International Union for Circumpolar Health Ministry of Public Health and Social Development of RF Russian Academy of Medical Sciences Siberian Branch of Russian Academy of Medical Sciences Siberian Branch of Russian Academy of Sciences Medical Polar Fund “Science” The Northern Forum

Abstracts

Occupational health

The problem of research of COPD in the labour medicine clinics is connected with the proved part of industrial aerosols in reversible components of bronchial obstruction development. Frequency of COPD in dust exposure occupations increases with the age, increase of length of exposure to industrial factor and smoker index. It is higher among workers of metallurgical, coal industries and vehicle building.

Our researches on COPD epidemiology at the huge factory of atomic branch and plain building testify for 180 to 324 cases to 1000 of workers. The disease reveals both at men and women equal who have intensive smoking or period of working of more than 20 years.

Knowing features of dust and toxic rhino-, pharingo-, bronchopathology in workers of high occupational hazard of COPD development we can suppose participation of additional mechanisms of inflammation development during this disease.

Preliminary data testify for prevalence of ThI-dependent immune response with CD8 lymphocyte activation and monocyte-macrophage association.

We revealed connection between immune mechanisms of inflammation and cellular hemostasis changes and early endotheliopathy forming during occupational bronchoobstructive syndromes. This is proved by significant changes of content of Ville brand factor, endothelin, spontanous and inducted trombocyte aggregation, N-oxide.

The special role of the test of reexposition of the patient to his working place and bronchocytological research during bronchoalveolar lavage in the same row with FEV1 and FEV1/FVC and postbronchodilataition research is shown. Desundent atrophy of bronchus with mucocilliar clearance depression, significant degenerative changes of epithelium structures, accompanying tracheobronchical dyskinesia are significant for connection between bronchoobstructive process with occupation. We defined optimal schemes of prophylaxis and treatment different stages of COPD depending on presence of irritated high respiratory tracts syndrome, phreoncontaining inhalators intolerance, rhythm of exposure to occupational aerosol during day we revealed advantage of early prescribe (at the first stage of COPD) of prolonged cholinoblokers (thiotropium bromide) to prevent ventilation impairments. It is proved additional prescribe of endothelioprotective medicine. Besides we noted the need of prophylactic grip vaccination in those patients.

That is why, COPD in high risk of COPD patient is characterized by clinic immunological and hemostasis features, which need optimization of tactics of treatment and prophylaxis.

Note. Abstracts are published in author's edition

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Last update: 06-Jul-2012 (11:52:05)