One of objective methods of early and differential diagnosis of occupational pulmonary diseases in miners (pneumoconiosis, silicotuberculosis, dust bronchitis) is bronchoscopy with a cytologic examination of bronchoalveolar lavage fluid (BAF). BAF-examination was carried out in a total of 88 patients with incipient and advanced forms of dust bronchitis, pneumoconiosis and silicotuberculosis. A direct relationship has been revealed between a decline in local cell-bound immunity caused by a dust-inducted affection mononuclear phagocytes and advancing of stages of dust-related diseases.
Clinical and morphological features of cancer were observed in two groups of miners (of Krivoy Rog iron-ore and Zholty Vody uranium mines), working in hazardous labour conditions. In both of groups the disease course had typical features for lung cancer. Roentgenologic changes were observed, central cancer of left and right lung was revealed by bronchoscopy method. In all the cases lung cancer was morphologically proved and classified as squamous. Rapid progression of the disease and late medical aid appealability cause the patients consulted with their doctors only at the stage of II-III, sometimes III of the disease and it makes a distinction of lung cancer in miners of iron-ore and uranium mines. In order to prevent such a late diagnostics all the miners should be referred to the group of risk on lung cancer.
86 miners (age of 30-40) of coal miners were examined. It was ascertained that the level of tension of neurohumoral mechanisms of regulation of myocardium activity and splanchnic function of organism in emotiongenic conditions is determined by the condition of ANS. The secretion of noradrenaline of normotonics prevails, peripheral and central mechanisms of vegetative regulation of chronotropic function of heart start their work, tone of resistive vascular resis slightly. The discharge of adrenaline to blood of vago- and sympatotonic prevails, considerable tension of mechanisms of vegetative regulation of myocardium and expressed rise of tone resistive vascular and breathing frequency are observed. People with parasympatotonic are noted to have the biggest tension of splanchnic and regulative systems. The lower emotional steadiness is typical for them.
Giant mining industry enterprises and huge iron-and-steel works are located in Krivbas. 169 mll. cu. m. of solid waste, over II.8 mll. cu. m. of waste water, nearly 1.3 mll. tons of dust and gaseous substances are created annually through the production process. Data available from numerous investigations both in this country and abroad refer health characteristics in the community to the environmental contamination. Demographic situation in Krivbas is marked by 22.4% reduction in birth-rate over the last 20 years, 49.2% increase in mortality rates. General mortality showed 2.4-fold increase over the last 5 years. The diseases of respiratory, circulatory and digestive organs are found to prevail as are complications of pregnancy and delivery; on the increase are malignant tumours. 1,600-1,700 diseases per 1,000 children are generally recorded. Planning of measures on protection and promotion of the environment (E) is to be carried out in consecutive order according to the E priority factors in their impact on health in the community. It is necessary that a concept of prenosological diagnosis be used in organization of diagnostic centres for detection of groups at risk for development of a pathology, which undertaking will contribute to early diagnosis as well as timely and well-targeted organization of preventive measures. There is a need for the environmental legislation and mechanisms of its implementation to be improved.
Research have been carried out on coal miners of the age of 30-35. It was determined that sympathonics have tension regular system of organism, connected with decline of reserve possibilities of parasympathetic nervous system. In conditions of muscular load it leads to the overstrain of myocardium, worsen of restoration processes, decline of aerobic and physical productivity of organism. High reactivity of vagotonic's sympathetic nervous system in combination with parasympathetic nervous system cause considerable activity of cardiovascular functions with less tension of myocardium and shortage of restoration period. Vital energy maintenance of organism with muscular work of people, having normatonia, take place mainly owing to the function of external breathing and it promotes saving of reserves of circulatory system and progress of a large aerobic and physical capacity to work.
The data submitted suggest that the most effective option in the treatment of rheumatoid arthritis is simultaneous employment of a nonsteroidal anti-inflammatory agent and metatrexate for 1.5 yr and courses of hormonotherapy, exercise therapy, and topical application to the joints of compresses with dimexide, heparin, and analginum as required and ultrasound with hydrocortisone as well. There was no increase in disability rates among patients with rheumatoid arthritis placed on the above combined treatment, which fact is also related to improvement of diagnosis rheumatoid arthritis, well-timed case follow-up, and prescription of courses of prophylactic treatment.