Pneumoconiosis-What is pneumoconiosis?
Long-term inhalation of dust pneumoconiosis due to fibrous lesions of the lung tissue-based disease. Others think that pneumoconiosis is the accumulation of dust in the lungs and cause tissue coal workers' pneumoconiosis reaction. Former defines only the reaction of the dust caused lung tissue fibers included in the severity of pneumoconiosis, comply with this condition of limited types of pneumoconiosis, a greater impact on the patient's health. Then a definition of lung reaction is not limited to the organization of fibrous lesions, the broader the definition of epitaxy. China and most countries of the world as a statutory occupational pneumoconiosis, using the former definition.Pneumoconiosis - etiologyPneumoconiosis pneumoconiosis to an occupational disease in many countries, particularly in developing countries, especially. The may occur pneumoconiosis trades the mine excavation work, the pneumatic drill workers, mining workers, demolition workers pillars workers, porters, etc.; refractories, glass, ceramics, building materials and industrial crushing workers, the sifter workers, with powder workers, porters, Packers; workers exposed to various kinds of dust in other production processes.
The cause of pneumoconiosis respirable dust cause pneumoconiosis, but inhalation of such dust does not necessarily lead to the occurrence of pneumoconiosis. Human respiratory organ itself have a strong defense dust entering and deposition in vivo function, and respirable dust in the air. First passes through the nose hair grille blocking filter, which in turn influenced by the anatomical structures of the nasopharynx, airflow direction and speed of change in the nasal cavity and pharynx form a vortex by the inertia of the role of dust particles larger than 10μm easy to hit and attached to the upper respiratory tract wall so generally barrier filter 30 to 50% of the dust in the air inhaled. The air flow into the lower respiratory tract, with the trachea, bronchi stepwise branch, the airflow velocity is more slowed, changes in airflow direction, the Settlement of airflow in the dust adhering to the wall of the mucous membranes, the swing of the ciliated cells in the mucus membrane will push the mucus throat excreted with sputum retention of dust in this part of the 2 ~ 10μm size. The the alveoli can enter the dust particles, most less than 2μm, most of the lungs phagocyte transferred to the ciliated cells of the bronchial mucosal surface by covering the alveolar surface layer of surfactant and alveolar relaxation activities, and then was transferred out. The dust particles into the alveoli is only a small part? Cells (phagocytes engulfed dust) into the alveolar septa, and reach the lung and other organizations of the human body through the lymphatic or blood circulation, causing physiological and pathological role. Respirable dust is deposited in the lungs, only occurs in respirable dust excessive, the defense function of the human respiratory organ can not be filtered, adhesion, retention, or the soot deposition in the alveoli can not completely cleared. Thus, good self-Imperial maintain respiratory function significance.
Pneumoconiosis - pathogenesisCan not be cleared of dust into the alveoli, because of its physical and chemical properties and biological role of different, give rise to different tissue reaction. The fiber cell lung tissue reaction summed usually caused by inhalation of dust into change of fibrous and non-fibrous change are two types, the former can form the general dust caused by the dust stoves and dust foci sexual stove, fibroblast foci, fiber stoves, as well as stoves increases, integration, and even the formation of mass-like lesions characterized. A result of such lesions are a lot of fibrous tissue hyperplasia, allows organizations such as lung and capillary damage and scarring, resulting in emphysema or atelectasis, structural deformation of the lung tissue, these changes are generally irreversible. Non-fibrous variable type (or the lung dust PAP) to form scar tissue, not the destruction of the alveolar structure and lung tissue, usually reversible damage. As the dust and more production is mixed, and biological effects of many factors that affect dust, dust caused both lung tissue reaction is not never ran separate.
Pneumoconiosis - CategoriesFast, slow, late onset; pneumoconiosis time can be divided into collagen fibrosis type pathological changes, interstitial fibrosis and nodular, irregular, diffuse clumps type; press the dust source divided into mineral and non-mineral. In China, the pneumoconiosis divided into five categories according to etiology.
Pneumoconiosis - Clinical performanceEarly silicosis are often no symptoms, or only very minor symptoms. At this time often little uncomfortable feeling, just by regular health checks only to find that the presence of early silicosis. However, with the progress of the disease, especially late silicosis you have symptoms or light or heavy. Silicosis is a chronic systemic disease, mainly affects the respiratory system, patients with common first symptom is shortness of breath. Mild, often engaged in heavy manual labor or climb l mountain feel shortness of breath, a little break for a while, you can turn for the better. Then, do some light work, obvious shortness of breath when walking uphill or on stairs. Serious illness or complications, respiratory and circulatory function by significant damage, then even if the rest or inactivity also felt the gas hold even sleep can not lie flat. In addition to the plant, shortness of breath, chest tightness, chest pain, cough, especially in the more common dry cough. Expectoration, hemoptysis, weakness, weight loss, insomnia, loss of appetite and other. Silicosis generally do not generate heat, there will not be a liver and puffiness, if these circumstances, complicated by other diseases.
Pneumoconiosis - pathological changesPneumoconiosis nodules Grossly: the lesions were round, state clearly, dark gray color, a solid sense of touch. Microscopy: or to silicon nodules, i.e. dust lesions having a collagen fiber core; or nodules of mixed dust, i.e. the collagen fibers and the dust interphase heteroaryl, but the collagen fiber component accounted for more than 50% of the lesions; or silicon tuberculosis Results section silicotic nodules or mixed dust nodular tuberculous lesions formed by mixing nodules.
2, pneumoconiosis diffuse fibrosis respiratory bronchioles, alveolar septal around small bronchi and small blood vessels, subpleural area due to dust deposition diffuse proliferation of collagen fibers.3, dust spots Grossly: lesions dark, soft state of confusion, the perifocal accompanied by more than 15 mm in diameter to expand gas chamber (perifocal emphysema). Microscopic examination: lesions in the net woven fibers, collagen fibers and dust and white mixed, collagen fiber content of less than 50%. Lesions and fibrosis lung was Astral Zhixianglian in shape, with perifocal emphysema.Dust massive fibrosis Grossly: lesions of 2 cm x 2 cm x2 cm above the gray-black or black, hard and tough fibrous clumps. Microscopy: or pneumoconiosis nodules fusion to become the large dust collagen fibrosis or becomes promiscuous text organization composed for a variety of pneumoconiosis.
5, dust response refers to the lung, pleura, lung draining lymph nodes dust deposition, macrophage response, slightly fibrous tissue hyperplasia.
Pneumoconiosis - diagnosis standardThe main basis of reliable dust job history and good quality chest X-ray on the character? Pneumoconiosis diagnostic criteria change, and to exclude the possibility of other diseases. Pneumoconiosis diagnosis group authorized by the health authorities at all levels in the diagnosis of pneumoconiosis in China. China pneumoconiosis X-ray diagnostic criteria are as follows.China pneumoconiosis X-ray diagnostic criteria (1986)Pneumoconiosis (code O)O: the no pneumoconiosis X-ray manifestations O +: X-ray performance is not serious enough for a diagnosis of "Ⅰ" byA pneumoconiosis (code I)Ⅰ: intensive one class round small shadows, the distribution range of at least two lung region have a diameter not less than 2cm; intensity a small irregular shaped shadow, its distribution The range of not less than two lung area.Ⅰ +: a small shadow increased significantly, but the intensity distribution in one is not serious enough as? Ⅱ "by.Two pneumoconiosis (code II)Ⅱ: intensive round or irregular-shaped shadow in the two classes, the distribution range over four lung area; intensive three small shadow, the distribution range of up to four lung area.Ⅱ +: intensive three small shadow, the distribution range of more than four lung area;, or not serious enough for a large shadow as "Ⅲ" by.Three pneumoconiosis (code-III)Ⅲ: a large shadow appears, and its diameter is not less than 2cm wide diameter not less than 1cm.Ⅲ +: more than the sum of the shadow area of the single or multiple large shadow area of the right upper lung area.The requirements are divided into superior (a) the quality of X-ray photo-liang (b) poor (c), the scrap (d) four, d level can not be used for pneumoconiosis diagnosis.
Pneumoconiosis - treatment principlePneumoconiosis should be promptly removed from dust-exposed, and the need for comprehensive treatment of the condition of patients, positive prevention and treatment of tuberculosis and other complications, in order to alleviate the symptoms, slow disease progression, extend a patient's life, and improving the quality of life in patients with.Pneumoconiosis - treatment methodTo the present (2010), at home and abroad has not an affirmation to be able to cure the effects of drugs of silicosis. However, a large number of Practice has proved that the the early adopt comprehensive measures in a timely manner and method of treatment can prevent or slow down the development of silicosis. The combination of these measures and treatment approaches include:1, has been determined to have silicosis should be immediately removed from the dust-exposed, and arrangements for other work, according to the health and physical possible, reduce labor intensity or shorter working hours.2, reasonable living habits including adequate sleep, proper physical and mental rest and civic life, avoid alcohol and smoking cessation. In addition, it should be based on the physical situation, carry out sports activities as Guangbo Cao, tai chi, qigong, breathing gymnastics, as well as a reasonable nutrition, appropriate to add some protein (milk, eggs, lean meat) and rich in vitamin C (fresh fruits and vegetables) food. These all help to promote health, enhance the body's resistance.3, China has several drugs, such as grams of silicon flat the piperaquine cha, aluminum citrate, animal experiments show that the inhibition of pulmonary fibrosis better results, the use of clinical patients also have some effect, mild toxicity . Under the guidance of a doctor can choose to use, efficacy observed.If you often have symptoms of shortness of breath, cough, expectoration, it should take Zhichuan, cough, antispasmodic, anti-inflammatory and expectorant drugs to relieve the spasm of the respiratory tract, infection control, accelerated sputum secretions discharged, so conducive to improve the patient's pulmonary function, and reduce other complications.5, active prevention and treatment of complications, such as tuberculosis, bronchial and lung infection.Pneumoconiosis - Occupational contraindications1, severe tracheal and bronchial deformity, resulting in double-lumen endobronchial tube can not be in place by.2, combined with active pulmonary tuberculosis.Subpleural bullae greater than 2 cm in diameter.4, severe emphysema.5, severe lung function is low.6, combined heart, brain, liver, kidney and other major organs of serious illness or dysfunction.7, coagulation dysfunction.8, malignancy, or immune function.Pneumoconiosis - treatment drugsGrams of silicon flat (poly-L-allyl pyridine nitrogen-oxygen compounds, referred to as P204) is a high molecular nitrogen oxides, the mechanism of action macrophages play a protective role in the process of destruction of silica dust, prevent and delay silicosis progress has effect, can be used for treatment and prevention. Usage: weekly 30 mg kg g intramuscularly, or an aqueous solution of 8-10 ml g 4% silicon level. Retreatment daily inhalation, three months for a course after the interval l-2 months 2-4 boils away, two courses a year after retreatment. The little aerosol inhalation side effects of this product. The small number of patients may have had elevated aminotransferases.Tetrandrine Chinese medicine Han Menispermaceae extracted double-benzyl isoquinoline drugs, which enables silicosis within collagen synthesis to reduce daily dose of 200-300 mg. Clinical improvement in patients after treatment improved x-ray. Acute silicosis better effect. The main side effects were anorexia, elevated serum transaminase, such as heart rate.3, other piperazine wow class (piperazine twitter, hydroxyphosphates piperazine cha, etc.), aluminum-agent drugs. The silicosis patients after treatment, subjective symptoms improved in different degrees, and some can slow disease progressionOf pneumoconiosis - susceptible to pneumoconiosis industry and tradesMining: various metal mine mining, tunneling and mining, as well as other metal mines mining of coal mine was to produce pneumoconiosis operating environment, the main job occupations drilling, blasting, pillar, transportation;2, metal smelting ore crushing, screening and transport;Institutions manufacturing cast with sand, modeling, casting sand cleaning, sandblasting, and welding work;4, the building materials industry, such as refractories, glass, cement, aggregates production in the mining, crushing, grinding, screening, spices, etc.; asbestos mining, transport and textiles;5, highway, railway, water conservancy construction in the dug tunnel blasting.Pneumoconiosis - how to prevent1, the process of reform, innovation, production equipment: the main way to eliminate dust hazards.Wet job: wet milling quartz, refractory, wet drilling in mine the underground haulage spray sprinkler.3, airtight, ventilation, dust removal: can not take the place of the wet work the closed ventilation dust approach should be used to prevent dust.4, the health of workers exposed to dust check: do Tuochen job check should include pre-employment and periodic health checks, out of the dust-exposed.5, individual anti jealous: wear a dust protective gear, such as dust-proof helmets, blast helmet, blast masks.Pneumoconiosis - complicationsRespiratory infections mainly lung infection, which is a common complication of pneumoconiosis.2, spontaneous pneumothorax is rare. Rupture of lung tissue and visceral pleura air into the pleural formation pneumothorax points closed pneumothorax the tension pneumothorax traffic pneumothorax three.3, tuberculosis dust-exposed workers, especially silica dust exposed workers than in the general population susceptible to tuberculosis.4, lung cancer and pleural mesothelioma is mainly seen in asbestos-exposed workers and patients with asbestosis.5, chronic pulmonary heart disease seen in some of the terminally ill as chronic bronchitis, airway narrowing and increased airway resistance, to produce the obstructive lung kinds, pulmonary hypertension, may cause chronic pulmonary heart disease.6 of respiratory failure on respiratory and lung infections, pneumothorax incentive occurred decompensated respiratory failure, abuse of sedative and hypnotic drugs also contributed to the pneumoconiosis people breathing sorrow exhaustible one of the reasons.
