From Big Medical Encyclopedia

OCCUPATIONAL DISEASES — category of the diseases resulting from impact on an organism of adverse factors of the production environment. Wedge, P.'s manifestations. often have no strictly specific symptoms, and only data on working conditions of the diseased allow to establish belonging of the revealed pathology to this category of diseases.

Item. are in the majority manifestation of action on a human body of this or that production harm (e.g., raise dust silicon dioxides at a silicosis).

Along with it the diseases developing under influence of both production, and other environmental factors meet; in the first case they are among professional (e.g., bronchial asthma at working chemical productions), in the second when they are connected with other etiol, a factor — to number of the general (e.g., the same bronchial asthma which developed from influence of household dust). Clinically specificity of occupational diseases is always relative, and only some of them are characterized by the special symptom complex caused inherent to these diseases fiziol., rentgenol., gematol. and biochemical, changes.

Standard and uniform classification of P. so far is absent. The greatest recognition was gained by classification, the cut is the basis the etiological principle. On this basis five groups of occupational diseases are allocated: 1) caused by influence of chemical production factors, 2) a dust factor, 3) physical factors, 4) an overstrain of separate bodies and systems, 5) action of biological factors. Out of this etiological systematics there are allergic diseases and new growths of the professional nature.

The following specific diseases (nosological forms and nozogruppa) are a part of the called groups.

1. The diseases caused by influence of volumetric factors: acute and chronic intoxications, and also their effects proceeding with the isolated or combined defeat of various bodies and systems; diseases of skin (contact dermatitis, photodermatitis, onychias and paronychias, melanoderma, folliculites); foundry fever, ftoroplastovy (teflon) fever.

2. The diseases caused by influence of a dust factor: a pneumoconiosis — a silicosis, silikatoza (asbestosis, a talcosis, kaolinoz, tsementoz, a mica pneumoconiosis, etc.), metalconioses (titanoz, a berylliosis, a siderosis, a baritosis, stanioz, etc.), karbokonioza (an anthracosis, grafitoz, etc.), a pneumoconiosis from organic dust, a pneumoconiosis from the mixed dust (a coal-miners disease, a siderosilicosis, siderosilikatoz, a pneumoconiosis of electric welders, etc.); chronic mechanic bronchitis; bronchopulmonary diseases from vegetable dust (byssinosis).

3. The diseases caused by influence of physical factors: vibration disease; the diseases connected with influence of contact ultrasound (a vegetative polyneuritis, an angioneurosis of hands); to a snizha ny hearing as cochlear neuritis (a noise disease); beam diseases — a radial illness (acute or chronic), focal radiation injuries (acute or chronic), a pneumosclerosis; the diseases connected with influence of electromagnetic radiations and scattered laser radiation; local damage of fabrics by laser radiation (burns of skin, defeat of a cornea of eyes, retinas); electroophthalmia; cataract; compressed-air (lacunar) disease and its effects, acute hypoxia; the diseases arising at unfavorable weather conditions; overheat (hyperthermia); disturbance of a water salt metabolism (convulsive disease); obliterating endarteritis, vegetative and sensitive polyneuritis (akroangionevroz), polyradiculoneuritis.

4. The diseases caused by an overstrain: diseases of peripheral nerves and muscles, recurrent neuralgia, neuritis, radiculoneurites, vegetative and sensitive polyneurites (akroangionevroz), cervicobrachial plexites, cervicothoracic radiculitises, lumbosacral radiculitises, diseases of the neuromuscular device of hands and a shoulder girdle — a vegetomiofastsita (vegetomiozita), myofascites (miozit), nevromiofastsit (neuromyosites); koordinatorny neurosises (writer's cramp, other forms of functional diskineziya); diseases of a musculoskeletal system (the chronic tendovaginitis stenosing tendovaginites — styloidites, a syndrome of a carpal tunnel, the latched finger; the chronic arthritises deforming arthroses, rearthritises, a bursitis, an epicondylitis, aseptic necroses; osteochondrosis of cervical, lumbar department of a backbone with radicular and vegetovascular disturbances); the expressed phlebectasia standing complicated inflammatory (thrombophlebitis) or trophic frustration; the diseases caused by an overstrain of the voice device (chronic laryngitis, vasculomotor monokhordit, small knots of voice folds — «small knots of singers», polyps of voice folds, contact ulcers of voice folds, a phonasthenia); the progressing short-sightedness; emphysema of lungs; psychoneuroses.

5. The diseases caused by action of biological factors: infectious and parasitic diseases, homogeneous with that infection, about a cut workers are in contact in operating time (tuberculosis, a brucellosis, sap, a malignant anthrax, a tick-borne encephalitis, an ornithosis, a toxoplasmosis, fungus diseases of skin, erizipeloid Rozenbakh, a mange, etc.); dysbacteriosis, candidiasis of skin and mucous membranes, visceral candidiasis.

6. Allergic diseases: conjunctivitis, rhinitis, pharyngitis, laryngitis, rinosinusit, bronchial asthma, an asthmatic bronchitis, dermatitis, eczema, a toksikodermiya, allergic polyserosites, a Quincke's edema, an acute anaphylaxis.

7. New growths: tumors of skin (giperkeratoza, epithelioma, papillomas, cancer, leukokeratoses); tumors of an oral cavity and respiratory organs; tumors of a liver; carcinoma of the stomach; leukoses; tumors of a bladder (papillomas, cancer); tumors of bones.

Distinguish acute, subacute and hron. prof. of a disease. Acute the prof. the disease (intoxication) arises suddenly, after single (within no more than one shift) influences of rather high concentration of the chemical substances which are contained in air of a working zone. Subacute the disease (intoxication) is observed by the prof. in the conditions of repeated influence of chemical substances during rather short time. Hron. the prof. a disease develops as a result of long systematic impact on an organism of harmful production factors. Chronic P.' feature. gradual increase of symptoms of a disease is.

Influence of harmful production factors on the state of health is known long ago. In 16 century doctors, describing a hard work of coal miners, scabblers, miners, revealed at them the diseases connected with a profession which called then a mountain tuberculosis. A. N. Nikitin, F. F researches. Erisman, D. P. Nikolsky, V. A. Levitsky, etc. the adverse effect of unfavorable conditions of work on the state of health of working was also established. They described prof. of poisoning during the work with phosphorus, mercury, lead.

Systematic and planned studying of P. began in our country after Great October socialist revolution. The first domestic management in the field of professional pathology (see) there was I. G. Gelman's monograph «Introduction to clinic of professional poisonings» published in 1929. Further the Soviet scientists N. A. Vigdorchik, I. G. Gelman,

S. M. Genkin, P. P. Dvizhkov, E. A. Drogichina, K. P. Molokanov, E. Ts. Andreyeva-Galanina, etc. would conduct basic researches on studying of clinic of P. Results of their work formed the basis of the actions directed to decrease in the prof. of diseases in the Soviet Union.

In our country thanks to socialist system of economy and progress a gigabyte. sciences the level of the prof. of incidence constantly decreases. Typiforms acute and hron, intoxications from influence of high concentration of chemical substances or completely disappeared, or became a big rarity. Practically severe forms of intoxications mercury (mercury encephalopathies), lead (a lead colica, lead paralyzes), manganese (manganese parkinsonism), benzene and hepatotropic poisons do not meet. For P.'s clinic. the forms of diseases, as a rule, erased, poorly expressed are characteristic. Main problem of P. there are dust diseases of lungs (see the Pneumoconiosis) and a vibration disease (see).

Pathogeny P.'s most. it is difficult. In a complex of the pathogenetic mechanisms participating in development of the prof. of diseases, the leading place is taken by the disturbances of metabolic processes caused by direct action of the prof. of vrednost on biochemical, structures of an organism. It is recognized that the disturbances of activity of various fermental systems leading to disturbances proteinaceous, lipidic, carbohydrate, mineral metabolism have major importance. Change of a condition of cytoplasmic membranes and especially their receptor device connected with regulators of metabolism is of great importance. Toxicants or directly interact with enzymes, or work as antimetabolites in various exchange processes or change intermolecular ratios in a cell and cellular structures, breaking thereby activity of biocatalytic systems of an organism (see Membranes biological).

The most important condition of the correct diagnosis of P. full studying a dignity is. - gigabyte. working conditions, the anamnesis of the patient, its of «a professional route», all-in the works performed by it since the beginning of work, identification of possible contacts in the course of work with the prof. vrednost and duration of their influence and also establishment of the occupational and nonprofessional diseases postponed in the past. Reliability of the diagnosis is reached by careful differentiation of an observed disease with similar on a wedge, symptomatology diseases of a nonprofessional etiology. In some cases only dynamic overseeing by the patient gives the chance to finally resolve an issue of communication of a disease with a profession.

At P.'s identification. the doctor makes the emergency notice, a cut during 24 hours send to local SES. The health officer on occupational health after obtaining the notice within a day makes investigation of each case of acute P.B. and within 7 days — each case hron. occupational diseases and poisonings.

The document which is used during the definition of belonging of this disease to number of professional is the «List of occupational diseases» with the instruction for its use approved by M3 of the USSR and the All-Union Central Council of Trade Unions. Lists of occupational diseases in the different countries differ from each other on structure, number of diseases and degree of a specification of the diagnosis.

Treatment Item. in most cases symptomatic and pathogenetic. Sometimes crucial importance in treatment has timely transfer of the diseased into the work which is not connected with influence of the prof. of the harm which caused a disease.

Prevention includes a gigabyte. rationing (see. Standards hygienic ), preliminary at revenues to work and periodic medical examinations (see. Medical examination ).

At initial forms P., which current is not inclined to progressing, the diseased can be temporarily transferred to the work which is not connected with the prof. vrednost. Such transfer (no more than for 2 months) is made out by issue of the shortpaid sheet of temporary disability to the patient. In case of approach of a palindromia or a tendency to its progressing, and also at emergence of permanent disturbances of the state of health of the diseased discharge of the work connected with the prof. harm. If transition of the worker for these reasons for other work involves impossibility of use of the qualification by it, it is directed to medical labor commission of experts (see) for definition of group of disability (see) owing to an occupational disease or extent of loss of professional working capacity (see). To persons of youthful or mature age with easy Forms P. disability can be given for limited term for retraining or retraining (professional rehabilitation).

Separate forms of occupational diseases — see articles devoted to specific diseases, e.g. Compressed-air disease , Manganoconiosis , Silicosis etc., and also article Poisonings , professional.

Bibliography: Andreyeva-Galanina E. Ts., etc. Noise and noise disease, L., 1972, bibliogr.; A berylliosis, under the editorship of K. P. Molokanov, etc., M., 1972, bibliogr.; Bochkaryov M. V., etc. Clinic, differential diagnosis and treatment of chronic intoxications pesticides, Chisinau, 1979, bibliogr.; Vibration on production, under the editorship of A. A. Letavet and E. A. Drogichina, M., 1971; Harmful substances in the industry, under the editorship of N. V. Lazarev, etc., t. 1 — 3, L., 1976 — 1977; Gratsianskaya L. N. and G. E. Klinik's Rozentsvit of professional neurotoxicoses, L., 1971, bibliogr.; Gratsianskaya L. N., Frolova M. A. and Yurkevich A. Ya. Social and labor and medical rehabilitation of patients with occupational diseases, L., 1978, bibliogr., Drogichina E. A. Occupational diseases of a nervous system, L., 1968, bibliogr.; E in e N the island and M. V., Zertsalov V. I. and Ivanova I. C. Professional mechanic bronchitis, M., 1972, bibliogr.; Occupational diseases in chemical industry, under the editorship of A. A. Letavet, M., 1965; Professional cancer, under the editorship of A. I. Shnirelman, M., 1979; Rashevskaya A. M. and Zorina L. A. Occupational diseases of system of blood of a chemical etiology, M., 1968, bibliogr.; R I e V. A. c and L. N Zimont. Professional incidence in some foreign countries, M., 1979; Senkevich N. A. Clinical forms of a silicosis and tuberculosilicosis, M., 1974, bibliogr.; From ohms about in B. A. and Dolgov A. P. Occupational diseases of skin in the leading industries of the national economy, M., 1976, bibliogr.; Examination of working capacity at occupational diseases, under the editorship of. To. P. Molokanova, etc., M., 1968; Asbestos-related disease, ed. by R. G. Fraser, N. Y., 1978; Hunter D. The disease of occupations, Boston, 1957; Research report, Chronic bronchitis and occupational dust exposure, Cross-sectional study of occupational medicine on the significance of chronic intialative burdens for the bronchopulmonary systems, Boppard, 1978.

A. M. Monayenkova.