Karakushikova
A.S., Bekmagambetova Z.D., Toguzbaeva K.K., Niazbekova L.S., Seyduanova L.B., Dzhusupov K.D., Umarova M.M., Junistaev D.D., Nurshabekova A.B., Myrzakhmetova S.K.
The Kazakh national medical university named after
S.D. Asfendiarov,
Republic of Kazakhstan, Almaty
THE HYGIENIC CHARACTERISTIC OF BRONCHIAL PULMONARY SYSTEM THE
WORKERS OF CEMENT MANUFACTURE AND A SCIENTIFIC BASIS OF PREVENTIVE ACTIONS
The Shymkent plant in the hygienic plan is
characterized by high degree of a dust content of atmospheric air in the aim of
manufacture and the prevalence among workers bronchial - pulmonary diseases.
Till 1980 was considered that the basic pathology of workers in cement manufacture
are pneumocanious. At the same time the research works of scientists show that
among dust manufacture workers has the wide chronic dust bronchitis [1]. A dust
bronchitis and pneumocanious leads to the growth of the level of the general
disease and the diseases with the time disability working in cement
manufacture. That reflects the quality and the output, reduces profitability
and raises the cost price of cement products [2]. The given circumstance shows
not only the hygienic importance of the present work, but also on an imperative
need of scientific working out of the preventive actions directed to the
prevention and decrease of level of disease of bronchial - pulmonary system,
working in cement manufacture.
The main aim was the establishment of hygienic and
clinical features bronchial -pulmonary pathology of workers of cement
manufacture and the working out of scientific bases of preventive maintenance
of dust diseases on the manufacture of cement products.
For the decision of an object in view we define the
following tasks:
– to give characteristics
to working conditions operating on the basic dust sites of production;
– to establish
peculiarities of formation of bronchial- pulmonary diseases, level, dynamics
and tendencies of developing of dust diseases at the workers;
– to determine the major
risk factors of developing dust bronchial-pulmonary diseases and also to define
the contribution of each risk factor and their join actins on formation of
level of indicators of disease who are employed professions;
– to describe clinical
features of dust bronchial-pulmonary diseases, and also before nozological
conditions of bronchial-pulmonary
system which became a basis for working out the differentiated preventive
actions of glutamine acid and potassium iodide on the experimental
animals.
The object of the
research: medical-demographic indicators (sex and age structure,
the reasons of diseases); manufacture environment (atmospheric air, humidity,
temperature, noise); rats (lung and other organs and tissue).
The methods of
the research: According to the objectives hygienic
conditions of labour workers of the cement manufacture were researched. Within
the indicators of the workers’ disease of the given harmful manufacture were
checked by methods of the medical statistics. Laboratory-clinical observation
was held among the workers suffering from diseases of the bronchial - pulmonary
system. In order to examine the spread of risk factors the sociological method
was taken as a base. The complex methods of the medical observation were used
for checking the indicators of health. The instrumental research methods were used for observing of
bronchial-pulmonary system. The experiments on rats were held to find the
changes in bronchial-pulmonary system and histomorphological data was
received.
The received
scientific results. The cement dust has the
negative influence on the health of the workers at the Shymkent cement plants.
The dust containing in atmosphere of industrial premises has a special hygienic
value among them. A characteristic feature of cement dust is high dispersion
and complexity of its chemical composition. By hygienic researches it was
revealed that the maintenance of a cement dust in the atmosphere of working
platforms of a factory exceeded its maximum permissible concentration in limits
from 10,5 to 23,8 times. Sanitary adverse conditions are revealed in all
producing sections of a plant but the atmospheric air on the sites of roasting
transportation clincers on conveyors, loading of ready cement on motor vehicles
and goods trucks is the most dusted, and the dust concentration in the air
fluctuates from 58,8 mg/m to 142,8 mg/m.
Among the workers, busy in production containing dust,
the level of disease of bronchial- pulmonary system according to applying data
to surgery-medical institutions is 1062%, according to complex medical
observations – 1234,1%. According to Pathologies data temporary disability is
86,2 out of 100 workers. Correlative –regressive analysis and mathematical
modeling of disease have shown that the high content of dust in a manufactured
atmosphere promotes formation of superbackground 35,9 % of level disease on
applying, 50,3 % level of disease with the temporary waste of disability and
56,2 % of level of disease according to the complex medical observations. The
part of the influence of the manufactured dust for appearing chronic
non-specific lung disease is 1.2%, non-specific bronchial diseases is 1,9%,
chronic obstruct bronchitis is 21,7%, bronchial asthma is 54,3% and bronchoectatic
diseases is 44,5%. The main causes of the diseases in the bronchial-pulmonary
system of workers in cement manufacture are the dust obstructive bronchitis,
the chronic bronchitis with asthmatic components and pneumocanious. They
progress depending on length of service and proceed with the mucus affection of
the top respiratory ways. Pathological changes in bronchial-pulmonary system
are accompanied by misbalance in proteinaz-inhibitoric system. It is shown with
increasing proteolitical activity of 5,4 times and decreasing of inhibitors
level of 1,6 times. It promotes chronic course of pathological process in
bronchial - pulmonary system.
Increasing the degree of dust bronchitis is
accompanied by reduction of vital capacity of lungs, decreasing bronchial tubes
circulation and gas exchange. The development of obstructive emphysema is high
in dust bronchitis in comparison with non-specific diseases of lungs. It is
considered that this phenomenon as clinical feature of development of dust
bronchitis of cement manufacture workers. Histomorphological changes gradually
develop at dust bronchitis. In an initial stage of development they are shown
catarrhal changes in a mucus membrane of bronchial tubes. Further hyalines are
formed; petrifications are formed in pulmonary tissue, per vascular and per
bronchial sclerosis of tissue develop.
The characteristic of glutamine acid and potassium
iodide define the parameters of oxyprolin, lipids in lung tissues and weight of
lung, lymphatic nodules of the 120 experimental animals with 200-220 g weight,
which were under the influence of dust. The research showed decreasing of the
level of oxyprolin to 31,2 %, lipids
to 19 %, weight of lung to 16.1% and lymphatic nodules to 18,2 % after using
the medicine. Similarly, using glutamine acid and potassium iodide showed that
the given medicine significantly stop the growing of pathology and decreasing
of complication risk. The glutamine acids and potassium iodide should be
penetrated for treatment and prophylaxis of patients with dust bronchitis in
hospitals.
The received scientific results have let the health
officers of department of labour hygiene and occupational diseases recommend
the additional sanitary - hygienic and sanitary - technical measures directed
to improvement of working conditions and recovering of working health in dust
manufactures of cement plants. The doctors of sanitary department are offered
the methods of before nozological
diagnostics of dust diseases of bronchial-pulmonary system, and the doctors of the
prophylaxis pathological department are additionally recommended preparations
of the glutamine acids and iodine of potassium to the basic medical complex of
the occupational patients.
Literature
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Аманбекова А.У., Газизов О.М.,
Карипбекова Д.К., Джакупбекова Г.М. Изучение состояния верхних дыхательных
путей у больных хроническим пылевым бронхитом // IV Международный конгресс пульмонологов Центральной Азии. – 2004. – Т.10. – С. 8-9.
2.
Головцев Ю.М., Кучеренко Е.М., Довгаленко В.Ф. и др.
Способ доклинической стадий пылевого бронхита // Гигиена труда и
профессиональные заболевания. – 1988. – №1. – С. 46-47.