1. PROFESSIONAL DISEASES OF RESPIRATORY ORGANS, CONDITIONED BY DUST IMPACT (BLACK-LUNG DISEASE, PNEUMOCONIOSIS)

2. BLACK-LUNG DISEASE is a respiratory disorder, a type of pneumoconiosis caused by repeated inhalation of coal dust over a period of years and dust depositing in lungs, and is also characterized by the development of diffusion fibrosis

3. The modern classification of pneumoconiosis (2002):
Silicosis
Silicatosis
Metalloconiosis
Carboconiosis
Hypersensitivity pneumonitis

4. The classification of dust aggresivity:
Dust diseases developing from a dust with high- and medium-fibrogenious influence (containing Si02 or asbest more than 10 %) – a silicosis, silicoantracosis, silicosilicatosis, silicosis derosis, asbestosis
Dust diseases developing from a dust with mild-fibrogen- ious influence (with the contents free silicon dioxid less then 10%, bonded Si02 or without Si02) – silicosilicatosis (kaolinosis, talcosis); carboconiosis (anthracosis, grafitosis, pneumoconiosis of coal dust, diamond pneumoconiosis); metalloconiosis (siderosis, kaolinosis, baritosis, manganoconiosis, aluminosis); a dust disease of the electric welders, polishing, grinding

5. Hypersensitivity dust diseases from a dust (aerosolum) with toxico-allergic influence – berylliosis, pneumonites from influence of chrom, nickel, platinum and others rare-earth metals and alloys; pneumonites from a dust of plastic, polymeric pitches, drugs (toxico-fibrogenious alveolites); a byssinosis, bagassosis, papricosis, exogenous allergic alveolitis, woodworkers

6. Radiological Characteristics of Pneumoconiosis
Code
Characteristics of shadows (form and size)
Spreading, density and territory of shadows
Stage
Absence of pneumoconiosis Control
Small nodular (small rounded shadows)
Double
0-1 p
Nodules, up to 1.5 mm in size
Small number of shadows
I, II q
Nodules, from 1.5 to 3.0 mm
Moderate number of shadows r
Nodules, from 3 to 10 mm
Numerous shadows

7. Radiological Characteristics of Pneumoconiosis
Code
Characteristics of shadows (form and size)
Spreading, density and territory of shadows
Stage
Interstitial (small shadows)
Double, diffusive
I, II s
Linearly and cellulary changes
Blurry outlines t
Pulled changes
Clear outlines (lung picture is clear) u
Sharply expressed pulled changes
Numerous shadows (lung picture is not defined)
III

8. Radiological Characteristics of Pneumoconiosis
Code
Characteristics of shadows (form and size)
Spreading, density and territory of shadows
Stage
Big nodular (big rounded shadows on nodular or interstitial background)
Double or one-sided A
Small nodular — diameter of nodules from 1 to 5 cm
Territory of spreading is not more than 5 cm2 B
Big nodular — diameter of nodules from 5 to 10 cm
Territory of spreading is not more than 1/3 of the lung field C
Massive — diameters of nodules is over 10 cm
Territory is over 1/3 of the lung

9. Clinical Characteristics of Pneumoconiosis
Clinical and functional characteristics
Disease progress
Complications
Bronchitis
Fast progressing
Tuberculosis:
Bronchiolitis
Slowly progressing
with separating forms of tuberculosis (according to the classification)
without noting the form of TB (small nodular, big nodular and massive TB-silicon)
Pneumonia
Brochnoectatic disease Bronchial asthma Pneumothorax
Atrophic arthritis
Neoplasm
Lung emphysema, stage I, II, III
Regressing
Lung failure, stage I, II, and III
Cor pulmonale, compensated, decompensated, stage I, II and III

10. SILICOSIS Silicosis is pneumoconiosis, caused by inhaling dust with free silicon dioxide (Si02). This is the most spread form of pneumoconiosis, the progress of which is particularly complicated

11. in metal mining industry
SILICOSIS met:
in metal mining industry
fireproof and ceramic materials
tunnel boring, sand grinding, quartz, granite and other ores

12. PATHOGENESIS
Colloid-adsorbing theory
Immune theory

13. PATHOLOGIC ANATOMIA
subtrophic, and later atrophic and sclerotic changes
precolagen and collagen fibers, silicotic nodules.
emphysema of lungs
hyalinized fascicles

14. CLINICS OF STAGE I dyspnea (much physical activity) pain in the chest
variable dry coughing
basal emphysema
stiff, in some places vesicular breathing
X-ray: deformation of lung picture, small nodular from 1 to 2 mm in size, located mostly in lower and mid lung

15. CLINICS OF STAGE II Intensification of dyspnea Pain in the chest Cough
Limitation of the motion of the lower end of lungs
Intensification and deformation of lung picture
Number of nodular shadows from 3 to 10 mm
Lung roots are expanded, carnified and start looking «cut»
The pleura thickened and deformed

16. CLINICS OF STAGE III Dyspnea in rest Intensive pain in the chest
Coughing
Box sound with dull
X-ray – disseminated miliary tuberculosis ("snow storm"), massive shadowings, pleurodiaphragm and pleurocardial commissures, buliosnic emphysema
Increase of minute volume

17. DIFFERENTIAL DIAGNOSTICS
disseminated tuberculosis
silicotuberculosis
sarcoidosis
syndrome of Haman-Rich

18. Complications of silicosis
silicotuberculosis
pneumonia
bronchiatic disease
bronchial asthma
atrophic arthritis
spontaneous pneumothorax
coniotic cavity

19. TREATMENT Inhalation of mineral waters
Glucocorticoids: prednisolone 20 to 25 mg/day for 10 to 12 days
Oxygen therapy
Stimulators of activity the respiratory center (Cordiamin)
Expectoration drugs (3 % of potassium iodide solution or the tincture of termopsis herb)
Alcohol extract of eleuteroke
Ultrasound, electrophoresis
Сardiac glycosides (strophanthin 0.5 ml of 0.05% solution), aminophylline (5-7 ml of 2.4% solution), diuretic (furosemide and hydrochlorothiazide)
Anabolic steroids (metanedrostenolon – g 1 to 2 times a day before meals, retabolil – 1 ml of 5% oil solution intramuscularly, total 8-10 injections)

20. Verification of work ability
Stage I: rational job.
Stage II: Invalidism Group (mostly Group III,
+ tuberculosis and respiratory insufficiency – Group II).
Stage III: occupational disablement of group II or I.

21. Asbestosis is silicatosis, which is caused by inhaling asbestos dust
SILICATOSES
Silicatoses are pneumoconiosis, which develop in the result of inhaling of silicate dust
ASBESTOSIS
Asbestosis is silicatosis, which is caused by inhaling asbestos dust

22. Chronic bronchitis symptoms + lung emphysema + pneumosclerosis
Clinics of asbestosis
Chronic bronchitis symptoms + lung emphysema + pneumosclerosis
dyspnea
dry rales
coughing
pain in the chest
headaches, general weakness and undue fatiguability
losing weight
dry disseminated crepitations

23. TALCOSIS
Talcosis is silicatosis, which appears due to the talc dust action (magnesia silicate).
(rubber, textile, paper, perfume industries)
not earlier than after 10 years of work
dyspnea at physical activity, pain in the chest, coughing, mostly dry with some mucus, weight losses, box sound

24. ANTHRACOSIS miners (mining coal), ore-dressing plants
professional rout 15 to 20 years
(2% of silicon dioxide)

25. Clinics of anthracosis
Stage I: fast fatiguability, dyspnea at physical activity, coughing and pain in the chest.
X-ray: small nuclear shadows, bigger shadows of lung roots.
Stage II: dyspnea, emphysema and bronchitis.
Stage III: general weakness, dyspnea, coughing, pain in the chest.
X-ray: massive homogenous shadows.

26. Berylliosis is metaloconiosis, caused by inhaling beryllium
(silvery-gray light metal)
beryllium oxide, beryllium sulfate, beryllium chloride, beryllium fluoride
X-ray tubes, luminescent lamps, atomic energy, ceramic production

27. Treatment of silicatoses
solux, ultraviolet radiation, oxygen therapy, respiratory exercises
bronchological, antihistamine and inflammatory drugs (P, ascorbic acid and nicotinic acid)
antibiotics and sulfanamides (pneumonia)
cardiac glucosides (strophanthin, corglucon)
diuretics (lasix, hydrochlorothiazide)

28. Thank You
Good Luck