Pulmonary ventilation and gases exchange disorders in workers engaged into refractory materials production

Introduction. Occupational exposure to dust in concentrations sometimes exceeding allowable norms, infl uence of associated hazards (irritating gases, toxic chemicals, unfavorable microclimate at workplace, heavy physical work) cause occupational and occupationally conditioned bronchopulmonary diseases and lower work capacity in workers with main occupations of refractory materials production.

Objective. To study functional state of respiratory system for diagnosis of early disorders of pulmonary ventilation and gases exchange in workers of moulded refractory materials production.

Materials and methods. Prospective randomized study included apparently healthy male workers (n = 61) of refractory materials plant producing chamott e-silica and spinel-periclase-carbon refractories. Clinic of Ekaterinburg medical research center in 2017–2018 provided examination of carriers (n=21) in spinel-periclase-carbon refractories production shop and pressmen (n=40) of moulding area in chamott e-silica refractories production, aged 27 to 60 years, with length of service in hazardous conditions from 4 to 37 years. Bodyplethysmography helped to assess general lung capacity (GLC), residual lung volume, ratio of residual lung volume to general lung capacity, functional residual lung capacity, bronchial resistance and diff usion lung ability by carbon oxide via single inspiration method. For nonventilated lung volume, the authors used ∆ GLC value that is a diff erence between GLC values measured via bodyplethysmography and via helium dilution in single inspiration maneuver.

Results. Obstructive syndrome (6.5%) was a main type of ventilation disorders among the examinees, and equally frequent among the workers engaged into spinel-periclase-carbon refractories production (9.5%) and in those engaged into chamott esilica refractories production (5%). Th e workers engaged into spinel-periclase-carbon refractories production had obstructive syndrome associated with lung hyperinfl ation, and those engaged into chamott e-silica refractories production had also a tendency to restrictive disorders. Lung gases exchange disorders were seen in one third of the examinees, equally frequent in both workers engaged into spinel-periclase-carbon refractories production and those engaged into chamott e-silica refractories production, manifested in 2 variants: lower diff usion lung capacity (fi rst variant) and lower diff usion lung capacity with increased ∆ GLC (second variant).

Conclusion. Th e study results prove necessity of bodyplethysmography and diff usion lung capacity diagnosis  to reveal perfusion and ventilation disorders at early stages in workers engaged into spinel-periclase-carbon refr actories production over 8 years and in those engaged into chamott e-silica refr actories production over 12 years. 

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