SILIKATOZA (silicatosis, the singular) — the chronic occupational diseases of lungs relating to group of a pneumoconiosis. Develop at long impact on a respiratory organs of dust of silicates — the minerals containing silicon dioxide in the connected state with magnesium, calcium, iron, aluminum and other substances, to-rye are eurysynusic in the nature and are applied in many industries of production. Getting to an organism, silicates break up, leading to slow release silicon to - you from the connected state that, apparently, and promotes development pneumoconiosis (see). Depending on composition of the inhaled dust distinguish the following forms C.: asbestosis, kaolinoz, not benign inoculation reticulosis, olivinoz, talcosis. They occur at persons with a long standing of work in mining, construction, aviation, mashino-and ship-building, tanning and other industries.
The pathological anatomy
the Pleura at S. has numerous commissures. The weight of lungs is increased. Fabric their tya-zhisty, plotnovaty, cellular, on a surface of cuts — expanded reinforced bronchial tubes, small and large bronchiectasias (see), filled with either slime, or putreform liquid. Dark gray and black consolidations (deposits of mass of dust), sometimes abscesses meet. Regional limf, nodes are increased, from gray till dark gray and black color, limes, often motley with adjournment. At microscopic examination along with adjournment of dust in lungs, the mass of the coniophages which are not giving a luminescence in a dark field notes diffusion increase in collagenic fibers around bronchial tubes, vessels, in interalveolar partitions (a diffusion pneumoconiosis).
A clinical picture
In most cases S. have a high-quality current (an exception — asbestosis). It is characterized by scarcity of symptomatology, slackness patol. process it is also expressed most often as a symptom complex hron. obstructive bronchitis (see), emphysemas of lungs (see) and pneumosclerosis (see), followed by short wind and cough. Pages (except for asbestosis) are characterized most often by an easy current, weak expressiveness rentgenol. changes, develop only at long length of service and contact with dust and seldom progress after the termination of contact with it.
Asbestosis holds a specific place among Page. On weight of a current, frequency of complications, rates of progressing it sometimes does not concede to a silicosis (see). Asbestosis develops gradually as a result of long inhalation of dust of asbestos — magnesium silicate and iron. The disease begins with emergence of irritation in a throat, cough, thorax pains, an asthma. Further the symptom complex hron is shown. obstructive bronchitis or bronchiolitis (see). Quickly the pulmonary heart accrues (see. Pulmonary heart ). In a phlegm «asbestos little bodies» — changed in biol quite often are found. to Wednesday asbestos fibers. On skin of extremities so-called asbestos warts develop. The disease is inclined to progressing. At the expressed forms of asbestosis disturbances of cardiovascular system are possible, went. - kish. path, metabolism. Rentgenol. the picture is expressed preferential intersticial (cellular and mesh) by the changes which are localized in lower parts of lungs. Nodular shadows are not numerous. The expressed reaction from a pleura is noted.
Kaolinoz is caused by influence of dust of the clays containing silicate — kaolinite. The disease occurs seldom and preferential at the persons contacting to kaolinite not less than 15 years. The disease is shown in the form of unsharply expressed subatrophic nasopharyngitis (see. Rhinitis ), hron. obstructive bronchitis, emphysema of lungs and pneumofibrosis. Radiological strengthening of the pulmonary drawing, expansion of shadows of roots of lungs, development of interstitial fibrosis decides on trace amount of nodular educations. Current favorable.
Not benign inoculation reticulosis develops as a result of influence of dust of nepheline-aluminosilicate of sodium and potassium. This form C. can meet at working in ceramic and glass productions, the aluminum and tanning industry. Not benign inoculation reticulosis, as well as other forms C., is characterized by defeat of a respiratory organs in the form of unsharply expressed hron. obstructive bronchitis, emphysema of lungs and pneumofibrosis. At rentgenol. inspection it is observed mesh tyazhisty fibrosis with low-intensive nodular shadows; quite often thickenings of an interlobar pleura are defined. Course of a disease favorable.
Olivinoz arises from long inhalation of dust of olivine — magnesium orthosilicate and iron.
One of its early manifestations is damage of upper airways in the form of subatrofiches-ky rinofarnngit. Further gradually the symptom complex unsharply expressed hron forms. bronchitis and emphysema of lungs, followed by dysfunction of external respiration. X-ray morphological changes in lungs at an olivinoza are expressed by diffusion mesh fibrosis with considerable number of melkouzelkovy educations in average and lower parts of lungs. A current its high-quality and compensated, without tendency to a progression to a rovaniye.
A talcosis — rather high-quality pneumoconiosis caused by long inhalation of dust of the talc representing natural magnesian silicate. The talcosis can meet at working in rubber, ceramic, paint and varnish and perfumery productions. The disease develops slowly and is shown by unsharply expressed obstructive bronchitis. Radiological in lungs mesh diffusion bilateral fibrosis with hardly noticeable single melkouzelkovy educations comes to light. A current its favorable, without tendency to progressing. More hard the talcosis as a result of inhalation of cosmetic powder can proceed.
Complications at S. are extremely rare. Only asbestosis often is complicated by tuberculosis of a respiratory organs (see), pneumonia (see); there are instructions on a possibility of development of malignant tumors.
At S.'s diagnosis the same methods are used and the same changes are considered, as at others pneumoconiosis (see). The final diagnosis give on the basis of the occupational history and marks of working conditions of the patient.
Treatment. Medicamentous means from group of bronchial spasmolytics, fermental and antibacterial drugs, cardiacs, an oksigenoteraniye, physical therapy are appointed. Food, respiratory gymnastics is recommended protein-rich and vitamins. It is shown a dignity. - hens. treatment.
Prevention — implementation organizational and technical and a dignity. - a gigabyte. actions for fight against dust; regular carrying out preliminary (at revenues to work) and periodic medical surveys; rational employment of the diseased for the work which is not connected with influence of dust.
Bibliography: Borschevsky Yu. M., And r t and m about N about in and V. G. and Re of t-N e in V. M. Silikatoza and occupational health, L., 1977, bibliogr.; P. P's cursors. Pneumoconiosis, M., 1965; K. P Prickly lettuces. Rehabilitation at a pneumoconiosis, M., 1977, bibliogr.
V. G. Artamonova; Yu. P. Likhachev (stalemate. An.).