OCCUPATIONAL DISEASES,

CAUSED BY PHYSICAL

FACTORS

Vibration disease is a professional disease, caused by

vibration

Vibration is a mechanical oscillation, which is repeated at

definite periods

Local vibration – vibration,

which impacts mostly onto hands of a worker when working with

vibroinstruments

General vibration – vibration, which impact the whole

organism

ETIOLOGY OF VIBRATION DISEASE

1.metal processing

2.machine engineering

3.metallurgic

4.construction

5.aircraft manufacturing

6.mineral resource industry

7.agriculture

8.transportation

PROFESSIONS

cutters, drillers, fettlers, riveters, polishers, drivers of heavy

earth-moving machines

PATHOGENESIS OF VIBRATION DISEASE

1. disorder of membrane transportation of calcium with the increase of basal concentration in unstriped muscular cells of blood vessels;

2. increase of the speed of active and passive transportation of potassium;

3. replace of properties of pre-membrane spectrin and actinic complex, decrease of urgent skeleton proteins of erythrocytes – spectrin and actin;

4. accumulation of primary and secondary products of lipid peroxidation and inactivation of ferments of antioxidant protection

GENESIS OF TROPHIC DISORDERS

1.microcirculation

2.hypothalamic-pituitary-adrenal system

3.correlation of vasoactive substances of rennin-

angiotensin-aldosteronogenic system and

hormones of pituitary-thyroidcompex

4.increase of prostaglandins in blood

5.affection of vitamin and microelement balance

Classification of local vibrationI. initial manifestations: 1. peripheral angiodistonic syndrome of upper extremities,

including rare angiospasms of fingers2. syndrome of vegetative-sensor polyneuropathy of upper

extremitiesII. moderately marked manifestation:1. peripheral angiodistonic syndrome of upper extremities often

with angiospasmic fingers2. syndrome of vegetative-sensor of polyneuropathy of upper

extremities:a) often with angiospasms of fingersb) with stable vegetative-trophic disorders of handsc) with distrophic disorders of a locomotor system for upper

extremities (myofibrosis, periathrosis and arthrosis)d) with cervicobrachial plexopathye) with cerebral angiodistonic syndrome

Classification of local vibration

III. marked manifestations:

1. syndrome of sensomotor polyneuropathy of upper extremities

2. syndrome of encephalopolyneuropathy3. syndrome of polyneuropathy with generalized

acroangiospasms

Classification of general vibrationI. initial manifestations: 1. angiodistonic syndrome (cerebral or peripheral)2. vegetative-vestibular syndrome3. syndrome of vegetative-sensor polyneuropathy of lower

extremitiesII. moderately marked manifestation:

1. cerebral-peripheral angiodistonic syndrome2. syndrome of vegetative-sensor polyneuropathy :a) syndrome of polyradiculoneuropathyb) with secondary lumbosacral plexus syndrome (due to

osteochondrosis of the lumbar sector)c) with functional disorders of the nervous system

(neurasthenia)III. marked manifestations:

1. syndrome of sensormotor polyneuropathy2. syndrome of encephalopolyneuropathy

DIFFERENTIAL DIAGNOSTICS OF THE VIBRATION DISEASE

1. Reino syndrome

2. syringomyelia

3. vegetative polyneuritis

4. myositis

TREATMENT

1. vitamin therapy (ascorbic acid, B, PP)2. preparations, which increase non-specific

reactivity of organism3. anticholinergic drugs (spasmolytin,

benactyzine)4. ganglionic blockers (pachykarpin,

benxohexamethonium, hexamethon)5. nicotine acid, papaverine6. calcium channel blocking agents (nifedipine,

corinfar)

PHYSICAL METHODS

1. iontophoresis of 5%solution of Novocain

onto hands

2. diathermy on cervical ganglions

3. UV irradiation of cervical ganglions

4. galvanic baths (hydrogen sulfide, nitric-

thermal, rhodon)

VERIFICATION OF THE ABILITY TO WORK

Stage I• temporarily (for one month) employed at work beyond

the action of vibration• treatment-expert commission (one year)

Stage II• transferred to work beyond the action of vibration

(2 months)• expert examination to determine the degree of the

loss of the ability to work for the period of re-qualification (1-2 years)

Stage III• limite ability to work• invalidism group

NOISE

Noise is a chaotic combination of sounds, mechanical vibrations in the zone of frequency from 20 Hz to 16 kHz, which are perceived by a hearing analyzer

1.engine testers2.riveters3.cutters4.copper-smiths5.weaver6.spinners7.mechanization experts in agriculture8.shop workers

PATHOGENESIS

Nervous system – agitation of the hearing center

Cardio-vascular system

CLINICS

Stage I

1.gradual development2.decrease of perception of high frequencies (4,000-6,000 Hz)3.reduction of bone conduction and perception of whispering4.20 years and more

CLINICS

Stage II

(cochlear neuritis with a mild degree of hearing worsening)

1.whisper can be perceived at the distance of 4 m2.audiometric research (audio frequency of 4 kHz) – decrease of hearing up to 60 dB

CLINICS

Stage III

(cochlear neuritis with a mean degree of hearing worsening)

1.whisper can be perceived at the distance of 2 m2.audiometric research (audio frequency of 4 kHz) – decrease of hearing up to 65 dB

CLINICS

Stage IV

(cochlear neuritis with a severe degree of hearing worsening)

1.whisper can be perceived at the distance of 1 m2.audiometric research (audio frequency of 4 kHz) – decrease of hearing up to 70 dB and more

TREATMENT

1. generally strengthening therapy2. organization of regular meals, sleep regime, obligatory

staying in the fresh air for 1-2 hours every day3. bromide, elenium, trioxazine, benactyzine, glutamine

acid and rutin4. ascorbic acid (300-500 mg), vitamins of group B5. spasmolitic means and ganglionic blockers (bromides,

aminazine, meprotane, bensohexamethonium and penthamine)

6. bromide, valerian, and diazepam in combination with spasmolytics

7. reserpine and rhaunatin8. physical methods (galvanization, darsonvalism,

diathermy, mud application, balneotherapy)

VERIFICATION OF THE ABILITY TO WORK

Mild decrease of hearing – a patient can work + dynamic doctor observation and sanatorium-preventoriums

Mean decrease of hearing – transfer a patient to another occupation.

Young people with a short period of work, unqualified workers and people who are subject to impulse noise – rational employment beyond noise

Sever degree of hearing worsening – rational employment, which is not connected with the impact of noise. If rational employment is impossible – expert commission to determine a group of invalidism

RADIATION SICKNESS

Radiation sickness is a disease that develops as result of ionising radiation in

doses exceeding permissible

Alpha rays and x-rays have the greatest penetrating power

Beta rays have smaller penetrating power

PATHOGENESIS

Direct radiation effect (of large doses) – denaturation of protein molecules

Indirect effect of ionising radiation – mechanism of water radiolysis

CLASSIFICATION

A. Radiation illness caused by effect of general external irradiation or radio-isotopes with their even distribution at an organism:

1. Stages: formation of a phase, or I, II, III and IV degrees of weight, recovery of consequences (hypoplastic conditions; hyperplastic processes – leucoses; accelerated involutory processes in vascular, nervous and endocrine systems)

2. Forms: transitional, marrow, intestinal and toxaemic.3. Phase or degree of weight: I – primary general reaction; II – latent; III –

height of illness; IV – renovationB. Radiation illness conditioned by influence of radio-isotopes with

selective depositing or local external irradiation:1. Period of formation of pathological process (preclinical stage).2. Stage of clinical manifestations and exit of disease (dystrophic and

hypoplastic conditions – hypoplastic anaemia; involutory processes – accelerated ageing, pneumosclerosis; hyperplastic processes – leucosis, swellings, canceroid)

ACUTE RADIATION ILLNESS

It’s a group of clinical syndromes, which develop

after short-lived (from several seconds till three

days) influence of penetrating radiation in doses

exceeding an average permissible dose for a

body, equal 1 Gy (100 Rads)

ACUTE RADIATION ILLNESS

(total level of doses, power and distribution)

1.haemopoiesis (1-10 Gy)

2.intestine (10-20 Gy)

3.general haemodynamic and toxaemia

developments (20-100 Gy)

4.cerebral violations (100 Gy)

CLINICS

Phase of the primary general reaction

1. dyspeptic syndrome2. neutrophyle leukocitosis3. lymphocythopenia4. destruction of young elements in cells5. chromosome aberrations in cells6. typical clinical symptoms (nausea, vomiting,

headache, increase of temperature, general weakness and erythema)

CLINICS

Phase of imaginary clinical health

1. continuing empting of marrow

2. changes on mucosa of intestines

3. suppressing of spermatogenesis

4. progress of skin changes

5. baldness

CLINICS

Phase of expressed clinical manifestations

1. deep lesion of blood system

2. depression of immunity

3. development of infection complications

(haemorrhagic-necrotic pneumonia)

4. haemorrhagic manifestations

CLINICS

Renovation phase

1. temperature reduces

2. haemorrhagic manifestations disappear

3. tearing away of necrotic mass and suppuration

of erosion surfaces on skin and mucosa

4. a hair growth renews from the 2-5 months

5. hidrosis is normalized

The chronic radiation illness is a complicated clinical syndrome, which develops in case of continuous influence of irradiation in doses

exceeding permissible.

1. slow development2. changes in nervous, cardiovascular and

endocrine, hemopoetic system, gastrointestinal tract, liver, kidneys

3. violation of exchange processes

TREATMENT

1. staff must immediately leave the reactor block2. transported in specialized clinic after vomiting ending3. immediately put respirators4. immediately accept a tablet of potassium iodide5. carefully washed and dressed in other clothing6. Cerucalum, Atropine 7. Saline solutions 8. Neuroleptics and sedative drugs (Aminazine,

Fenobarbitalum)9. Plasmapheresis10. Cordiamine11. Lasix12. Prednisolon13. Antibiotics

Decompression sickness(caisson disease)

It’s a pathological condition that develops

owing to formation of gas bubbles in blood

and tissues in case of decrease of external

respiration

PATHOGENESIS

transition of gases of blood and tissues from dissolved condition in free one – similar to

gas (nitrogen) – in case of decrease of environment atmospheric pressure

1. destroy normal blood circulation2. stimulate nervous endings3. deform and damage tissues of organism

CLINIC

MILD1.Itch of skin, eruption2.non-acute pain in muscles, bones, joints and along nerve trunk

MEAN1.internal ear2.gastrointestinal tract 3.organ of sight – syndrome Menyera

HIGH-GRAVITY DEGREE

formation of emboluses in vessels of central nervous system, heart and lungs

TREATMENT

Recompression

TREATMENT

Recompression

VERIFICATION OF THE ABILITY TO WORK

Mild degree – 10 days

Return the sufferer of caisson sickness of mean gravity to the same work is authorized after a

period of temporary incapacity for work

The labor forecast at a high-gravity degree of a caisson illness is always unfavorable

Thank You