PATOLOŠKA STANJA UZROKOVANA AEROSOLIMA

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Transcript PATOLOŠKA STANJA UZROKOVANA AEROSOLIMA

PATOLOŠKA STANJA
UZROKOVANA AEROSOLIMA
KRONIČNI BRONHITIS
BRONHALNA ASTMA
PNEUMOKONIOZE
KRONIČNI BRONHITIS
 Podrazumijeva da bolesnik
produktivno kašlje najmanje 3
mjeseca godišnje u zadnje 2 godine
Komponente razvoja KB
 Endogena komponenta
 tzv. “ astmatičko-bronhitička”
konstitucija  hipereaktivnost
traheobronhalnog stabla, sklonost
alergijskoj senzibilizaciji
 Egzogene komponente:
 Infekcija, pušenje, aerozagađenje,
alergeni (profesionalni i ambijentalni)
Slide 5 of 43

• Cigarette smoke contains over 4,000
chemicals and a dozen gases.
• The main components of this are Nicotine,
Carbon Monoxide and Tar.
• Carbon monoxide – odorless and tasteless
with higher affinity for hemoglobin
NICOTINE
• Reinforces and strengthens the desire to
smoke.
• Psychological and physical dependence
• Temporary stimulant action followed by a
depressing action on the nervous system.
• A drop of pure nicotine injected into the
body would cause instant death in a few
minutes.
OTHER IMPORTANT
SUBSTANCES
• Tar is a brown sticky substance that cause
changes in the cells that lead to cancer.
• Phenols, Ammonia and Arsenic are found
in trace amounts and are considered to be as
carcinogenic and poisonous.
No Such Place as Away
How solid waste management decisions
affect public health.
http://www.lexingtonma.org/swat/HomePage.htm
Jill E. Stein, M.D.
John W. Andrews
Lexington Solid Waste Action Team
17 Trotting Horse Road, Lexington, MA 02421
[email protected]
Revision 1.0
(SWAT.Health.PPT- 1)
Allergens
• anything that causes
allergies
• need more than 1
exposure to product
• after the 1st exposure
the body develops a
negative response
• when exposed again,
the body responses
negatively = allergic
reaction
Allergies can
cause
• trigger an asthma
attack
• shock
• rashes, blisters,
contact dermatitis
• itchy, watery eyes
• sneezing
BRONHALNA ASTMA


PNEUMOKONIOZE
 Udisanje čestica prašine može
uzrokovati poremećaje u dišnom
sustavu preko 3 mehanizma:
 1. iritacija
 2. senzibilizacija
 3. retencija
 ili kombinacijom navedenog.
Tip oštećenja ovisiti će o:
  veličini čestica
  koncentraciji
čestica
  vrsti čestica

PNEUMOKONIOZA
 u doslovnom prijevodu  "prašina u
plućima“
 Danas prihvaćena preciznija ILO definicija
  " akumulacija prašine u plućima
praćena tkivnom reakcijom na njezinu
prisutnost"
"BENIGNA
PNEUMOKONIOZA"
  prisustvo inertne prašine u
plućima. Inertna prašina =
anorganska prašina čija retencija ne
dovodi do disrupcije alveola i ne
stimulira depoziciju kolagena, pa je
stoga najčešće asimptomatska. Te
prašine sadrže  1 % SiO2 .
Primjeri:
 sideroza (željezni oksid)
 stanoza (kositrena rudača)
 baritoza
“Kolagenska
pneumokonioza"
  retencija prašina koje dovode do
alveolarne disrupcije i kolagenske
proliferacije  fibroza pluća
Najvažnije: silikoza
azbestoza
pneumokonioza kopača ugljena
(stari naziv antrakosilikoza)
Pneumoconiosis (“dust disease”)
• Damage to lung parenchyma due to the
inhalation of toxic inorganic dust
• Damage is caused by lung’s reaction to
dust
• Excludes asthma, bronchitis
Physiological reactions in pneumoconiosis
• Deposition and retention of dust
• Macrophages engulf particles
• Macrophage death provoking
inflammation
• Release of inflammatory mediators from
neutrophils
• Fibrosis (scarring)
SILICOSIS
Caused by inhalation of silicon dioxide
Slate mining, metal foundries, stone masonry, sand
blasting, tunneling etc.
Freshly cut silica appears to have free radicals. They can
damage the membranes of macrophages. Eventually the
damaged macrophages die and then re-ingested by other
macrophages.
Damaged macrophages release fibrogenic factors (IL-1,
TNF-, lipid mediators etc), and attract fibroblasts which
lay collagen- Fibrotic nodules/Silicotic nodules.
Left Pneumothorax
BLACK LUNG DISEASE
(Coal Workers’ Pneumoconiosis)
Coal dust is composed of amorphous
carbon together with other components
including silica
Bituminous (soft) coal – not fibrogenic
(macrophages are not killed)
Anthracite (hard) coal – contains silica
(can be fibrogenic depending on the
amount of silica)
CWP - Black Lung
ASBESTOSIS
Most of the patients are over 40
years, because in 1960 legislation to
ban the use of asbestos became
effective.
Asbestos is a collective name for
silicate minerals which occur in thin
long fibers.
Types of asbestos: Crocidolite;
Amosite; Chrysotile (most common)
Background
• The word “Asbestos” is derived from a
Greek adjective meaning inextinguishable
• Asbestos is a naturally occurring mineral
– Once extracted from the earth, asbestos
containing rocks are crushed, milled and
graded, this produces long, thread-like fibers
Uses of Asbestos
• Because of its unique properties:
–
–
–
–
fire resistance
high tensile strength
poor heat and electrical conductivity
impervious to chemical attacks
• Most common use
– fireproofing material
Health Effects
• Asbestosis
– a disease characterized by fibrotic scarring of
the lung
• latency period of 10-20 years
• Lung Cancer
– there are many causes of lung cancer, of which
asbestos is only one
• cigarette smoking is more than 50 times more likely
to contact lung cancer
• latency period is typically 20 years
Health Effects
• Mesothelioma
–
–
–
–
greatest concern and rarest
cancer of the chest cavity lining
spread rapidly and is always fatal
latency period 20-40 years
Cancer - Tumor In Right Lung
Lung Cancer
Smoking and lung cancer:
 Risk of lung cancer is proportional to the number of
cigarettes smoked and with the age at which smoking was
started
 If smokers who smoke fewer than 20 cigarettes a day stop,
the increased risk of lung cancer decreases, reaching that
of a non-smoker after 13 years
 If smokers who smoke more than 20 cigarettes a day stop,
they retain a small increased risk over non-smokers for life
 For passive smokers the risk of developing lung cancer is
twice as great as that for those not exposed to smoke