Comparative dynamics of spirometry indicators in patients with different occupational pathologies of the bronchopulmonary system

   Chronic obstructive pulmonary disease is the third leading cause of death in the world. According to studies, 20 % of chronic obstructive pulmonary disease cases are associated with an occupational factor. It seems to be impossible to find in modern publications unambiguous answers to the questions regarding the relationship between chronic bronchitis of occupational etiology and chronic obstructive pulmonary disease, as well as spirometry indicators in dynamics in patients with such pathologies.

   The study aimed to analyze the comparative dynamics of spirometry indicators in patients with chronic bronchitis of occupational etiology CB OE, chronic obstructive pulmonary disease of occupational etiology and pneumoconiosis.

   Materials and methods. In the clinic of the Nizhny Novgorod research institute for hygiene and occupational pathology, 245 trainees occupied in mechanical engineering were examined; they had been exposed to silica-containing dust during their work and were in the post-contact period. The parameters dynamics of the external respiration function was analyzed retrospectively throughout the entire duration of observation (about 10
years).

   Results. According to the data obtained, in half of the patients with the initial chronic bronchitis of occupational etiology forced expiratory volume in 1 second statistically significantly decreased by 21 % over 10 years, and the modified Tiffno index became less than 0,7. At the same time, in the group with initial chronic obstructive pulmonary disease of occupational etiology, the decrease in forced expiratory volume in 1 second was 10 %. Correlative analysis revealed a statistically significant inverse correlation between forced expiratory volume in 1 second and documented disease duration.

   Conclusion. Chronic bronchitis of occupational etiology from exposure to silica dust is a disease with a high risk of transformation into chronic obstructive pulmonary disease of occupational etiology. It should be advised to patients with chronic bronchitis of occupational etiology who are occupied in hazardous industrial conditions to employ somewhere without exposure to silica-containing dust, due to the high risk of the disease progression; also, in-depth examination to detect early signs of chronic obstructive pulmonary disease can be recommended. Thus, patients with chronic bronchitis of occupational etiology require a comprehensive implementation of the recommendations for secondary prevention of chronic obstructive pulmonary disease, which will slow down the progression of respiratory disorders, prevent disability and preserve the capacity of patients to work.

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