 2 — 5 microns in size prevail. It consists preferential of organic matters (proteins, polysaccharides, lipoid) with impurity mineral (generally silicon dioxides); at it surely there are bacteria and fungi which quantity and species composition depend on term and storage conditions of raw materials. At long-term storage sporiferous bacteria and fungi of Penicillium and Aspergillus prevail. In preparatory workshops find from 1,5 million to 16 billion bacteria and fungi on 1 g of dust. Emergence and B.'s progressing are promoted acute and hron, by respiratory diseases, especially bronchitis.

To a crust, time does not exist the uniform standard theory of a pathogeny of B. V to literature the following theories are discussed: 1) the theory of influence of endotoxins of the gram-negative bacteria allocated from cotton dust. This hypothesis is disproved by the researches which established that pathogenic activity of cotton dust remains after boiling though endotoxins are inactivated; 2) theory of direct gistaminliberiruyushchy effect of cotton dust. However the chemical nature of the factor releasing a histamine from mast cells is not established. This theory, as well as previous, it is impossible to explain all clinical symptomatology of a disease. Against this theory also lack of therapeutic effect of antihistaminic drugs testifies; 3) in recent years some researchers include B. in group of the allergic pulmonary diseases caused by organic dust and fungi which cornerstone the sensitization of an organism with formation of precipitant antibodies (is see. Pneumonia , alveolites). Fabric changes at this option of a sensitization arise on the mechanism of a phenomenon of Artyus (see. Artyusa phenomenon ).

The pathological anatomy

Pathological anatomy is studied insufficiently. The persons who died in the III stage have diseases, only nonspecific changes characteristic for hron, bronchitis with typical complications are described (a bronchoectatic disease, hron, pneumonia, a pneumosclerosis).

The clinical picture

the Disease usually begins after 5 — 10 years of work in the preparatory workshop. The course of a disease can be divided into 3 stages. To the I stages patients complain of an asthma and feeling of a prelum to the breasts arising in several hours after the beginning of work. An asthma of the mixed or expiratory character is followed by irritation in a throat, dry cough, the general weakness, weakness, sometimes subfebrile temperature. Soon after completion of work all these feelings disappear. Symptoms, as a rule, arise and recur during the resuming of contact with cotton dust after more or less long break, i.e. after the days off, issue (so-called symptoms of Monday). Characteristic auskultativny and percussion data in this stage are not observed. Symptoms not of considerable emphysema of lungs can be noted (without explicit clinic of bronchitis!). There are no also typical radiological and laboratory changes. Decrease in bronchial passability is defined by researches of function of external respiration, a cut then it is gradually liquidated.

At continuation of contact the disease passes into the II stage. An asthma amplifies and remains during the whole working week, provocative factors (smoking, an exercise stress, cooling) aggravate respiratory insufficiency. The phenomena hron can join, bronchitis (see). Symptoms of emphysema are more expressed, than in the I stage. At auscultation rigid breath, scattered dry and wet rattles is noted. Decrease in bronchial passability remains constant, but, as well as all symptoms, amplifies during the resuming of contact with cotton dust after a break.

In the III stage a disease clinically not an otlichima from hron, bronchitis. Complications in the form of emphysema of lungs, bronchiectasias, a pneumosclerosis, a pulmonary heart are characteristic.

The diagnosis

the Diagnosis in early stages is made on the basis of complaints to an asthma, cough, feeling of a prelum in a breast after resuming of contact with cotton dust (symptoms of Monday) and existence of temporary or constant disturbance of bronchial passability.

The forecast

in I and often even in the II stage of a disease leads the Termination of contact with cotton dust to an absolute recovery. In the III stage of change in easy and other bodies are irreversible.

Treatment

needs to be eliminated contact with cotton dust (employment of the patient). At the phenomena of bronchitis with respiratory insufficiency of patients it is necessary to transfer to the work which is not connected with influence of dust, the irritating substances, adverse meteorological factors, and also not demanding big physical tension. Specific methods of treatment do not exist. Hron, bronchitis and its complications demand the corresponding treatment (see. Bronchitis ).

Prevention comes down to the measures of a technical and technological order directed to reduction of formation of cotton dust, restriction of its hit in air of production rooms and ventilation of the last. Marginal level of dust content for the enterprises of the cotton industry in the USSR — 2 — 4 mg/m 3 . The persons suffering hron inflammatory diseases of the respiratory device, shall not be allowed to work in preparatory workshops.


Bibliography:Vyortkin Yu. I . Byssinosis, D., 1971, bibliogr.; P e r e of l y and N V. M. Bissinoz and his place in professional pathology, Works Kirgizsk. nauch. - issled. in-that epid., mikr. and gigabyte., t. 11, p. 2, page 38, Frunze, 1972; In e 1 i n L. and. lake of Byssinosis in cardroom workers in Swedish cotton mills, Brit. J. industr. Med., v. 22, p, 101, 1965, bibliogr.; E1 of B a t a w i M. A. Byssinosis in the cotton industry of Egypt, Brit. J. industr. Med., v. 19, p. 126, 1962; P r an u s-n i t z C. Investigations on respiratory dust disease in operatives in the cotton industry, L., 1936, bibliogr.; Roach S.

A. a. Schilling R. S. F. A clinical and environmental study of byssinosis in the Lancashire cotton industry, Brit. J. industr. Med., v. 17, p. 1, 1960.

H. V. Adrianova.

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