tin pneumoconiosis
Introduction
Introduction to tin pneumoconiosis Tin pneumoconiosis is mainly due to the fact that metal dust refers to tiny solid particles of metals and their compounds suspended in the air for a long time, also known as metal aerosols entering the upper respiratory system of humans. The clinical symptoms of tin pneumoconiosis are mild, and there are few systemic symptoms. When there are a lot of dense speckled shadows on the chest X-ray, there are mild chest pain, shortness of breath, and cough. basic knowledge Sickness ratio: 0.05% Susceptible people: tin workers Mode of infection: non-infectious Complications: emphysema
Cause
Tin pneumoconiosis
Causes:
Tin pneumoconiosis is a lung disease caused by long-term inhalation of an aerosol containing tin dioxide during the smelting process. The incubation period is 15 to 20 years, and the disease develops slowly. China has not classified tin pneumoconiosis as an occupational disease.
There are few reports on the pathological manifestations of tin pneumoconiosis. Guangxi Medical College and Guangxi Institute of Occupational Diseases have injected tracheal tin dioxide (SnO2) dust into the trachea. After 6 months and 12 months, a large number of dust cell foci in the lungs were found. And granulomatous inflammatory lesions, there are a few fibroblasts around the dust stove, no nodules or interstitial fibrosis, no autopsy in Guangxi millet tin mine, a tin smelter tin pig diagnosed before birth, 5 years of tin dust contact History, due to liver cancer death, pathological examination found that there are 3 ~ 4mm brown-black tin dust lesions in the lungs, no obvious fibrosis and pleural thickening.
Pathogenesis:
Tin pneumoconiosis is a lung disease caused by long-term inhalation of an aerosol containing tin dioxide during the smelting process of a tin-smelting worker. The incubation period is 15 to 20 years, and the disease develops slowly.
Prevention
Tin pneumoconiosis prevention
Prevention is first of all to reduce the dust of the working environment, strengthen publicity and education, formulate a health cleaning system, and achieve civilized production. Pre-employment and regular physical examinations, regular chest radiographs, and regular follow-up for those who have been out of dust. For those with upper respiratory tract disease, bronchopulmonary disease, especially those with tuberculosis and cardiovascular disease, they should not engage in silica dust. Strengthen personal protection, pay attention to personal hygiene, carry out physical exercise, pay attention to nutrition and so on. Prevention of repeated infections, lung patients due to the defense function of the respiratory tract and the body's immune system are affected by the dust and damage, as well as diffuse fibrosis of the lungs, resulting in bronchoconstriction, poor drainage, prone to bacterial and viral infections. Patients with respiratory infections should be strictly controlled, and the ward should be ventilated regularly and UV disinfected.
Complication
Tin pneumoconiosis Complications emphysema
Combined emphysema, combined with infection is common.
Symptom
Tin pneumoconiosis symptoms common symptoms chest pain shortness of breath
The clinical symptoms of tin pneumoconiosis are mild, and systemic symptoms are rare. When there are a lot of dense speckled shadows on the chest X-ray, there are mild chest pain, shortness of breath, and cough.
Examine
Tin pneumoconiosis
Increased white blood cells in patients with bacterial infection.
Chest X-ray performance can be divided into three phases.
1. At the beginning of the morphological change, there are irregular shadows with high density and low circular shadows with low density in the lung field.
2. The spotted lungs are full of 2~4mm high density, sharp edge-like shadows on the edges, high density of hilar shadows, and similar to metal block shadows.
3. The formation of hilar metal block shadows has various forms around the first stage of the hilar, and the block shadows with high density along the bronchus are the sputum of the tin in the bronchus and lung lymph nodes. The maximum ventilation and the first second time were significantly lower than normal.
Diagnosis
Tin pneumoconiosis diagnosis
According to the history of contact with the dust, X-ray findings and clinical symptoms, it is generally not difficult to make a diagnosis of stagnation (or pneumoconiosis), but China has not classified the pneumoconiosis as an occupational disease.
Differential diagnosis
1. Acute miliary tuberculosis has no occupational exposure history, and children are more common. It is part of acute hematogenous disseminated tuberculosis, with acute onset, severe poisoning symptoms, sometimes associated with tuberculous meningitis and tuberculosis in other areas. X-ray chest radiograph shows uniform distribution of double lung fields, uniform density and size, edge Clear miliary shadows, anti-tuberculosis treatment is better. The clinical manifestations of silicosis have no symptoms of systemic poisoning, and the small nodule shadow has a higher density on the chest radiograph and a history of occupational exposure.
2. Hemosiderin is more common in rheumatic heart disease mitral stenosis, has a history of left heart failure, no occupational history. It is characterized by repeated episodes of hemoptysis, shortness of breath and unexplained ischemic anemia. It has signs such as clubbing (toe) and spleen. Chest radiographs can be seen in varying sizes, uneven distribution, a certain number of fine nodule shadows, high density, with a small number of cord-like shadows, and extensive pulmonary interstitial fibrosis in the late stage. Macrophages that phagocytose hemosiderin can be found in sputum and bronchoalveolar lavage fluids, often with signs of heart disease.
3. Sarcoidosis is an unexplained, non-caseous epithelial cell granulomatous disease. Can invade many organs of the body, but mostly in the lungs and intrathoracic lymph nodes. There were no obvious symptoms or signs in the early stage. The stage II nodular disease had hilar lymphadenopathy with pulmonary infiltration. The lung lesions were widely distributed symmetrically on both sides, showing nodular, punctate or flocculent shadows. Stage III sarcoidosis showed fibrotic changes in the lungs, while hilar lymph nodes disappeared. There are often granuloma shadows in the fibrotic shadows. In a wide range of lesions, lung shrinkage, diaphragmatic elevation, and hilar elevation may occur. The diagnosis of sarcoidosis is based on chest radiograph, chest CT changes, histological biopsy, and positive Kvein test. Patients may be accompanied by other organ lesions, serum angiotensin-converting enzyme activity is increased, tuberculin skin test negative or weak positive can be used as a reference indicator.
4. Alveolar microlithiasis often has a family history, and there is no history of dust exposure. The X-ray chest radiographs are covered with fine sand-like shadows, the size is about 1mm, the edges are clear, the lungs are more common inside, the lungs are not big, the lung texture is not changed, and the disease progresses slowly.
5. Bronchioloalveolar carcinoma often coughs more white foam, sometimes hemoptysis, and cancer cells are found in the sputum.
