Može li se spriječiti pojava bronhijalne astme u radnika u elektrolitskoj ekstrakciji aluminija?

Bronchial reactivity was evaluated in a group of 35 workers at preemployment examination using the metacholine lest. Three workers showed an increased bronchial reactivity, the rate being in accordance with the previous experience. Ten randomly chosen subjects with normal reactivity, who were engaged as potroom workers, were followed up during a two-to-five-year period. None of them experienced any significant respiratory complaints and their bronchial reactivity also remained normal. Only one worker had a borderline finding (PD20FEV1). Although selection al preemployment medical examination is a measure that has to be used only exceptionally, based on the finding obtained by non-specific bronchoprovocation challenge it seems that it can be recommended in the case of that particular exposure.Od 35 radnika testiranih metakolinskim testom u okviru zdravstvenog pregleda prije primanja na posao, 32 su imala uredan nalaz a trojica su pokazala povećanu nespecifičnu reaktivnost bronha. Nakon provedene selekcije, 10 radnika koji su na temelju urednog nalaza primljeni na rad u pogon elektrolitske ekstrakcije aluminija praćeno je u razdoblju od dvije do pet godina. U tom vremenskom intervalu nitko od njih nije razvio nikakve značajnije respiratorne tegobe. Kontrolni metakolinski testovi pokazali su također nalaze u granicama normoreaktivnosti. Jedino je jedan radnik razvio granični nalaz testa (PD20FEV1). Dobiveni rezultati, makar se radi o malom broju ispitanika, upućuju na opravdanost da se preporuči selekcija prilikom prethodnih pregleda korištenjem testa nespecifične reaktivnosti bronha. Međutim, kada je riječ o tvornici na koju su se ispitivanja odnosila, treba nažalost, navesti da je već početkom ratne agresije na Hrvatsku ona onesposobljena za daljnju proizvodnju

Učestalost dišnih tegoba kod radnika u elektrolizi aluminija i njihova povezanost s promjenama spirometrijskih vrijednosti

The goal of this study was to examine the prevalence of chronic respiratory symptoms in potroom workers and to compare these results with changes in spirometric parameters. A modified questionnaire on respiratory symptoms from the British Medical Research Council was used to take the medical history data about respiratory symptoms. Spirometric parameters were determined on the same day (as a part of regular checkups) using the Jaeger spirometer. The study included 215 potroom workers from the aluminium factory in Podgorica, Montenegro. All subjects were men, but they differed in age and duration of work. The group used for comparison consisted of 81 unemployed male applicants for jobs in the factory who had never been exposed to this kind of air pollution before. Potroom workers mostly complained of breathlessness associated with the workplace (56.7 %) or weather changes (rain, cold wind, and humidity) (41.9%) and of dyspnoea when climbing stairs (51.2 %), but only 22.3 % reported using medication to treat these episodes. Most workers reported to have been smoking at the time of the study (62.4 %). Spirometric data showed only insignificant variations compared to the expected values (CECA standards). Chronic obstructive pulmonary disease (COPD), characterised by FEV1/ VC % <88 % was found in only 17 (7.9 %) potroom workers, while asthma was identified in 9 (4.2 %). Although the prevalence of chronic respiratory symptoms reported by the examined potroom workers was quite high at the group level, they were not associated with ventilatory impairments.Cilj rada bio je da se kod radnika u pogonu elektrolize aluminija ispita učestalost respiratornih simptoma koji imaju kroničan karakter i da se usporedi s učestalošću promjena spirometrijskih parametara kod istih osoba. Anamnestički podaci o respiratornim simptomima uzimani su s pomoću modificiranog upitnika o respiratornim simptomima Britanskog savjeta za medicinska istraživanja. Spirometrijski parametri određivani su ispitanicima istoga dana (u sklopu njihova periodičnog pregleda) s pomoću spirometra marke Jaeger. Skupinu ispitanika činilo je 215 radnika pogona elektrolize Kombinata aluminijuma u Podgorici. Svi ispitanici bili su muškog spola, a različite dobi i dužine ekspozicije u elektrolizi. Istodobno je na jednak način ispitana skupina od 81 radnika također muškog spola, svi kandidati za radno mjesto u istoj tvornici, koji do tada nisu bili izloženi toj vrsti aeroonečišćenja. Najčešći respiratorni simptomi kod radnika u elektrolizi bili su napadaji gušenja na radnome mjestu (56,7 %), dispneja pri usponu (51,2 %) i utjecaj vremenskih prilika (kiša, hladan vjetar, povišena vlažnost zraka) na disanje (41,9 %). Međutim, tek je četvrtina (22,3 %) navela da pri napadu gušenja uzima neki od medikamenata. Među pregledanim radnicima bilo je najviše aktivnih pušača (62,3 %). Istodobno, vrijednosti ventilacijskih volumena pokazale su samo neznatna odstupanja od očekivanih (po standardima CECA), a prevalencija kronične opstruktivne plućne bolesti (KOPB) definirana kriterijem FEV1/VC % < 88 % nađena je samo kod 17 (7,9 %) radnika. Na osnovi ovog istraživanja zaključili smo da je učestalost respiratornih simptoma koje prijavljuju radnici elektrolize aluminija visoka, ali da nju ne prate adekvatni pomaci objektivnih pokazatelja kakvi su spirometrijski

Possible mechanisms of non-specific respiratory effects of certain types of occupational exposure

Sažeti su rezultati vlastitih istraživanja koji se odnose na nespecifične respiratorne učinke pojedinih profesionalnih izloženosti. Mogući mehanizmi takvih učinaka svode se na opetovane mehaničke lezije sluznica bronhijalnog dijela respiratornog trakta npr. u prolongiranoj izloženosti prašinama, zatim u remećenju procesa čišćenja (clearance) alveola i dišnih puteva s posljedična povećanom sklonošću infekcijama pa i kroničnih oštećenja (mangan) te induciranoj hiperreaktivnosti bronha sa slikom bronhalne astme i bržim smanjenjem ventilacijskih funkcija pluća u odnosu na očekivani pad u funkciji životne dobi. U dijelu registriranih učinaka ističe se i moguće značenje kombinirane izloženosti aerosolima krutih čestica malog aerodinamskog promjera i plinovitih nadražljivaca. Adsorpcijom na čestice prašine plinoviti nadražljivci gornjeg dijela respiratornog trakta prenose se u duboke dijelove u koje inače ne prodiru i gdje se, zbog toga Što je adsorpcija reverzibilna veza, oslobađaju pa mogu uzrokovati lokalni iritativni učinak. Razumije se da u evaluaciji registriranih oštećenja treba imati u vidu i ulogu drugih faktora iz okoline i posebno naviku pušenja s obzirom na mogući aditivni a ponekad i sinergistički učinak.A summary is made of the author\u27s research related to non-specific respiratory effects of certain types of occupational exposure. Possible mechanisms of such effects are a) repeated mechanical lesions of the mucous membrane in the bronchial part of the respiratory tract, e.g. in prolonged exposure to dusts, b) disturbance in the process of clearance of the alveoli and respiratory pathways, resulting in increased tendency to infection, and chronic damage (manganese), and c) induced hyperreactivity of the bronchi with symptoms of bronchial asthma and faster reduction in ventilatory lung function in relation to the expected fall with regard to age. The possible significance of combined exposure to aerosols of solid particles of small aerodynamic diameter and gaseous irritants is emphasized. By adsorption on dust particles the gaseous irritants of the upper part of the respiratory tract are carried deep into areas not usually penetrated, where, because adsorption is a reversible bond, they are released and can cause a local irritative effect. When evaluating the registered damage the role of other environmental factors should be kept in mind, particularly the habit of smoking, because of the possible supplementary and occasionally synergistic effect

Asthma in aluminium electrolysis workers

Prikazan je ukratko pregled radova i opažanja koji se odnose na pojavu respiratornih smetnji tipa bronhalne astme uočenih i opisanih u proizvodnji aluminija. Vlastita istraživanja provedena u jednoj tvornici, koja se u elektrolitskoj ekstrakciji aluminija koristila Alu-Swiss procesom s pretpečenim anodama, upućuju po prvi puta na to da se radi o simptomima koji bi se mogli objasniti bronhalnom hiperreaktivnošću. Dodatno ispitivanje usmjereno ocjeni mogućeg udjela alergije nije dalo rezultate koji bi takav mehanizam potvrditi. U vezi s respiratornim učincima izloženosti istaknuta je moguća uloga adsorpcije plinovitih fluonida (i sumpornog dioksida) na čestice koje se ovisno o veličini unose u dublje dijelove bronhijalnog aparata. Na tim mjestima se tako unijeti plinoviti nadražljivci mogu dijelom osloboditi uzrokujući lokalni iritativni učinak na mjestu gdje se oslobađaju. Provedena ispitivanja upućuju i na povećani rizik razvoja kronične opstruktivne bolesti pluća u proizvodnji aluminija.The available literature on respiratory disorders such as bronchial asthma reported among workers in the aluminium industry is briefly surveyed. Own investigations. which were conducted in an aluminium plant where Alu-Swiss technology with prebaked anodes is used for electrolytic reduction, led to believe that the symptoms observed could be explained in terms of bronchial hyperreactivity. A separate investigation which was aimed at evaluating a possible allergic reaction showed no evidence confirming such mechanism. A possibility of respiratory intake of fluorides (and sulphur dioxide) through their adsorption on particles is discussed. According to particle size the gaseous irritants are taken deep into the bronchial tree wherefrom they can be partly released causing a local irritating effect. Present investigations point at an increased risk of chronic obstructive lung diseases in the aluminium industry

Problemi morbiditeta radnika s posebnim osvrtom na kronične degenerativne bolesti

Nakon uvodnog dijela, u kojem se ističe značenje kroničnih degenerativnih bolesti u uzrocima izostanaka s posla i invaliditeta radnika, daje se pregled izvršenih radova na tom području. Prikazuje se djelatnost na rješavanju metodoloških problema (sistem medicinske dokumentacije i evidencije; način provedbe sistematskih zdravstvenih pregleda radnika), rezimiraju se provedena ispitivanja o općem morbiditetu radnika u našim prilikama, a zatim se iznose podaci o provedenim epidemiološkim ispitivanjima koronarne srčane bolesti, arterijske hipertenzije i kroničnog bronhitisa u grupama industrijskih radnika

Toxicological problems of environmental protection

U uvodu se ukratko rezimiraju najvažniji izvori onečišćenja različitim toksičnim agensima koji mogu izazvati nepovoljne biološke efekte bilo putem profesionalne ekspozicije, stanovanjem odnosno boravkom u sredini s onečišćenom vanjskom atmosferom ili unošenjem u organizam putem hrane, vode za piće ili upotrebom različitih predmeta. Pored toga razmatra se problem učinka malih količina pojedinih toksičnih tvari kad se one unose u organizam ingestijom ili inhalacijom u toku dužeg razdoblja. Ističe se dalje da u proučavanju toksičnosti pojedinih onečišćenja treba obratiti pažnju i na interakciju različitih činilaca, posebno prehrane. U pogledu toksičnosti pojedinih onečišćenja okoline izdvaja se posebno vulnerabilnost fetusa i djeteta, za što se također navode primjeri. Na kraju se citiraju predloženi prioriteti za izradu zdravstvenih kriterija, kao i preporuke u odnosu na smjerove daljih istraživanja.In the introduction are briefly reviewed the most important sources of pollution with various toxic agents which may produce adverse health effects either through occupational exposure, dwelling in an environment with polluted atmosphere, through intake of food, drinking water or through the use of various objects. The problem of the biological action of small amounts of some toxic substances which enter the organism by ingestion or Inhalation over a certain period of time is also considered. It is pointed out that in the study of the toxicity of some pollutants attention should be paid to the interaction of various factors, particularly nutrition. Examples are given which prove that the fetus and child are specially vulnerable to the toxic action of environmental pollutants. In the end are quoted priority proposals for the setting up of health criteria and recommendations for further research

Criteria for the assessment of asbestos disease as occupational disease

The commentary deals with the development of asbestos disease, its cause and latency, especially in connection with the carcinogenic effect of asbestos exposure. Diagnostic criteria and the approach to disability assessment are summarized. Legislative and organizational aspects in the assessment of the disease as occupational are discussed

Problems of workers\u27 morbidity with particular regard to chronic degenerative diseases

After an introduction dealing with the importance of chronic degenerative diseases as a cause of workers\u27 absenteeism and disability reviewed are studies performed in this field at the Institute for Medical Research. Work on the methodological problems is surveyed (a system of medical documentation and evidence, method of carrying out systematic health examinations in industry), results obtained in studies of general morbidity of Yugoslav workers are summarized and data on completed epidemiological studies of coronary heart disease, arterial hypertension and chronic bronchitis in groups of industrial workers are presented