Anthracnose

Anthracosis is an occupational lung disease caused by prolonged inhalation of coal dust. Let's look at the causes of anthracosis, symptoms, diagnostic methods and treatment.

Anthracosis is included in a group of diseases called pneumoconiosis and are professional. The degree of damage to the lung structure directly depends on the chemical composition of the dust. Let's consider the main groups of professional lung diseases:

• Carboniosis is a group of diseases that occur due to the inhalation of dust with a high coal content (anthracosis, graphitosis, pneumoconiosis).
• Siderosilicosis, anthracosilicosis – develop when the lungs are exposed to mixed dust. Occupational diseases of electric welders and gas cutters.
• Pneumoconiosis, which occurs when inhaling dust of organic origin (flax, wool, sugar cane). According to clinical signs, this disease is similar to bronchial asthma or allergic alveolitis.

Pure anthracosis has a long and benign course, unlike silicosis. The whole point is that coal dust is well excreted by macrophages through the bronchi and lymphatic drainage of the lungs. If the dust contains a high percentage of silicon dioxide impurities, this leads to pronounced pulmonary sclerosis, that is, mixed pneumoconiosis (anthracosilicosis, silicoanthracosis).

Long-term inhalation of coal dust leads to its local accumulation in the body. In this case, the accumulation is not noticeable until massive pulmonary fibrosis develops. Coal dust accumulation, or pulmonary anthracosis, occurs not only in people working with coal, but also in those living in industrial areas and especially in smokers. Dust is found in the lymphatic drainage system, macrophages, around the bronchioles and in the lumen of the alveoli. In people living near industrial areas, dust accumulation rarely causes lung problems. Only coal miners who have worked for many years in very dusty mines experience serious consequences.

The prevalence of this disease among miners is about 12%, and among those who have worked in anthracite mining for more than 20 years, 50% suffer from lung diseases. Among miners who mine hard coal (which occupies an intermediate position in the degree of coalification between anthracite and brown coal), anthracosis is rare. Coal dust acts like tobacco smoke, so very often the symptoms of anthracosis are similar to chronic bronchitis.

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Causes of anthracnose

The causes of anthracosis are inhalation of coal dust over a long period of time. The disease affects people who have a long history of working in conditions of constant exposure to coal dust, i.e. miners, workers in enrichment plants and other industrial production.

Lung damage occurs due to the effects of silicon dioxide. Coal pigment contributes to the development of sclerosis, the severity of which depends entirely on the composition of the rock and the nature of the coal. Coal dust does not have sclerosing properties. Anthracite dust leads to the development of the most pronounced lung damage, in contrast to bituminous coals, and wood coal dust does not cause pathologies at all.

Lung damage occurs due to inhalation and prolonged retention of dust particles, i.e. irreversible stretching of the small airways. Without timely diagnosis and treatment, the disease begins to progress, affecting both lungs. This leads to an increase in fibrous tissue, merging of foci of pathology and extensive destruction of the lung structure.

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Anthracosis of the lungs

Anthracosis of the lungs develops in people with long-term work experience in mines with a high concentration of coal dust. Anyone who processes coal in unfavorable working conditions is susceptible to the disease. This is a progressive disease that has several stages of development.

The risk of developing pathology is directly dependent on the intensity and duration of dust exposure and individual sensitivity of the organism. Early radiographic changes are a restructuring of the pulmonary pattern, small nodules appear (focal shadows 1-5 mm in diameter). Anthracite of the lungs causes calcification in 10% of cases and, as a rule, in patients with long-term experience in anthracite mining. The tumor-like form of the disease is nodular formations in the upper parts of the lungs. The nodular form develops in 10-15% of cases and depends on the type of inhaled coal.

Coal pneumoconiosis is accompanied by clinical manifestations resembling bronchitis and pulmonary emphysema. Patients develop pronounced disorders of the external respiratory system. Let's consider three stages of the disease:

Stage I

Rapid fatigue, cough, minor chest pain and shortness of breath during physical exertion appear. In some cases, the disease does not manifest itself and its presence can only be found out after an X-ray examination. The image will show small focal shadows against the background of a deformed reticular pattern of the lung. The middle sections of the lung are susceptible to damage, the size of the foci from 1 to 5 mm.

Stage II

Shortness of breath and cough appear even at rest, chest pains increase. At this point, the symptoms of anthracosis look like bronchitis or emphysema. X-rays show an increase in the number of small focal tissues and their sizes. Shadows appear in the middle, subclavian and subdiaphragmatic sections. Pleural changes in the interlobar fissures and at the diaphragm are possible.

Stage III

This stage occurs rarely. The patient suffers from general weakness, severe shortness of breath, cough with phlegm, severe chest pain. X-rays show massive homogeneous darkening up to 5-10 cm. The shadows have an irregular shape, but clear contours, are located at different heights, both in one and in both lungs at once. According to the X-ray course and clinical signs, anthracosis can be classified as a slowly progressing disease of a chronic nature.

Symptoms of anthracnose

Symptoms of anthracosis do not always make themselves known, at the first stage, the disease may not manifest itself. That is, the primary form of pathology is asymptomatic, but if the pathogenesis is complicated, the patient develops a cough, shortness of breath, and the release of black sputum. Shortness of breath increases with physical activity. Due to the long course of the disease, the sputum becomes thick, yellow or green.

• The lung damage develops very slowly, so the main symptoms: cough, general weakness and shortness of breath, can accompany the patient for a long period of time. The disease can lead to pulmonary hypertension, tuberculosis and an increase in the volume of the heart. In smokers with anthracosis, chronic bronchitis or emphysema is possible.
• Coal dust irritates the mucous membrane of the bronchi, causing hypersecretion of the bronchial glands and an inflammatory reaction, which in its symptoms is similar to the manifestations of bronchitis. Due to the weakened breathing as a result of emphysema, crepitant wheezing can be detected.
• On X-ray, anthracosis looks like a pronounced expansion and compaction of the roots and lungs. Small-spotted shadows, which are a reflection of nodular fibrosis, are clearly visible in places where dust accumulates. In this case, the disease can remain at the same stage of development for many years.
• Rapidly progressing anthracosis is extremely rare. The condition of patients worsens due to the addition of pneumonia, emphysema, pulmonary or pulmonary-cardiac insufficiency, chronic bronchitis to the main disease. Complications significantly change the clinical and radiological picture of the occupational disease.

Diagnosis of anthracosis

Diagnosis of anthracosis begins with a physical examination. With pronounced signs of the disease, the doctor notices a barrel-shaped chest and other symptoms that are not typical for healthy lungs. A mandatory diagnostic method is chest X-ray. The image shows small shadows in all areas of the lungs, but most of all in the upper sections. If anthracosis takes a complicated form, then a large opaque area is visible on the X-ray.

Computer and magnetic resonance imaging can help determine the nature of anthracosis (massive, spotty, nodular) and the stage it is at. If the disease progresses, it leads to an increase in the area of damage and the amount of tissue. In this case, blood flow and ventilation in different areas of the lung tissue are assessed for diagnosis. Lung scintigraphy and zonal rheopulmonography are used to conduct this study.

To study external respiration, spirometry, pneumotachography, and plethysmography are performed. This allows one to determine the type of disorders (obstructive, restrictive). In the case of a pronounced clinical picture of anthracosis, the patient undergoes bronchoscopy, puncture of the lymph nodes of the lung root, and transbronchial biopsy of the lung tissue. A study of the pulmonary function is also performed to assess the capacity of the lungs. To establish a final diagnosis, an analysis of the gas composition of arterial blood is performed, which provides information on the level of oxygen in the blood. Further diagnostics completely depend on the severity of symptoms and the stage of development of pneumoconiosis.

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Treatment of anthracosis

Treatment of anthracosis is aimed at eliminating the symptoms of the disease, reducing oxygen deficiency and preventing infectious damage to the respiratory tract. Treatment and preventive measures are carried out on an outpatient basis, less often in a hospital. Patients are prescribed medications to expand the small airways and steroids. Physical therapy has therapeutic properties, for example, coughing with percussion and vibration according to a certain pattern, for complete removal of sputum.

A mandatory condition for treatment is to increase fluid intake, up to 2-3 liters per day. If anthracosis is at the first stage, then the usual therapy is used for treatment, as for respiratory diseases. But if the disease is at the last stages, then the patient is given artificial ventilation or given oxygen through a mask.

If a patient with a long history of working in conditions of regular inhalation of coal dust has been diagnosed with stage I anthracosis, but there are no functional disorders or complications, then there is no need to change profession. But such people need dynamic medical observation to control their health. If the disease is at stage II or III, complicated by bronchitis and the indicators of external respiration function are impaired, the patient is contraindicated to work in conditions of contact with dust.

Prevention of anthracosis

Prevention of anthracosis is aimed at reducing air dustiness. To reduce the number of occupational diseases, various technologies are used in the coal industry, which are accompanied by minimal emission of dust masses. Periodic preventive examinations of miners are mandatory, once every 6 months. The worker is examined by a therapist, radiologist, phthisiatrician and other specialists. To detect early signs of anthracosis, chest X-ray, blood test for leukocyte and hemoglobin levels, spirometry are performed.

All workers at risk for this disease and other occupational pathologies need general medical and preventive measures. First of all, it is necessary to ensure a rational work and rest regime, adequate nutrition with a high content of vitamins and proteins. Physical activity and giving up bad habits, especially smoking, will not be superfluous. In order to reduce or completely cure the symptoms of pneumoconiosis, it is recommended to avoid infections, get annual flu vaccinations and lead a healthy lifestyle. Such methods help to reduce further progression of the disease.

Anthracnose prognosis

The prognosis of anthracosis depends on many factors: the stage of the disease and the length of service in conditions of inhalation of coal dust, the type of lung damage, the patient's age and individual characteristics of the body. As a rule, an asymptomatic disease that does not cause complications can suddenly begin to progress after a short period of inhalation of the pathogenic agent. In this case, the risk of complications increases. The prognosis worsens if tuberculosis and other diseases join the lung damage. In especially severe cases, the disease leads to loss of working capacity, cardiac and pulmonary failure.

Anthracosis is a disease that affects everyone whose work involves prolonged inhalation of coal dust. The disease has a benign course, but without early diagnosis and treatment it can lead to disability and a number of chronic lung diseases.

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