Ukrainian journal of occupational health 4(57) 2018

https://doi.org/10.33573/ujoh2018.04.040

Rubtsov R. V.

Significance of some changes in indices of inflammation in workers with combination of pneumoconiosis and chronic obstructive pulmonary disease engaged in mining and metallurgical industry

State Institution "Ukrainian Research Institute of Industrial Medicine", Kryvyi Rig

Full article (PDF), UKR

Introduction. Chronic obstructive pulmonary disease (COPD) of occupational etiology and pneumoconiosis (PC) are, at present, the most prevalent types of occupational pathology among workers of the mining and metallurgical industries. These diseases have common etiological factors and pathogenetic mechanisms, based on the processes of systemic and local inflammation. The studies of these mechanisms in the combined course of PC and COPD, using widely accessible and understandable methods, have not been conducted so far. Therefore, it is quite relevant to study peculiarities of some inflammatory parameters in patients with PC in combination with COPD.

The aim of the research was to study the peculiarities of changes in some indicators of the inflammation activity in workers with PC in combination with copd of mining and metallurgical industry.

Materials and methods of research. Some parameters of the leukocyte formula, indices of inflammation and approximate evaluation of the immune status in workers of mining and metallurgical industry with combination of PC and COPD have been studied. There were examined 99 patients. The comparison groups included: 21 patients with PC and 515 patients with COPD of occupational etiology; the control group consisted of 21 healthy workers.

Results. Some parameters of the general blood test in mine workers with combination of PC and COPD exceeded those in the comparison groups: leukocytes – from 9,2 to 13,4 %, eosinophils – from 7,8 to 11,8 %, stab leukocytes – from 15,5 to 40,0 % and the erythrocyte sedimentation rate (ESR) index was higher from 2,13 to 2,67 times. The indices of inflammatory activity in these patients were higher than in the groups of patients with PC and COPD: leucocytes ratio to erythrocyte sedimentation rate (LCESR) – from 21,8 to 32,1 %, neutrophils ratio to erythrocyte sedimentation rate (NESR) – from 8,7 to 26,2 %, non-segmented neutrophil ratio to erythrocyte sedimentation rate (NSNESR) – from 41,1 to 63,6 %, and the total activity index (TAI) – from 15,1 to 30,2 %. The indices of the indicative estimation of the immune status leucocytic index (LI) and index of neutrophiles and lymphocytes correlation (INLC) in patients with the combination of PC and COPD, as well as patients with COPD, were higher by 60,0 and 40,0 % and by 12,0 and 8,0 %, respectively For patients with PC in combination with COPD the LI and INLC values were higher than in patients with PC and COPD, which exceeded the values in these groups by 60,0 and 14,2 % and by 27,2 and 3,7 %, respectively.

Conclusion. High activity of systemic inflammatory processes with significant tension of links of the cellular and humoral immunity, activation of cells of specific and non-specific defense, the growth of hypersensitivity of immediate and delayed types, developing as a result of the mentioned changes and which define the course of the disease revealed workers of the mine and metallurgical industry according to indices of the general blood test, indices of inflammatory activity and indicative estimation of the immune status. The revealed changes can help to better understand mechanisms of PC development in combination with COPD in order to develop measures of their timely diagnostics, treatment and prevention in workers of mine and metallurgical industry.

Key words: pneumoconiosis, chronic obstructive pulmonary disease, workers, mine and metallurgical industry, inflammation, indices

References

  1. Abrosimov V. N. (2012), "Chronic obstructive pulmonary disease and pneumosclerosis – one more phenotype", Pulmonolohiya, 4, 95–99.
  2. Velichkovskiy B. T. (1998), "The main pathogenic mechanisms of occupational pulmonary disease of dust etiology", Meditsina truda i promyshlennaya ekologiya, 10, 28–38.
  3. Kosarev V. V. (2009), "Dusty lung or pulmonary dust disease", Gigiyena truda i professionalnyye zabolevaniya , 8, 34–39.
  4. Malashenko A. V. (2006), "On interrelation of pneu­moconiosis and dust bronchitis in the formation of lung pathology", Meditsina truda i promyshlennaya ekologiya, 1, 22–26.
  5. Metodychni rekomendatsii: "Zasosuvannya klasy­fikatsii pneumokonioziv v Ukrayini" 2002, [Methodological recommendations "Use of the classification of pneumoconiosis in Ukraine", approved by the Ministry of Health of Ukraine of 26.06.2002 and agreed by the National Academy of Medical Sciences of Ukraine on 07.08.2002, Ministry of Health of Ukraine, Kyiv.
  6. Kundiev Yu. I., Basanets A. V. (2012), Pnevmokonioz: epidemiologiya, rannya diagnostyka, profilaktyka.Pneumoconiosis: epidemiology, early diagnostics, prophylaxis, Avicenna, Kyiv.
  7. Pertseva T. O., Konopkina L. I. (2007), "The role of systemic inflammatory markers in formation of an immune response on infection/colonization in patients with chronic obstructive pulmonary disease", Ukrayinskyi pulmonolohichnyi zhurnal, 1, 22–25.
  8. On approval and implementation of medical and technological documents on the standardization of medical care in chronic obstructive pulmonary disease. (2013), Order of the Ministry of Health of Ukraine, No. 555, available at: http://www.goldcopd.com/.9.
  9. Smirnova E. L., Poteryaeva E. L., Maksimov V. N. and co­authors. (2016), "A prognostic role of genetic markers in the formation of pneumoconiosis in the postcontact period", Meditsina truda i promyshlennaya ekologiya, 11, 41–44.
  10. Shpagina L. A., Poteryaeva E. L., Kotova O. S. and co­authors. (2015), "Actual problems of pulmonology in modern occupational practice", Meditsina truda i promyshlennaya ekologiya, 9, 11–14.
  11. Global Initiative for Chronic Obstructive Lung Disease (GOLD). Poket guide to COPD diagnosis, management and prevention 2017. URL: https:// goldcopd.org. (Last accessed 23.10.2018).

ORCID ID of author:

Rubtsov R. V. (ORCID ID 0000-0001-6875-1239)