Anthracosis

Anthracosis is a professional lung disease caused by prolonged inhalation of coal dust. Consider the causes of anthracosis, symptomatology, methods of diagnosis and treatment.

Anthracosis is included in a group of diseases called pneumoconiosis and are professional. The degree of destruction of the pulmonary structure, directly depends on the chemical composition of the dust. Consider the main groups of occupational lung diseases:

• Carboconiosis is a group of diseases that arise from the inhalation of dust with a high content of coal (anthracosis, graphitosis, pneumoconiosis).
• Siderosilikoz, anthracosilicosis - develop when exposed to light mixed dust. Professional diseases of electric welders and gas cutters.
• Pneumoconiosis, arising from the inhalation of dust of organic origin (flax, wool, sugar cane). According to clinical signs, this disease is similar to bronchial asthma or allergic alveolitis.

Pure anthracosis has a long and benign course, unlike silicosis. The thing is that coal dust is well excreted by macrophages through the bronchi and lymphatic drainage of the lungs. If dust contains a high percentage of silicon dioxide, this leads to severe lung sclerosis, that is, mixed pneumoconiosis (anthracosilicosis, silicoanthracosis).

Long-term inhalations of coal dust lead to its local accumulation in the body. In this case, the clusters are invisible until massive pulmonary fibrosis is formed. An accumulation of coal dust or pulmonary anthracosis, appears not only in people working with coal, but also in those who live in an industrial zone and especially in smokers. Dust is found in the lymphatic drainage system, macrophages, around the bronchioles and in the lumen of the alveoli. In people living near industrial areas, dust accumulation rarely causes problems with the lungs. Only coal miners, working for many years in highly dusty mines, have serious consequences.

The prevalence of this disease among miners is about 12%, and among those who work on the extraction of anthracite for more than 20 years, 50% of lung diseases suffer. Among miners mining coal (occupying an intermediate position in the degree of coalification between anthracite and brown coal) anthracosis is rare. Coal dust acts like tobacco smoke, so very often the symptoms of anthracosis are similar to chronic bronchitis.

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Causes of anthracosis

The causes of anthracosis are the inhalation of coal dust over a long period of time. The disease affects people who have a long record of work in the condition of constant exposure to coal dust, that is, miners, workers in dressing plants and other industrial industries.

The defeat of the lungs is due to exposure to silica. Coal pigment contributes to the development of sclerosis, the severity of which depends entirely on the composition of the rock and the nature of the coal. Coal dust does not possess sclerosing properties. Anthracite dust leads to the development of the most pronounced lung injury, in contrast to bituminous coals, and charcoal dust does not cause pathologies at all.

The defeat of the lungs is due to inhalation and prolonged confinement of dust particles, that is, irreversible stretching of small airways. Without timely diagnosis and treatment, the disease begins to progress, it affects both lungs. This leads to an increase in fibrous tissue, fusion of foci of pathology and extensive destruction of the structure of the lungs.

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Lung anthracosis

Anthracosis of the lungs develops in people with a long working experience in mines with a high concentration of coal dust. Everyone who treats coal in unfavorable working conditions is affected. This is a progressive disease that has several stages of development.

The risk of developing pathology is directly related to the intensity and duration of exposure to dust and the individual sensitivity of the organism. Early radiologic changes represent a restructuring of the pulmonary pattern, small nodules appear (focal shadows 1-5 mm in diameter). Lung anthracosis causes calcification in 10% of cases and, as a rule, in patients with long experience in the extraction of anthracite. Tumor form of the disease is the nodal formations in the upper parts of the lungs. The nodular form develops in 10-15% of cases and depends on the type of inhaled coal.

Carbon pneumoconiosis is accompanied by clinical severity, resembling bronchitis and emphysema of the lungs. Patients develop severe disturbances in the external respiration apparatus. Let's consider three stages of the disease:

Stage I

There is rapid fatigue, cough, minor pain in the chest and shortness of breath during physical exertion. In some cases, the disease does not manifest itself and its presence can be recognized only after an X-ray study. In the picture, shallow focal shadows will be seen against the background of a deformed mesh pattern of the lung. The middle sections of the lung are affected, the size of the foci is from 1 to 5 mm.

II stage

Shortness of breath and coughing appear even at rest, chest pains increase. At this point, the symptoms of anthracosis look like bronchitis or emphysema. An x-ray shows an increase in the number of small-focal tissues and their size. Shadows appear in the middle, subclavian and subdiaphragmatic areas. There may be pleural changes in the interlobar crevices and in the diaphragm.

III stage

This stage is rare. The patient suffers from general weakness, severe shortness of breath, there is a cough with phlegm, severe pain in the chest. On the x-ray, massive homogeneous shadows of up to 5-10 cm are visible. Shadows have an irregular shape, but distinct contours are located at different heights, both in one and in both lungs at once. According to the X-ray and clinical signs, anthracosis can be attributed to slowly progressing chronic diseases.

Symptoms of anthracosis

Symptoms of anthracosis do not always make itself felt, at the first stage, the disease may not manifest itself. That is, the primary form of pathology is asymptomatic, but if the pathogenesis is complicated, the patient has a cough, shortness of breath, black sputum. Shortness of breath increases with physical activity. Because of the long course of the disease, sputum becomes thick, yellow or green in color.

• Lung damage develops very slowly, so the main symptoms: cough, general weakness and shortness of breath, can accompany the patient for a long period of time. The disease can lead to pulmonary hypertension, tuberculosis and increased heart volume. In smokers with anthracosis, chronic bronchitis or emphysema is possible.
• Coal dust irritates the bronchial mucosa, causing hypersecretion of bronchial glands and inflammatory reaction, which in its symptoms is similar to manifestations of bronchitis. Due to weakened as a result of emphysema, respiratory crepitations can be determined.
• On roentgen, anthracosis appears as a pronounced expansion and consolidation of the roots and lungs. Clearly visible are small-spotted shadows, which are a reflection of nodular fibrosis, in places of dust accumulation. In this disease for many years can be at one stage of development.
• Rapidly progressing anthracosis is extremely rare. The condition of patients worsens due to adherence to the main disease of pneumonia, emphysema, pulmonary or pulmonary heart failure, chronic bronchitis. Complications significantly change the clinical-renlenological picture of occupational disease.

Diagnosis of anthracosis

Diagnosis of anthracosis begins with a physical examination. At the expressed signs of disease the doctor notices a barrel chest and other symptoms not characteristic for healthy lungs. An obligatory method of diagnosis is chest x-ray. In the picture, you can see small shading in all areas of the lungs, but most of all in its upper sections. If anthracosis takes a complicated form, then on the roentgenogram shows a large opaque area.

With the help of computer and magnetic resonance tomography it is possible to establish the character of anthracosis (massive, spotted, nodular) and the stage on which it is located. If the disease progresses, it leads to an increase in the area of the lesion and the number of tissues. In this case, the evaluation of blood flow and ventilation at different sites of the lung tissue is used for diagnosis. For this study, lung scintigraphy and zonal rheopulmonography are used.

For the study of external respiration, spirometry, pneumotachography, plethysmography are performed. This allows you to determine the type of violations (obstraktivnye, restructive). With a pronounced clinical picture of anthracosis, the patient undergoes bronchoscopy, puncture of the lymph nodes of the lung root and transbronchial lung tissue biopsy. Pulmonary function tests are also performed to assess lung capacity. For the final diagnosis, an analysis is made of the arterial blood gas composition, which provides information on the level of oxygen in the blood. Further diagnosis is completely dependent on the severity of symptoms and the stage of pneumoconiosis.

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Treatment of anthracosis

Treatment of anthracosis is focused on eliminating the symptoms of the disease, reducing oxygen deficiency and preventing infection of the respiratory tract. Treatment and prophylactic measures are carried out on an outpatient basis, less often in a hospital. Patients are prescribed medicines for the expansion of small airways and steroid agents. Healing properties have physical therapy, for example, coughing with percussion and vibration according to a certain scheme, for the complete removal of sputum.

A mandatory condition for treatment is an increase in fluid intake, up to 2-3 liters per day. If the anthracosis is in the first stage, then conventional therapy is administered for treatment, as with respiratory diseases. But if the disease is in the last stages, then the patient is ventilated or breathed oxygen through the mask.

If a patient with a long experience of work in conditions of regular inhalation of coal dust was diagnosed with stage I anthracosis, but there are no functional disorders or complications, then it is not necessary to change the profession. But such people need dynamic medical supervision to monitor their health. If the disease is in stage II or III, complicated by bronchitis and the parameters of external respiration function are violated, the patient is not allowed to work in conditions of contact with dust.

Prevention of anthracosis

The prevention of anthracosis is aimed at reducing the dustiness of the air. To reduce the number of occupational diseases, the coal industry uses a variety of technologies, which are accompanied by a minimum release of dust masses. Periodical preventive examinations of miners are mandatory, once every 6 months. A worker is examined by a therapist, radiologist, phthisiatrist and other specialists. To identify early signs of anthracosis, chest radiographs, blood tests for leukocyte and hemoglobin levels, spirometry are performed.

All workers who are at risk for this disease and other pathologies of a professional nature need general medical and preventive measures. First of all, it is necessary to ensure a rational mode of work and rest, full-fledged nutrition with a high content of vitamins and proteins. It will not be superfluous to exercise and refuse bad habits, especially from smoking. In order to reduce or completely cure the symptoms of pneumoconiosis, it is recommended to avoid infections, undergo annual vaccination against the influenza virus and lead a healthy lifestyle. Such methods help to reduce further progression of the disease.

Forecast of anthracosis

The prognosis of anthracosis depends on many factors: the stage of the disease and the length of service in conditions of inhalation of coal dust, the type of pulmonary involvement, the age of the patient and the individual characteristics of the organism. As a rule, an asymptomatic disease that does not cause complications can dramatically start to progress, after a short period of inhalation of the pathogen. In this case, the risk of complications increases. The prognosis worsens if tuberculosis and other diseases join the lung injury. In especially severe cases, the disease leads to loss of ability to work, cardiac and pulmonary insufficiency.

Anthracosis is a disease that affects everyone whose work is associated with prolonged inhalation of coal dust. The disease has a benign course, but without early diagnosis and treatment can lead to disability and a number of chronic lung diseases.

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