This prospective open comparative non-randomized study was aimed to assess effect of physical rehabilitation on exercise tolerance in Chernobyl clean-up workers with radionuclide-induced pneumopathy. The inpatient training programme included skeletal muscle training of upper and lower extremities and breathing strategies. Of 26 patients, 14 males underwent ≥ 4 training courses during the study and 12 males underwent < 4 courses. As a result, physical rehabilitation in patients with radionuclide-induced pneumopathy improved physical tolerance but it should be more prolonged and be targeted both to skeletal and respiratory muscles. Further studies are necessary to assess long-term effects of rehabilitation in these patients.

Results of complex laboratory examination of 103 patients with dust related bronchitis caused by exposure of various industrial dusts, 22 patients with pneumoconiosis and 12 subjects not having respiratory pathology and not exposed to quartz dust or any other occupational hazards are presented in this article. Laboratory examination included morphological investigations of sputum and bronchial brush biopsy specimens, cytochemical characterization of bronchial ciliated epithelium and blood cells, and bacteriological and serological investigations of bronchial mucus. Our results demonstrated that morphological lesions of bronchial epithelium cells leading to their death followed cell dysfunction, disorders of enzyme activity, hypoxemia, predominance of Haemophilus influenzae in microflora, and significant inflammatory and allergic response in blood. These changes were found in different clinical stages of dust related bronchitis and pneumoconiosis. The findings obtained are of great importance for understanding pathogenic mechanisms of dust related lung diseases as well as from clinical point of view such as diagnosis and development of individual treatment strategies.

Based on results of investigation of 144 patients the authors described functional, bronchoscopic, microbiological, and immunological peculiarities of chronic dustrelated bronchitis and chronic toxico-chemical bronchitis.

To study a rate and a character of respiratory and allergic pathology in subjects engaged in industrial production of sausages and other meat foods, this prospective longitudinal trial was performed in workers of one of the leading meat processing factories at Moscow. The trial involved 110 subjects (53 females and 57 males) aged 20 to 73 yrs with mean length of service of 11.7 yrs. There were 56 current smokers (50.9 %) with smoking history of 21.5 pack-yrs in average. The authors used the specialized SWORD questionnaire, clinical and ENT examination, spirometry and bronchodilating test with Ventolin, peak flowmetry to detect specific bronchial hyperreactivity, measured serum cytokine levels (TNF-α, IL-4, IL-6). According to the questionnaire results, 38 workers (34.5 %) had respiratory symptoms (cough, sputum production, breathlessness, asthma attacks) and 17 workers (15.5 %) had allergic symptoms (skin itch, urticaria, tearing, eyelid itch and hyperemia, rhinorrea, nasal congestion). Clinical respiratory signs were found only in 13 (11.8 %) of the workers. Lung function disorders were found in 40 (36.4 %) of the workers. The degree of FEV₁  and PEF decrease significantly correlated with the length of service (r = –0.26 and r = –0.29, respectively). Av inverse correlation was found between FEV₁ and cytokine levels (r = –0.3; r = –0.31 and r = –0.26 for IL-4, IL-6, and TNF-α, respectively). Therefore, the results show the actuality of healthcare problems in subjects involved in meat processing.

Recent guidelines define chronic obstructive pulmonary disease (COPD) as a preventable and treatable disease characterized by airflow limitation and systemic consequences. Airflow limitation in COPD worsens over years as assessed by FEV1 . Parametric and nonparametric statistic techniques were used to analyze prognostic influence of acute exacerbations of COPD, smoking, compliance, and type of treatment on forced spirometric parameters in a cohort of 191 consecutive patients with COPD and chronic bronchitis followed up during 1, 2, 3, 4, 5, and 6-7 years. This study showed that acute exacerbations of COPD, smoking, and low compliance have negative impact on the patient's prognosis. We conclude that deterioration of health status in patients with COPD and chronic bronchitis could be reduced by the treatment adherence to the GOLD guidelines, smoking cessation and improvement in the patient's compliance.

Smelters working with aluminum and brass-bronze alloys and electric welders working with carbide and low-alloyed steel develop primary myocardial injury independent on hypertension and coronary atherosclerosis. This injury is characterized by structural disorders such as myocardial concentric and eccentric hypertrophy, concentric remodeling left heart myocardium, non-coronarogenic pain, changes of T-wave in ECG, and cardiac arrhythmias. According to the 10th International classification of diseases, such signs should be considered as cardiomyopathy caused by environmental exposure, namely by fine-particle aerosols of condensates of zinc, aluminum and iron oxides having slow solubility and cytotoxity.

Placebo controlled trial of efficacy of inhales silver micro-particles for prevention of exacerbations of chronic obstructive lung diseases (COPD) was carried out in industrial workers in Jamal. The study duration was 360 days (180 days of therapy and 180 days of follow-up without treatment). The patients (120 persons) were divided into 3 groups: the 1st group received inhalations of dry aerosol of silver micro-particles, the 2nd group was administered dry aerosol of sodium chloride (placebo), and the 3rd group did not receive any preventive treatment. In the group received silver inhalations exacerbations decreased twice, duration of exacerbations decreased to one third and the physical tolerance increased when compared to the placebo group.

Clinical, bronchoscopic, functional, and echocardiographic peculiarities of pneumoconiosis and dust related bronchitis caused by exposure of mixed limestone and dolomite dust are describes in the paper. Authors have studied a rate of biological aging under exposure of low-fibrogenic aerosols. Relationship has been demonstrated between functional and structural disorders of respiratory and cardiovascular systems in dust related respirato- ry pathology caused by exposure of limestone and dolomite dusts. A difference between actual and predicted biological age is shown to be used as a marker of premorbid conditions in workers exposed to industrial dust.

The aim of this work was to study functional and diagnostic characteristics of COPD caused by exposure of occupational hazards (chronic dust related bronchitis) using conventional and novel diagnostic methods. The study involved 52 patients (28 males, 24 females) having a history of long-term exposure to low to moderate concentrations of silica dust at the workplace. Of them, 31 % were smokers, 11 % were ex-smokers quitting the smoking ≥ 1 year before, 58 % never smoked. All were diagnosed with moderate COPD. We analyzed findings of spirometry, body plethysmography, and amplitude-frequency characteristics of respiratory sounds using bronchophonography. The functional "image" of COPD caused by occupational hazards included mixed obstructive and restrictive disorders, lung emphysema signs in body plethysmography, significant obstructive disorders in bronchophonography in all the patients, bilateral diffuse and focal abnormalities of lung perfusion in multi-projectional perfusion scintigraphy, worse spirometric values in smokers compared with non-smokers.

Uncontrolled course of asthma leads to ineffective consumption of healthcare resources and increase in indirect costs due to work-off days, disability and increased mortality. The aim of this pharmacoeconomic study was economic substantiation of maintenance treatment in asthma. Pharmacoecomonic analysis was performed retrospectively using data of clinical and population-based trial, monitoring of drug prices and sales, law papers. Maximal rate of achievement of long-term asthma control was 75 % (according to the GOAL study), the mean cost of medications for asthma treatment was 16,006.42 rubles per 1 patients per a year. Length of inpatient stay, calls for emergency service, unscheduled visits to a doctor and work-off days were 22.88; 4.46; 2.28; and 22.80 vs. 0.136; 0; 0.08; and 0.008 in uncontrolled and fully controlled asthma, respectively. The costs provided by unscheduled consumption of healthcare resources were 37,872 and 12223.73 rubles per 1 patient per a year, respectively. The total cost was 25,642.25 rubles per 1 patient per a year under use of maintenance treatment and 37,872.12 rubles per 1 patient per a year without the maintenance therapy. Therefore, the saving effect was 12,230 rubles. In conclusion, maintenance treatment for achieving the full asthma control is economically reasonable and well-founded.

Investigation of various asbestos-induced lung diseases caused by exposure of chrysotile and chrysotile dust allowed description clinical, radiological, and functional features of occurrence, presentation, course, and outcomes of respiratory pathology, such as chrysotile asbestosis, occupational bronchitis and lung carcinoma in workers at asbestos industry. There is a reduction in morbidity of chrysotile asbestosis together with increasing prevalence of chronic bronchitis in modern asbestos industry. Morbidity of asbestosis-induced lung diseases is strongly and directly related to the length of service and level of pollution at the workplace. Preventive measures should include prevention of development of asbestos-induced diseases and rehabilitation of workers aimed to keeping health and restore adaptive reserve.

Hemodynamic parameters of right and left heart ventricles and both greater and lesser blood circulations were studied using Doppler echocardiography in 129 patients with arterial hypertension, 54 patients with dust related respiratory pathology and 97 subjects of two control groups. Relying on the results we concluded that (1) the right heart ventricle and pulmonary circulation are targets for arterial hypertension, (2) pressure increase in arteries of lesser circulation occurs at the initial stage of dust related respiratory disease, (3) and the research of pulmonary hemodynamics with functional load should be obligatory when examining relationship between the disease and the profession.

Etiopathogenic features and diagnostic criteria of occupational diseases studying in workers engaged in colored metallurgy have been given in the paper. Polyvalent sensitization to metal allergens (nickel, chrome, beryllium, manganese) was found. A toxic effect of nickel on DNA was shown that could be used as a biomarker of exposure for biological monitoring in colored metallurgy workers. Biochemical investigations determined the main pathogenic mechanisms underlying pathomorphology of bronchopulmonary diseases caused by the exposure of colored metals, such as activation of lipid peroxidation, "proteolysis – antiproteolysis" imbalance, growing significance of infection. This is the first study demonstrating clinical and biochemical parallels between characteristics of development and course of respiratory pathology caused by the exposure of colored metals. Infectious, inflammatory, toxico-allergic, and destructive processes predominated in this pathology. Preventive and rehabilitation strategies have been developed.

Data of morbidity of respiratory diseases in children at Sankt-Petersburg are given in the article. The authors described significance and current features of respiratory diseases in children, showed a role of mucostasis in poor course and importance of mucoactive therapy in community-acquired and in-hospital respiratory pathologies. Results of post-marketing clinical trial of mucoactive efficacy of Prospan in 180 children of 6 months to 17 years of age with wide-spread respiratory diseases have been presented in the article. High mucolytic and bronchodilating activity and good safety profile of Prospan, which is dry extract of ivy leaves, have been demonstrated. No interaction was noted between Prospan and other medications used in the treatment of respiratory diseases in children. Therapy with dry extract of ivy leaves was safe in children with most prevalent co-existing pathology including early age children.