Clinical analysis of 56 cases of occupational pulmonary thesaurosis induced by dust of iron and its compounds / 中国职业医学

Objective: To analyze the clinical characteristics and imaging features of occupational pulmonary thesaurosis induced by dust of iron and its compounds (OPTIDIC). Methods: A total of 230 cases of occupational welder's pneumoconiosis (OWP) patients or observation subjects were selected as the research subjects using the retrospective analysis method. They were diagnosed in four occupational disease diagnosis institutions in Shandong Province from 2010 to 2017. The high kV X-ray chest radiography or chest digital radiograph (hereinafter referred to as X-ray) were re-read to screen OPTIDIC patients. The clinical data of OPTIDIC patients were collected and analyzed. Results: Among the 230 cases, 56 cases were diagnosed as OPTIDIC, accounting for 24.3%. The clinical symptoms of the 56 patients with OPTIDIC were cough, sputum, chest tightness, shortness of breath, and difficulty breathing, while their physical signs were low or coarse breath sounds in lungs and others. Most of the X-ray results showed p shadows or q shadows, accounted for 98.2%, of which p/p shadow and q/q shadow accounted for 62.5%. The result of chest computed tomography (CT) showed diffuse point/round shadow and diffuse glass shadow in OPTIDIC patients. The result of fibro-bronchoscopy showed that a large amount of iron lutein particles was accumulated in macrophages and biopsy of lung showed idiopathic pulmonary hemosiderosis in OPTIDIC patients. Conclusion: The clinical characteristics of OPTIDIC patients showed no different from OWP. However, the result of X-ray of OPTIDIC patients mainly showed small circular shadows, and their CT images mainly showed diffuse point/round shadows or grinding glass shadow, which could be used to the differential diagnosis of OPTIDIC and OWP.

Comparison of two imaging diagnosis methods in the diagnosis of pulmonary thesaurosis induced by dust of iron and its compounds / 中国职业医学

OBJECTIVE: To compare the diagnostic value of high-k V X-ray chest photography and chest high-resolution computed tomography( HRCT) in the diagnosis of pulmonary thesaurosis induced by dust of iron and its compounds(hereinafter called the iron pulmonary thesaurosis). METHODS: A total of 80 workers exposed to iron oxide dust in a magnetic material factory were collected as the study subjects by convenience sampling method,and they were examined with high-k V X-ray chest photography and HRCT. Differences between the two methods in the diagnosis of iron pulmonary thesaurosis were compared. RESULTS: Of the 80 workers,only 5 of them(6. 2%) showed no abnormal changes in chest HRCT,others showed varying degrees of diffuse distribution of air-cavity nodules and ground-glass lesions. High-k V X-ray chest photography and chest HRCT diagnosis of iron pulmonary thesaurosis accounted for 8. 8%( 7/80) and 37. 5%(30/80) with extreme mild degree,and 21. 3%(17/80) and 26. 3%(21/80) with mild degree respectively. The diagnostic rates for iron pulmonary thesaurosis were 30. 0%( 24/80) and 63. 8%( 51/80),respectively. There was consistency between the two methods for the diagnosis of iron pneumoconiosis( Kappa = 0. 411,P < 0. 01). The chest HRCT has a higher diagnostic classification and diagnosis rate compared with the high-k V X-ray chest photography( P <0. 01). CONCLUSION:s The chest HRCT has a higher diagnostic grade and higher diagnostic rate for lung siderosis compared with the high-k V X-ray chest photography,which is helpful for the early diagnosis of the disease.

Study on airway inflammation in patients with occupational pulmonary thesaurosis induced by iron / 中华劳动卫生职业病杂志

Objective@#To study the airway inflammation feature difference in the patients with occupational pulmonary thesaurosis induced by iron.@*Methods@#Induced sputum samples were obtained from 20 healthy men, 20 patients with stable asthma, 25 patients with occupational pulmonary thesaurosis induced by iron. Differential cell counts in induced sputum were examined. The levels of supernatant IL-8 were measured by ELISA.@*Results@#The pulmonary function result was normal in the patients with pulmonary thesaurosis., their FVC (4.1±1.2) L was similar to FVC (4.3±0.9) L in mal group; but their FEV1.0 (2.9±0.9) L、FEV1/FVC (71.9%±5.4%) were lower than normal group’s FEV1.0 (3.2±0.7 L) 、FEV1.0/FVC (79.2%±9.9%) , and were hirher than asthma group’s FEV1 (2.5±0.8) L and FEV1.0/FVC (68.7%±6.1%) . In induced sputum, macrophages percentage in patients with pulmonary thesaurosis (54.3%±9.7%) was higher than asthma group and normal group (48.4±6.4, 51.9±7.3, P<0.05) , neutrophils percentage in patients with pulmonary thesaurosis group (43.9%±7.6%) was higher than asthma group and normal group (41.3%±7.1%, 39.8%±6.9%, P<0.05) , eosinophils percentage in patients with pulmonary thesaurosis group (0.3%±0.1%) was lower than asthma group (2.8±0.3, P<0.05) , lymphocytes percentage in patients with pulmonary thesaurosis group (2.0%±0.4%) was lower than asthma group (4.7±0.6, P<0.05) ; the sputum levels of IL-8 in patients with pulmonary thesaurosis group (914.7±24.3) pg/ml was higher than asthma group and normal group (747.9%±16.8 pg/ml, (405.4±13.7) pg/ml, P<0.05) .@*Conclusion@#Macrophages and IL-8 may play an important role in the pathogenesis of airway inflammation after long-term inhalation of iron and its compounds, the airway function in patients of occupational pulmonary thesaurosis was found damaged.

Iron metabolism index in patients with occupational pulmonary thesaurosis induced by dust of iron or iron compounds / 中国职业医学

OBJECTIVE: To investigate the changes of iron metabolism index in patients with occupational pulmonary thesaurosis induced by dust of iron or iron compounds after ending iron dust exposure for 10 years. METHODS: A total of 22 patients with occupational pulmonary thesaurosis induced by dust of iron or iron compounds were selected as study subjects.They were misdiagnosed as electric welder's pneumoconiosis in 2004-2006. After ending exposure to iron dust for 10 years,high k V X-ray photography and computed tomography of chest were conducted. Indicators of serum iron metabolism,blood routine and blood biochemical were examined. Six patients were randomly selected to detect genes of hereditary hemochromatosis. The study subjects were divided into observation group( 13 patients) and control group( 9 patients)according to the lung examination. RESULTS: The median of serum ferritin( SF) was 858. 2 μg/L. The over standard rate of SF was 77. 3%( 17/22),and the iron overload was seen in 40. 9%( 9/22) of patients. The over standard rate of serum total iron binding capacity( TIBC) was 22. 7%( 5/22). The over standard rate of serum iron was 4. 5%( 1/22).The SF level of observation group was higher than that of the control group( P < 0. 05). The SF was positively correlated with alanine aminotransferase( ALT)( P < 0. 05). The serum TIBC was positively correlated with prealbumin( P <0. 05). The serum iron were positively correlated with ALT and aspartate aminotansferase respectively( P < 0. 05). But the above 3 iron metabolism indices were not correlated with the blood routine indices,blood glucose and C-reactive protein( P > 0. 05). The six patients tested for genes of hereditary hemochromatosis were excluded from disease. CONCLUSION: There were iron metabolism abnormalities in patients with occupational pulmonary thesaurosis induced by dust of iron and iron compounds,which is related to the iron deposition in lung.