Occupational bronchial asthma and its prevention

Industrial contact of workers with certain irritating types of dust and chemicals can lead to the development of specific sensitization in them, which may result in professional bronchial asthma.  

It has been established that in some cases asthma develops in people who have industrial contact with substances and which do not have an irritant effect, but are known as strong sensitizers (rosin, bitumen, chlorpromazine, antibiotics, etc.) – In these cases, asthma can develop almost at the first year of work. For other production factors that have an irritating effect, a rather long period of time is required to cause professional bronchial asthma, the precursor of which, as a rule, is chronic bronchitis (acids, alkalis, asbestos dust, graphite, soot, quartz, etc.). Contact with substances with a sensitizing and irritating effect (ursol, chloramine, chromium, welding sprays, nitro-paints, organic solvents, cement, cotton, tobacco, etc.) is especially dangerous.

The clinical picture of professional bronchial asthma is not very specific. This circumstance makes it necessary to recommend obtaining detailed information on the presence of industrial contact with substances that can cause this occupational disease. A clear connection should be established between the occurrence of asthmatic attacks and contact with a professional allergen. The disease is manifested by attacks of suffocation and expiratory shortness of breath. In patients with wheezing, hard breathing with a rough exhalation and multiple dry rales is heard. An asthmatic attack of professional bronchial asthma, like normal, results in a cough with sputum production.  

Primary professional bronchial asthma not only develops relatively quickly, but is also accompanied by a number of allergic reactions from the skin and mucous membranes (eczema, allergic edema, etc.). The disease often develops suddenly, against the background of general health, and at first it is provoked only by inhalation of a professional allergen.

With the progression of the disease, asthma attacks can occur not only as a reaction to a professional specific antigen, but also to other irritants (emotions, stress, smells, temperature fluctuations, etc.), which characterizes the change in specific sensitivity to polyvalent sensitization. The analysis of the allergic nature of bronchial asthma is usually helped by a blood test in which eosinophilia is detected, as well as a sputum test, in which eosiophils and Charcot-Leiden crystals are determined.  

When establishing a diagnosis of occupational bronchial asthma, it is necessary to identify the type of allergen, for which special methods of immunological diagnosis are used, including the provocation method with inhalation of a particular allergen or introducing it intradermally.  

Prevention consists in observing measures that exclude the accumulation of sensitizers in the air of working premises and irritating the respiratory tract of substances (sealing and sheltering of production equipment, effective local exhaust and general ventilation, etc.).  

Persons suffering from diseases of the upper respiratory tract, lungs, cardiovascular and nervous systems, as well as those with allergic diseases or even only a predisposition to them, should not be allowed to work in contact with substances that cause occupational asthma .  

Treatment of occupational bronchial asthma should consist in desensitizing the body and eliminating bouts of bronchospasm.

With the elimination of attacks of bronchospasm, epinephrine, noradrsnaline, ephedrine, etc. are effective. It is advisable to combine the introduction of antispasmodics with substances that relieve spasm of the smooth muscles of the bronchi (atropine, platifillin and the like). At the same time, reflex methods of treatment are used (banks, hot baths for the feet, etc.). To prevent and suppress the infectious process, antibacterial treatment (sulfonamides and broad-spectrum antibiotics) is advisable. The course of treatment with corticosteroids (hydrocortisone, prednisone, etc.) has an anti-allergic (anti-inflammatory) effect.

When providing first aid, it is necessary to reassure the patient, seat him, to ensure the flow of clean air. Various measures are used to stop the attack: subcutaneous injections of a 0.1% solution of adrenaline (0.5-1 ml), 5% solution of ephedrine (1 ml) or 0.1% solution of atropine (1 ml), as well as 0.2% solution of platyphyllin (I ml). Oxygen therapy The doctor’s consultation. Hospitalization is indicated for a seizure attack, repeated frequent seizures, and heart failure.

event_note September 18, 2019

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