The Rules of Diagnostics and Confirmation of Diagnosis of Occupational Diseases

Acute occupational diseases:

· The diagnosis of acute occupational disease must be made by any doctor, who receives a patient, because it has characteristic clinical symptoms;

· The doctor in case of acute occupational disease must write Emergency Notice about acute occupational disease and send it to the department of hygiene of work of Rospotrebnadzor;

· The doctors of Rospotrebnadzor after receiving such Emergency Notice within 24 hours must go to the place of patient’s work and make sanitary inspection of working conditions (as for availability of harmful occupational factor at a level higher than hygienic norms) and write the official Act of sanitary investigation case of acute occupational disease;

· Official diagnosis of acute occupational disease can be made only after proving the availability of harmful occupational factor at a level higher than hygienic norms.

 

Chronic occupational diseases:

· The diagnosis of chronic occupational disease can be made only by a doctor-specialist in occupational pathology, working in special department or hospital of occupational pathology,

· After making diagnosis of chronic occupational disease this special department or hospital of occupational pathology informs the local Rospotrebnadzor (where the patient lives or works) about the case of chronic occupational disease;

· The doctors of department of hygiene of work of local Rospotrebnadzor within 7 days must go to the place of patient’s work and make sanitary inspection of working conditions (as for availability of harmful occupational factor at a level higher than hygienic norms) and write official Act of sanitary investigation case of chronic occupational disease;

· Official diagnosis of chronic occupational disease can be made only after proving the availability of harmful occupational factor at a level higher than hygienic norms.

The basic directions of prevention of occupational diseases include the following:

· Normative-legislative measures. TheCLL (the Code of Laws on Labour), State Standards, Sanitary rules, etc.

· Hygienic measures:preventive and current sanitary inspection.

· Medical-preventive measures: preliminary and periodic physical examinations, medical prophylactic nutrition.

· Sanitary education of workers about harmful and dangerous occupational factors and occupational diseases.

· Technological measures on decrease or elimination of OHF.

· Individual means of protection.

Occupational Dust Pathology and its Prevention

Dust as an Occupational Harmful Factor

Effect of dust on workers is observed in mining and coal industry, in the building industry (cement, etc.), at metalworking, in agriculture, etc.

Classification of Industrial Dust

v According to origin:

Ø inorganic (mineral, metal),

Ø organic (vegetative, animal, polymeric),

Ø mixed.

v According to formation:

Ø aerosols of desintegration (at crushing solid bodies),

Ø aerosols of condensation of vapours on metal particles

v According to dispersion:

Ø visible (the size of particles > 10 microns)

Ø microscopic (2.5-10 microns)

Ø ultramicroscopic (< 0.25 microns)

The size of dust particles determines the depth of their penetration into lungs and area of damage.

v According to effect on organism:

Ø toxic (manganese, lead, arsenic, etc.),

Ø irritating (limy, alkaline, etc.),

Ø infectious (microbes, spores, etc.),

Ø allergic (woolen, synthetic, etc.),

Ø carcinogenic (asbestos, etc.),

Ø fibrinogenic (pneumoconiotic), containing silicium.

v According to toxicity:

Ø nontoxic dust (soil, wood) - maximum permissible concentration is 10 mg/m3;

Ø toxic dust - silicate containing silicon (maximum permissible concentration is 1 mg/m3), lead dust (maximum permissible concentration – 0.01 mg/m3).

At hygienic characteristics of dust the chemical composition, dispersion, solubility in blood, hardness, absorption properties are taken into account.

Effect of Dust on Organism

There are different ways of getting dust into organism:through inhalation, deglutition with saliva and mucus, through skin.

Nonspecific effect: the action of dust may cause the diseases of respiratory organs, mucous membranes of eyes, skin. It contributes to the development of tuberculosis, allergic diseases.

Specific effectis manifested in theformation of pneumoconiosis, carcinogenic action.

Pneumoconiosis are the most common dust occupational diseases.

There are: Silicosis (effect of silicon dioxide), silicatosis (dust of silicic acid salts), asbestosis, anthracosis(coal dust) refer to them. The can also develop at effect of metal dust.

Silicosis is the most common type of pneumoconiosis. Pathogenesis: dust particles in the lung tissue are absorbed by histiocytes, thus fibroblasts are formed leading to the formation of collagenic fibres (connective tissue) which results in reduction of lung surface.

Symptoms and signs: respiratory insufficiency of different degree of severity, bronchitis, pneumonia, emphysema.

Classification of Pneumoconiosis

· Pneumoconiosiscaused by effect of highly and moderately fibrinogenic dust (the content of free silicon dioxide SiO2 > 10 %): silicosis,anthracosilicosis, silicosiderosis, silicosis complicated by tuberculosis – silicotuberculosis.

· Pneumoconiosiscaused by effect of low fibrinogenic dust (SiO2 < 10 %): silicatosis (asbestosis, etc.), carboconiosis (anthracosis, etc.), byssinosis (vegetative dust).

· Pneumoconiosisfrom aerosols of a toxic-allergenic action: berylliosis, aluminosis, farmer’s lung, chronic pneumonia with allergenic component.

Diagnostics of Pneumoconiosis

Morphologic forms are:

· nodular

· interstitial

· mixed

According to the course of disease the forms are divided into:

· slowly progressing

· quickly progressing