Collection Occupational hygiene, Issue 27, 1991 year

On the features of the pathogenesis of occupational pathology of the bronchopulmonary system in ferrous metal welders

I. P. Lubyanova

doi

Kiev Research Institute of Occupational Hygiene and Occupational Diseases

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The welding aerosol, complex in composition and variable in the number and toxicity of its constituent components, plays a leading role in the development of the main pathological changes in workers of welding professions, whose working conditions are characterized by the effect on the body of a complex of unfavorable factors.

At present, at mechanical engineering enterprises, the main part of welding work is welding of carbon, low, medium and high alloy steels by manual and mechanized arc method. The high productivity of semi-automatic welding in a shielded gas environment with solid wires or flux-cored wires, in contrast to manual arc welding with electrodes, is associated with an increase in the density of welding operations (up to 90% of a work shift), which, accordingly, increases the intensity of the adverse effect of production factors, including and welding aerosol on the working organism. The main part of the aerosol when welding steels, along with oxides of manganese, silicon, chromium, nickel, carbon, nitrogen, as well as fluorine compounds, the content of which varies depending on the welding method and the qualitative composition of steel up to 45% or more, are iron oxides.

In the structure of occupational pathology developing in welders under the influence of welding aerosol, the main place is occupied by pneumoconiosis and chronic bronchitis [3, 9].

According to the literature [4, 10], a hereditary predisposition to iron accumulation is inherent in heterozygous carriers of the hemochromatosis gene, the prevalence of which in the Caucasian population reaches 10%.

The accumulation of iron in tissues is largely due to a decrease in the content of transferrin, total serum iron-binding capacity (TIBC) and an increase in the percentage of transferrin iron saturation (SAT) [5, 8].

The development of pneumoconiosis in welders is accompanied by a decrease in TIBS and an increase in the percentage of SAT compared with these indicators in patients with chronic bronchitis and in practically healthy welders, which is characteristic of primary and secondary hemochromatosis and indicates the general pathogenetic mechanisms of the development of interstitial fibrosis in the lung tissue.

The role of individual predisposition (genotype) in the development of pneumoconiosis or chronic bronchitis in welders is confirmed by the data on the distribution of blood antigens of the ABO and Shc systems. Thus, among welders with pneumoconiosis, it is much more common than among people in the control group [5, 7] and patients with professional chronic bronchitis , there were individuals with blood group A (II) and Pb_. Chronic bronchitis was more common among welders with antigens B (III) blood group.

Thus, additional data on the pathogenetic role of iron in the development of occupational pathology of the bronchopulmonary system in welders explain some of the features of its clinical manifestations. Further study of this problem, in our opinion, will allow expanding and deepening information about the diagnostic criteria, predicting the development and course of occupational pathology in welders, and developing the necessary therapeutic and preventive measures.

References

  1. Bol'shakov V. VFilippov A. A. Gemokhromatoz//Klin. khirurgiya.—- 1983. — № 8. — S. 62—65.
  2. Vershinina K. YA., Grinberg I. I. Sluchay generalizovannogo gemokhromatoza TS Arkh. patologii. — 1987. — T. XI, vyp. 6. — S. 63—66.
  3. Gorbat L. I., Krasnyuk Ye. P., Faktorov I. Ye. Vliyaniye usloviy truda na sostoyaniye zdorov'ya i zabolevayemost' rabochikh v svarochnom proizvodstve// Occupational hygiene. — 1983. — Vyp. 19. — S. 40—49.
  4. Yeliseyeva O. M. Porazheniye serdtsa pri gemokhromatoze (diagnostika i lecheniye) // Terapevt, arkhiv. — 1987. — № 8. — S. 159—160.
  5. Zilva Dzh. F., Pennell P. R. Klinicheskaya khimiya v diagnostike i lechenii: Per. s angl. — M.: Meditsina, 1988. — 528 s.
  6. Idel'son L. I. Gipokhromnyye anemii. — M.: Meditsina, 1981. — 192 s.
  7. Mostovoy YU. M., Kandybal'skiy V. V. Raspredeleniye geneticheskikh markerov krovi u bol'nykh khronicheskim bronkhitom//Vracheb. delo. — 1988. — № 3.— S.' 90—92.
  8. O diagnostike nasledstvennogo gemokhromatoza / Tokarev YU. N., Kagan I. Ye., Settarova D. A. i dr.//Klip, meditsina.— 1988. — № 12. — S. 90—93.
  9. Sostoyaniye zdorov'ya rabochikh, zanyatykh svarkoy chernykh metallov v srede uglekislogo gaza i nerzhaveyushchey stali / Lubyanova I. P., Timofeyeva N. T., Rossiyskaya L. N. i dr.//Occupational hygiene.— 1983. — Vyp. 19. —S. 51—56.
  10. Tokarev YU. N., Settarova D. A. Mekhanizmy vozdeystviya i klinicheskiye proyavleniya peregruzki organizma zhelezom pri nasledstvennom gemokhromatoze (obzor) //Gematologiya i transfuziologiya. 1987. — T. XXXII, № 2. — S. 51—57.
  11. Tokarev YU. N., Settarova D. A. Nasledstvennyy gemokhromatoz // Klin, meditsina. — 1988.—№ 3. — S. 136- 142.
  12. Toropov A. A., Likhacheva II.. Zalomova V. II 11nsvmokopioz elektrosvarshchikov potochnykh p komplokspo-aitomatpzirovannykh liniy na predpriyatiyakh tyazhelogo mashinostroyeniya // Professional'nyye bolezni pylevoy etnologii.— M.: NII gigiyeny nm. <1>. F Ernsmapa, 1988. -- S. 81—84.
  13. Epidemiologicheskiye poperechnyye issledovaniya no profpatologii u svarshchikov / Shneyder V. D., Grund V., Liyebikh F. i dr.//Occupational hygiene.— 1984. —- Vyp. 20. — S. 8—12.