Silicosis (from Latin silicium – “silicon”), or chalicosis (from Greek chalix – “calcareous stone”) is a disease that develops as a result of prolonged inhalation of dust containing free silicon dioxide.
It is characterized by diffuse growth in the lungs of connective tissue and the formation of characteristic nodules.
The disease is more often observed in miners of various mines (drillers, cutters, fasteners), foundry workers (sandblasters, cutters, core workers), workers in the production of refractory materials and ceramic products. This is a chronic disease, the severity and rate of development of which can be different and are directly dependent on both the aggressiveness of the inhaled dust (dust concentration, the amount of free silicon dioxide in it, dispersion), and the duration of exposure to the dust factor and the individual characteristics of the organism.
Silicosis, being a chronic disease, often does not bother the sick person for a long time. The initial clinical symptoms are poor: shortness of breath on exertion, chest pain of an indefinite nature, and a rare dry cough. Pain in the chest in the form of tingling, mainly in the area of the shoulder blades and under the shoulder blades, also in the form of a feeling of tightness and stiffness in such patients, is due to changes in the pleura due to its microtraumatization and the formation of adhesions in the pleural cavity due to dust penetrating through the lymphatic system of the lungs. The causes of dyspnea in silicosis are pneumofibrosis, emphysema, and bronchitis. Therefore, in the early stages of the disease, in the absence of severe emphysema and bronchitis, shortness of breath is observed only with great physical exertion.
In addition to the defeat of the respiratory system, with silicosis, changes are observed on the part of other organs and systems. This is evidenced by the infrequent dysproteinemia in the form of an increase in coarse proteins, which is directly dependent on the stage of pneumofibrosis, as well as the presence and severity of the concomitant tuberculous process. There is evidence of a moderate increase in ESR, a trend towards a decrease in the number of erythrocytes and hemoglobin in severe stages of uncomplicated silicosis. On the part of the gastrointestinal tract, functional disorders of secretory activity are noted: an increase in spontaneous secretion of gastric juice, a decrease in the content of hydrochloric acid in gastric juice and the activity of digestive enzymes (pepsin, trypsin, amylase, lipase).
Important for the diagnosis and establishment of the severity of silicosis are studies of the function of external respiration. Disturbances in the function of external respiration may precede the development of the pneumoconiotic process, which, apparently, is a reflex reaction of the body to the introduction of dust. Patients with uncomplicated silicosis are characterized by a restrictive type of respiratory dysfunction. If such patients have chronic bronchitis or bronchial asthma, obstructive respiratory dysfunction is traditionally observed. The assessment of the degree and type of respiratory failure is carried out on the basis of a study of a set of indicators: vital capacity (VC), forced expiratory volume (EF exp.), maximum ventilation of the lungs (MVL), respiratory rate (respiratory rate), maximum air jet velocity per exhalation (MS ex.).
- Elimination of contact with silicon dust
- Humidified oxygen inhalation and breathing exercises
- Sedative and antihypertensive drugs are not recommended
- Bronchoalveolar lavage in acute silicosis
- Bronchodilators with concomitant obstructive syndrome
- TB products
- Isoniazid 300 mg/day for 1 year if tuberculin skin test is positive
- For silicotuberculosis, at least 3 anti-tuberculosis products are used, including rifampicin.
Surgical treatment – lung transplantation in the development of massive fibrosis.