MECHANIC BRONCHITIS (Greek bronchos a windpipe + - itis) — the kind of chronic bronchitis, in an etiology to-rogo major importance has long influence of production dust.
Cases of P. can be registered among workers coal, mining, machine-building, I metalloobrabatyvat Russian cabbage soup of the industry, productions of construction materials, hlopko-and the lnopererabatyvayushchy, flour-grinding enterprises, etc. Features the clip, currents and an originality morfol, changes at P. give the grounds to consider this disease as a special form of dust pathology of lungs. In the Soviet Union P. it is entered in the list of occupational diseases (see. Occupational diseases ).
One of the main features of P. — existence of long stage of latency with fading in and increase a wedge, symptoms. Development patol, process happens on average within 7 — 10 years and more and depends on the level of dust content, severity of the performed work, and also on specific features of the organism working. Separate signs of dust damage of bronchial tubes come to light at most of workers, is long affected by dust in conditions of production while the expressed forms of a disease are observed only at individuals.
Representations about pathogeny Item. are confirmed by endoscopic researches (see. Bronkhoskopiya ), which show that at this disease atrophic changes of a mucous membrane of bronchial tubes with the atrophy of bronchial glands expressed, accruing in process of progressing of process prevail (especially at the workers who are affected by kvartssoderzhashchy dust). Defeat of a bronchial tree has diffusion bilateral character; changes extend from a trachea to large and small bronchial tubes. Development of dystonia of a hymenoid wall and deformation (owing to sclerosing processes) certain sites of a bronchial tree aggravate stagnation of a secret, leading to disturbance of bronchial passability and creating favorable conditions for development of the infection important in further progressing of a disease.
Depending on expressiveness of process allocate three stages in a course of a disease: The I stage — the slight, unstable bronchitis without the expressed functional frustration which is not followed by considerable deterioration in overall health and disturbance of working capacity; The II stage is characterized by more expressed and resistant symptomatology of bronchitis with respiratory insufficiency of the I—II degree; The III stage — the heavy, complicated forms of a disease with development of the expressed emphysema, an asthmatic syndrome, heavy respiratory insufficiency. Various options a wedge, P.'s currents are observed. The most often complicated forms of a disease proceed as obstructive bronchitis (see). At some patients the disease is characterized by dominance of symptoms of pulmonary emphysema (see. Emphysema of lungs ) — a syndrome «emphysema — bronchitis». Development of the expressed inflammatory changes in a bronchial tree at hron, bronchitis of a dust etiology meets rather seldom.
Some distinctions during a disease can be caused by different chemical composition of the inhaled dust. At the workers who are affected by the dust aerosols having the irritating and sensibilizing effect (cement dust, some types of organic dust) P.'s development would more often be noted. with dominance of an asthmatic syndrome.
In to diagnosis Item., as well as at bronchitis of other etiology, the greatest value complaints of patients (long cough, dry or with a scanty phlegm, an asthma) have, data of a physical research (scattered dry rattles, the hardish or weakened breath) and indicators of functional tests. Establishment of the diagnosis in each case requires detailed studying of the anamnesis of the patient in close connection with his professional activity.
Treatment depends on a stage of a disease, and generally it is carried out by the same principles, as treatment of patients hron, by bronchitis in general. Workers with long length of service in contact with production dust need medical observation and carrying out preventive, and at emergence of symptoms of a disease — medical actions (courses of alkaline inhalations, fortifying therapy, etc.).
Forecast, as a rule, favorable that is promoted by transfer of the patient into the work which is not connected with influence of production dust.
P.'s prevention. — see. Dust .
Examination of working capacity sick P. the dignity is carried out taking into account features of a course of a disease, degree of its weight, the available complications or associated diseases, age, an experience, qualification of the patient, specific. - a gigabyte. conditions of its work. At easily proceeding, uncomplicated P. the worker can be left at former work on condition of careful dynamic observation and preventive treatment. At the expressed, complicated P. the issue of working ability of the patient is resolved, as at hron, bronchitis of a nonprofessional etiology. It is reasonable to patient of young age to recommend rational employment and retraining with definition of group of disability for limited term.
Bibliography: Volkova V. M. To a problem of a chronic mechanic bronchitis, the Gigabyte. work and the prof. having got sick., No. 3, page 15, 1977; Ivanova I. S. Zertsalov and V. I. and P and l and at sh and N and A. I. K to a question of clinical group of a mechanic bronchitis and the principles of creation of the diagnosis at this disease, in the same place, No. 5, page 14, 1979, bibliogr.; To l e y-N e r A. I. and d river. Prevalence of chronic bronchitis at working modern foundry workshops of mechanical engineering industry, in the same place, No. 2, page 10, 1979, bibliogr.; Milishnikova of V. V. Bronkhofibroskopiya in diagnosis of dust diseases of lungs, Vestn. USSR Academy of Medical Sciences, No. 6, page 20, 1981.
V. I. Zertsalova.