IMPACT OF OCCUPATIONAL PATHOLOGY ON LIFE QUALITY INDICATORS AND CLINICAL AND FUNCTIONAL STATUS OF MINING AND METALLURGICAL INDUSTRIES’ EMPLOYEES WITH PNEUMOCONIOSIS ASSOCIATED WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Rubtsov R. V

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

The study of indicators of life quality and clinical and functional status is a field of research, which enables to determine informative criteria for the diagnosis and evaluation of the effectiveness of treatment of occupational bronchopulmonary pathology in employees of mining and metallurgical industry, patients with PC associated with COPD. The analysis of changes in these indicators allow us to determine the signs of the occupational pulmonary pathology manifestation and to develop the further measures of its treatment and prevention. The object and methods of research. There were examined 170 workers of the mining and metallurgical industry, patients with occupational lung diseases. The average age of the employees was 58.6±2.4 years, work experience in unfavorable working conditions was 18.9±0.8 years. Among patients, the first group consisted of 31 workers with PC, the second group consisted of 60 workers with PC associated with COPD, the third group – of 79 workers with COPD of occupational etiology. Results of the research and their discussion. The data obtained indicated, that comparing to patients with PC, life quality indicators on the Symptoms-scale were lower by 32.5% (p < 0.001) and, on the contrary, in patients with COPD of occupational etiology were 2.1 times higher (p < 0.001), in terms of the Impact-scale, in patients with PC associated with COPD were significantly lower (38.4%, p < 0.001), and in patients with COPD of occupational etiology – less than 10.2%. On the Activity-scale in patients with pneumoconiosis associated with COPD they were lower by 5.9%, and in patients with COPD of occupational etiology – higher by 15.5% (p < 0.01), on the Sum-scale in patients with PC associated with COPD -less by 24.5% (p < 0.001), in patients with COPD – higher by 23.9% (p < 0.001). At comparing life quality indicators with a group of patients with PC associated with COPD, in patients with COPD of occupational etiology this rate by the Symptoms-scale was 2.8 times higher (p < 0.001). According to the Impact and Activity scales, COPD patients had higher rates, respectively, of 25.2% (p < 0.01) and 22.4% (p < 0.01). The integrated rating on the Symptoms-scale was also higher by 54.0% (p < 0.001). Estimation of clinical and functional status showed that comparing to patients with PC walking distance after loading test 6MWD in patients with PC associated with COPD was 36,2% (p < 0,001) lower, in patients with COPD of occupational etiology was higher by 40.5% (p < 0.001). The manifestation of dyspnea by Borg scores before the 6MWD test was greater in patients of these groups, respectively, by 69.5% (p < 0.001) and by 47.8% (p < 0.001), and after the loading test 6MWD the manifestation of dyspnea in patients was increased: in patients with PC associated with COPD by 39.6% (p < 0.001), and in patients with COPD – by 73.7% (p < 0.001). The distance walked after the 6MWD test in patients with COPD of occupational etiology was longer by 92.4% (p < 0.001) than in patients with PC associated with COPD. The manifestation of dyspnea before loading in COPD patients was less by 14.7% (p < 0.002), and after the loading test, was increased by 24.5% (p < 0.001), in patients with PC after 6MWD test dyspnea increased by 65.2% (p < 0.001), in patients with PC associated with COPD – by 35.9% (p < 0.001), and in patients with COPD of occupational etiology – by 94.1% (p < 0.001). Conclusions. Life quality indicators according to all scales in employees of mining and metallurgical industries with PC associated COPD were much decreased than in patients with other occupational lung pathology. The disease significantly restricts the functional status of patients and determines the level of its clinical manifestations and physical activity. The obtained results should be considered as one of the major markers in the disease diagnosis and should be used in full assessment of general health status of patients, as well as additional criteria for evaluating the effectiveness of treatment and prevention measures for this occupational lung disease. Perspectives for further investigations. The obtained data concerning features of clinical and functional status and life quality of the employees of mining and metallurgical industry with pneumoconiosis associated with COPD, allow to improve the diagnosis of the disease and to determine the prospects for further investigation relating to assessment of treatment and prevention methods.

pneumoconiosis, chronic obstructive pulmonary disease, employees, life quality, clinical and functional status.

1. Makarov IA, Potapova IA, Mokeyeva NV. Osobennosti dinamiki professional’noy khronicheskoy obstruktivnoy bolezni legkikh u rabochikh pylevykh professiy. Pulʹmonolohyya. 2017;27(1):37-40. [in Russian].
2. Shpagina LA, Poteryayeva YeL, Kotova OS, Shpagín ÍS, Smirnova ÍL. Aktual’nyye problemy pul’monologii v sovremennoy profpatologicheskoy praktike. Meditsina truda i promyshlennaya ekologiya. 2015;9:11-4. [in Russian].
3. Jones PW, Bosh TK. Quality of life changes in COPD patients treatments with salmeterol. Am. J. Respir. Crit. Car. Mtd. 1997;155:1283-9.
4. Van Namen YG, Bindels PJ, Dekker FW The influence of the COPD on health-related quality of life independent of the influence of co morbidity. J. Clin. Epidem. 2003;56:1117-84.
5. Babakov SA, Averina OM. Diagnostika, lecheniye i profilaktika professional’nykh zabolevaniy legkikh. Rossiyskiy meditsinskiy zhurnal. 2012;6:306-12. [in Russian].
6. Razumov VV. K probleme traktovki sushchnosti pnevmokonioza i vozmozhnykh putyakh yeye resheniya. Meditsina truda i promyshlennaya ekologiya. 2014;10:43-8. [in Russian].
7. Roslaya NA, Khasanova GN. Vliyaniye professional’nykh zabolevaniy organov dykhaniya na pokazateli kachestva zhizni patsiyentov. Meditsina truda i promyshlennaya ekologiya. 2010;2:44-7. [in Russian].
8. Rubtsov RV. Dinamika pokazateley kachestva zhizni u rabochikh gornorudnoy promyshlennosti pri khronicheskom obstruktivnom zabolevanii legkikh professional’noy etiologii v postkontaktnyy period. Ukraí̈ns’kiy medichníy al’manakh. 2007;4(10):149-51. [in Ukrainian].
9. Krasnyuk OP, Tkach SI, Prylypsʹka NI, Shkondin AM, Kovalʹchuk TA, Valutsyna NI. Zastosuvannya klasyfikatsiyi pnevmokonioziv v Ukrayini: metodychni rekomendatsiyi. Kyyiv: 2002. 15 s. [in Ukrainian].
10. Global Initiative for Chronic Obstructive Lung Disease (GOLD). Poket guide to COPD diagnosis, management and prevention 2019. Available from: https://goldcopd.org. (Last accessed 02.03. 2019)
11. Nakaz MOZ Ukrayiny vid 27 chervnya 2013 № 555. Pro zatverdzhennya ta vprovadzhennya medyko-tekhnolohichnykh dokumentiv zi standartyzatsiyi medychnoyi dopomohy pry khronichnomu obstruktyvnomu zakhvoryuvanni lehenʹ: Dostupno: http://document.ua/prozatverdzhennja-ta-vprovadzhennja-mediko-tehnologichnih-d-doc166218.html [in Ukrainian].
12. Borg GA. Psychophysical basses of perceived exertion. Med. Sci. Sports. Exerc. 1982;14:377-81.

«Bulletin of problems biology and medicine» Issue 3 (157), 2020 year, 137-141 pages, index UDK 616.24-057+613.6.008 (622+669)

10.29254/2077-4214-2020-3-157-137-141