Katamanova Elena V. and Elena Abramatets A.
Federal State Institution of the East Siberian, Institute of Medical and Environmental Research, Angarsk, Russia
Respiratory diseases are among the most common human diseases, they are among the leading in the number of days of disability, causes of disability and mortality. Occupational respiratory diseases occupy the 3rd place among all the identifiable nosological forms. The aluminum industry is one of the most promising and fastest growing sectors o f non-ferrous metallurgy. In the production process of aluminum workers are exposed to the fluorides (both in the form of gaseous hydrogen fluoride and a solid insoluble compounds, including silicon fluorides), ammonia, carbon oxide and dioxide, aerosol complex chemical composition.
Material and Methods: It was examined and treated 40 patients with occupational chronic obstructive pulmonary disease. The examination included an assessment of indicators of lung function was performed using a spirometer «Shiller Spirovit 1», Switzerland, multislice imaging light, body plethysmography measurement of blood gases, basic therapy included daily inhalation Indakaterola 1 times a day at the same time, in a daily dose of 150 micrograms. Evaluating the effectiveness of the treatment was performed using spirometry, the intensity of respiratory symptoms was assessed using standardized scales: shortness of breath on a 4-point scale MRS (Medical Research Council), before and after therapy. The symptoms of cough and sputum production (1st scale) were analyzed by using the questionnaire survey COPD Assessment Test (CAT). Statistical analysis was performed using the software package «Statistica 6.0» (StatSof, USA, 1999).
The Research Results: Examined patients were divided into 2 groups based on the severity of COPD. 21 patients were referred to the first group (mild COPD), with an FEV1 / FVC <70%, FEV1> 80% of the normal value, with or without respiratory symptoms (chronic cough and sputum production). The second group (moderate COPD) 19 people - FEV1 / FVC <70% FEV1 - 50-69% of the normal value.
Before the start of the research group examined complaints of cough episodes imposes 71.4%, complaints of shortness of varying severity imposed on all running. 66% used the short-β2-agonists, and exacerbation of the disease more than 2 times a year 19% of the surveyed noted. When comparing patients with mild to moderate severity (groups 1 and 2) COPD was revealed: It expressed the same degree of dyspnea and was 2.4 points. While cough was more pronounced in the group with an average degree of severity of the disease and amounted to 2.2-2.8 points, respectively. The average value FEV1 group with mild was 80%, with an average severity of COPD - 63% of the normal value (p = 0.002).
Data analysis survey questionnaire CAT found that patients with COPD of varying severity have noted the deterioration of the health, at baseline research, primarily due to clinical symptoms (shortness of breath and cough): 2.0 (1.8-2.2) score in group 1 and 2.5 (2.3-2.7) for the second group (p = 0.03).
Assessment of indicators of clinical and functional status during the 3-month treatment with Indacaterol showed a significant positive trend. At the end of treatment of all workers observed a significant decrease in coughing from 2, 5 ± 0, 8 to 1, 9 ± 1, 1 points (p <0.01). The greatest clinical effect was observed after 3 months of therapy in the form of reduced of dyspnea with 2,42 ± 0,67 to 0,95 ± 0,66 points (p <0.001) and the lack of need for short-β2-agonists, which continues to use 1 person (4.7%). The frequency of exacerbations during the observation period has decreased by 4 times. It should be noted that when receiving indacaterol not observed adverse effects associated with stimulation of β2 -receptor. In the research of external respiratory function showed statistically significant increase in FEV1 and FVC during therapy and continued throughout the course of treatment.
Keywords: Chronic obstructive pulmonary disease, treatment, diagnosis, occupational respiratory diseases.