PECULIARITIES OF RESPIRATORY ORGANS DISEASES IN SMELTERS DEALING WITH TITANIUM ALLOYS UNDER COMBINED EXPOSURE TO FINE-DISPERSE DUST AND CHLORINE COMPOUNDS

Abstract

Introduction. Harmful working conditions, specific for titanium production enterprises, pose a potential risk to the workers health, and, primarily, concerning the development of respiratory pathology. Material and methods. The observation group consisted of 111 smelters of titanium alloys; the average age is 35.9 ± 2.7 years; the average term of service is 11.4 ± 6.3 years. The comparison group included 47 representatives of the enterprise administrative apparatus of the same age (37.4 ± 1.5, p> 0.05), having an average work experience of 12.8 ± 2.3 years (p> 0.05). The analysis of medical documentation, working conditions, a comprehensive survey of workers, static processing of the results was carried out. Results. Working conditions at workplaces for smelters are classified as “harmful”, the degree of harmfulness acconted of 3-4 (the class of working conditions 3.3 - 3.4). In the structure of the overall morbidity of the examined observation group, respiratory pathology ranked first and was characterized by a high degree of production causality (RR = 2.90; 95% CI = 1.81-4.64; EF = 65.49%). According to the ECHO-DKG data, 10.8% of titanium alloy smelters with 12.3 ± 3.5 years of experience had thickening of the interventricular septum, increased pressure in the pulmonary artery and the presence of right ventricular diastolic dysfunction. Discussion. Smelters have chronic catarrhal inflammation of the mucous membranes of the upper respiratory tract in the first year of operation; the activity of the pathological process increases significantly with the experience of 10 years and is accompanied by the predominance of the hyperplastic nature of inflammation with an increase in work experience of more than 10 years. Subsequently, the lower parts of respiratory tract are involved in the process. With an experience of 12.3 ± 3.5 years, reversible violations of the bronchial patency become persistent irreversible, which is accompanied by the development of basal emphysema of the lungs and morphological restructuring of the right heart. Conclusion. Because of combined long-term exposure to dust, a fine fraction and compounds of chlorine and chlorine vapor, causes the damage of the airways at all levels of the respiratory tract.