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Silicatose
Last reviewed: 23.04.2024
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Silicatosis refers to diseases of the respiratory system of the professional sphere, caused by the inhalation of silicate dust.
Silicates are a kind of minerals, consisting of a compound of silicon and other chemical components (magnesium, iron, etc.). It is most common in people whose work is related to the extraction, production, processing and use of silicates.
Silicosis causes healthy pulmonary tissue to be replaced by fibrotic tissue, mainly the lower parts of the lungs are affected, the tissues next to the bronchi, vessels. The category of silicates includes:
- asbestoses,
- talcose,
- cementases,
- silicates, etc.
The most common form of silicosis is asbestosis. Developed by inhalation of asbestos dust. The severity of the pathology is caused not so much by the effect of dust, but by the mechanical damage to the lung tissue asbestos. Pulmonary tissue is then inflamed and replaced by a connective, which adversely affects respiratory function and leads to a number of severe lung diseases. Asbestoses usually develop within 5-10 years under condition of constant contact with dust of asbestos at workers of shipbuilding production, construction, slate production, etc.
Causes of silicosis
Silicate is one of the occupational diseases caused by prolonged systematic inhalation of silicate dust (high in silica). Among the occupational diseases of the respiratory system, silicatoses are more common than all the other groups of pneumoconiosis.
Suffer from this disease, employees of mining, porcelain, metallurgical, machine-building enterprises, as well as in other industries specializing in the manufacture and processing of ceramics, refractory materials and materials containing silicon dioxide.
Getting into the respiratory tract, silicate dust leads to the fact that normal lung tissue begins to replace the connective, there are connecting nodular seals. Accordingly, the function of the lungs begins to be suppressed, the process of penetration of oxygen saturation with the organism is disturbed. In addition, the lungs become more vulnerable to other viral and bacterial infections and increases the risk of developing tuberculosis, bronchitis, bronchiectasis, emphysema.
The mechanism of development of pathology depends not only on the volume and frequency of inhalation of silicate dust, but also on the individual characteristics of the body - physical preparation, immunity.
[Symptoms of silicosis
Symptoms of silicosis - with progressive lesions of lung tissue, dyspnoea also appears, dry cough, after physical exertion, pain in the chest and sputum, in whose samples a large number of "asbestos bodies" are concerned. Also, silicates are accompanied by rhinopharyngitis, laryngitis, pulmonary insufficiency.
In later stages, symptoms manifest themselves as a triad of diseases:
Also silicatoses provoke the appearance of fibrous nodes (benign tumors), affecting the pleura, bronchi, lungs. This is due to the fact that the dust of silicates, getting into the lungs and settling there, causes inflammation, followed by the replacement of normal lung tissue with a dense connective. The most common complication with silicates is pneumonia, bronchial asthma, bronchitis, bronchiectatic disease.
Smoking also aggravates the course of silicosis, increasing the load on the respiratory system. At an early stage, silicates are reversible and treatable, for this purpose, at enterprises with high dustiness and difficult working conditions, examinations with obligatory consultation of a pulmonologist and a phthisiatrist are conducted at least twice a year.
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Diagnosis of silicosis
Diagnosis of silicosis is carried out according to the X-ray study. With controversial issues, a tomography of the thorax is performed in parallel with the chest X-ray. To diagnose at the first stages of the disease, macroradiography, large-scale fluorography, and so on are the latest methods of X-ray study.
On X-ray photographs, the key signs of silicosis are connective tissue nodules that are distinguished by:
- size,
- contours,
- generalization area.
With the started form of silicosis, the bronchi and roots of the lungs in the picture are enlarged, the bronchial branch is partially atrophied, the organs in the mediastinum are displaced, the lymph nodes are not uniformly calcined. Foci of emphysema in the pictures are visible even at the initial stage of the disease as clear spots. Pleura in the pictures in places has thickenings, adhesions, locally fused leaflets.
In addition to radiography, the diagnosis of silicosis is based on the characteristics of working conditions, the degree of dustiness of the workplace, the composition of the dust, and also on the data of earlier medical examinations. Diagnosis at an early stage and specific treatment helps maintain respiratory function and prevents the development of severe complications.
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Treatment of silicates
The treatment of silicosis is mainly carried out by conservative methods. However, silicosis can not be fully cured, it is possible to slow down the process of fibrous tissue proliferation in the lungs only slightly. The main drug, polyvinyllidine-M-oxide, refers to the latest generation of drugs, which can slow down the growth of fibrous formations in the lungs.
The standard scheme of treatment of silicates is based on:
- Prevention and inhibition of disease progression.
- Treatment of complications.
- Restoration of respiratory function.
- Restoration of metabolism.
To restore the respiratory function, bronchodetics are prescribed, drugs that improve the sputum discharge - Chymotrypsin, Himosin, enzymatic preparations of hyaluronidase (Lidase, Ronidasa) to improve tissue permeability and increase the effect of antibiotic treatment and slow down the growth of fibrous tissue, and oxygen therapy is also prescribed.
With the development of complications (bronchial asthma, bronchoectatic disease, emphysema, pneumonia, bronchitis), appropriate treatment is prescribed in a hospital. In addition to drug therapy in an acute period, treatment in sanatoriums and dispensaries at the place of residence and on the southern coast of the Crimea is shown.
Prophylaxis of silicosis
Prevention of silicosis is the control and compliance with technical and sanitary standards to combat dustiness of the workplace. But in addition, all employees must systematically undergo a medical commission both on the basis of the fact of entering the workplace and during the year, with mandatory chest x-rays. The main task of the medical examination is to timely identify at an early stage occupational diseases of the respiratory system (such as tuberculosis, bronchial asthma, emphysema) for which contact with dust is unacceptable, and at an early stage to detect pneumoconiosis.
Also, preventive measures include: a shorter working day, extended leave and the possibility of additional leave, food at the expense of the company, social benefits and financial compensation, annual allocation of vouchers to sanatoriums, sanatoriums, rest homes and other health trips.
To measures slowing progressing pneumoconiosis (for silicoses, transfer to a place of work with sparing working conditions is shown before the clinical manifestation of the disease), refer employment of patients to enterprises with favorable working conditions that exclude the burden on the respiratory system.
Prognosis of silicosis
The prognosis of silicosis depends on the form and stage of the disease, the presence of concomitant complications. The most severe prognosis for the disease is silicosis, berylliosis, asbestosis. With the confirmation of these types of pneumoconiosis, the progressive lesion of the lung tissue does not cease even after the contact with the silicate dust has ceased. These dust compounds can accumulate in the lung tissue and this often causes the disease after a long time after stopping work in a dusty environment.
Other types of pneumoconiosis (caused by prolonged inhalation of mixed dust) have an easier flow without intensive progression. From one stage of the course of the disease to the next, it can take 5-10 years, and during this time the process of fibrotic stabilization is stabilized, and only the diseases of the respiratory system-bronchitis, pneumonia, emphysema, bronchiectatic disease, etc., can complicate the course.
The easiest form of silicates is siderosis, baritosis, etc. They are caused by inhalation of radiopaque dust and with these diseases the probability of recovery with complete lung purification is very high.
It is impossible to cure completely pneumoconiosis, but with timely diagnosis and maintenance therapy, it is possible to maintain respiratory function of the lungs and metabolism, while preventing the development of possible complications.