professional poisoning with toxic gases

7/25/2019 PROFESSIONAL POISONING WITH TOXIC GASES

1/78

PROFESSIONAL POISONING WITH TOXIC GASES

Classification of toxic gases according to effect:

1. GASES WITH IRRITABLE EFFECT - IRRITANTS

a) with main effect to breathing passages:

Sulphur oxides (mainly sulphur dioxide)

AmmoniaChlorine

b) with main effect to lung parenhim:

PhosgeneNitrogen oxides

Ozone

2. GASES WITH ASFICTIC EFFECT

a) Simple asfictic gases nontoxic gases:

NitroenAron

!ethaneCarbon dioxide

So!e "#e$ %&e&


2/78

b) Chemical asfict ic gases

Carbon monoxide

"ydrogen cyanide

'. (AIN TOXIC GASES )ot* &+&te!i, %n $o,%$ e""e,t&"ydrogen sulphidArsenic "ydride

P*o&*in

For!%$e*+e

Et*+$en o/ie

T*e )%&i, 0%+ o" enetr%tion in or%ni&! i& re&ir%tor+ tr%,t #

SLPHR IOXIE

$xtent and professional ris%

appears in smelting of sulphide ores and alloys

in foundries

in combustion of coal in manufacture of sulphur ac id

in battery forming

in bleaching& desinfection& desinsection

!ain effect 'ocal: irritable to respiratory tract

eneral toxic effect

metabolic acidosis

disorder in metabolism of proteins and carbohydrates

(polyglobulia& methemoglobinemia and sulphates in urine)


3/78

C$ini,%$ "e%t#re&A,#te oi&onin3

S$i*t eree: irritation of upper breathing passages and eye mucous membrane& tic%ing and aches in

throat& cough& hus%iness

(oer%te eree: headache& cough& aphonia& aches in epigastrium& omiting& nausea

H%r eree3diffuse bronchitis& acute emphysema& toxic pneumonia& lung oedema& asphyxia# *ystrophic

changes of miocard& lier& %idneys#

C*roni, oi&onin3

Chronic rinitis& laringitis& bronchitis& hiposmia and anosmia& con+unctiitis& stomach and intestinal

disorders& disorder in endocrinal glands and nerous system& lung emphysema and pneumosclerosis#

A((ONIA


in fertiliser manufacturing (ammoniumsulphate and ammoniumnitrate raw materials

for bleaching in textile and furniture industry

in production of artificial fibbers& commercial refrigerant etc#

$ffect : ,rritable


4/78

C$ini,%$ "e%t#re

A,#te oi&onin3

S$i*t eree3irritation of con+unctias and upper breathing passages

(oer%te eree3swelling of larynx mucous membrane& bronchitis& bronchopneunionia and lungoedema& damage of cornea (ambliopia)

H%r eree: reduction in pulmonary and cordial function (egsitus)

C*roni, oi&onin3

chronic con+uctiitis& nasal and throat catar& anosmia& chronic bronchitis& pneumosclerosis& dyspeptic

appearnesses& anaemia of moderate degree#

CHLORINE


is produced commercially by electrolysis of natrium chloride

desinfection of drin%ing and waste waters& pools

bleaching of cotton& paper& pulp

in manufacture of chlorine compounds& polyinilcliloride& synthetic rubber etc#

$ffect: irritable

protoplasmic poison (C-./ ".0 1 ."C,/0)

reflectie as a result of irritation of breathing passage interreceptors

C$ini,%$ "e%t#re3

A,#te oi&onin3


5/78

S$i*ter eree3irritation of eye mucous membrane& nose and throat (-2 ppm)# ,n higher concentrations

(34 ppm):

reflectie spasm of smooth muscular bronchioles: sudden cough attac%& retrosternal pain and

omiting& aleolar damage lung oedema#

H%r eree3reflectable effect to breathing centre (-44-444 ppm)& exitus#

C*roni, oi&onin

in concentrations of -5 ppm headache& di66iness& gingiitis& oercoloured teeth& caries& chronic

con+unctiitis& dermatitis& ec6ema& functional lier disorder

S$i*ter "or!& of chronic poisoning: chronic rhinofaringitis& laringotracheitis& bronchitis& lungemphysema& pneumosclerosis#

H%r "or!&of chronic poisoning: diffuse pneumosclerosis& bronchiectasy& bronchial asthma& chronic lung

insufficiency and chronic cord#pulm# ,n blood: leucocitosis& polyglobulia& accelerated

sedimentation#

P%t*o$oi,%$ ,*%ne&hae irreersible character& prognosis in faourable

PHOSGENE


in application of means for fire extinguishing which contain

tetrachlorinecarbon

thermal degradation (brea%down) of chlorine carbohydrates:

tetrachlorinemethane& trichlorineethylen& chloroform


6/78

$ffect to human body

doesn7t result in significant irritable effects to upper breathing passages

influences to bronchiole damaging endotel of lung capillary

lung oedema

C$ini,%$ "e%t#re

A,#te "or! o" oi&onin3

-# initial stadium: slight irritation of upper breathing passages

.# latent period 32 h& -. h& .8 h#3# appearance of lung oedema (dispnea& cyanosis& cough& bluegrey cyanosis9eg6itus caused by

asphixia or cardial insufficiency#)

Co!$i,%tion&3 pneumonia& apsces& emboli& bronchie%tasia

Tre%t!ent3 repose& oxigenotherapy& antibiotic therapy

NITROGEN OXIES OR NITRIC GASES

!ixture of oxides: nitrogenoxidul (N.0)

nitrogenoxide (N0)

nitrogendioxide (N0.)nitrogentrioxide (N.0&)

nitrogenpentoxide (N.05)


7/78


in production of nitrogen acid& anilinic colours& artificial sil%&fertilisers

in contact of nitrogen acid organic matters or metals

$ffect to organism

cause damages of deep respiratory tract parts

C$ini,%$ "e%t#re

A,#te oi&onin3

-#Slight irritation of eyes& nasal and upper breathing passage;s mucous membrane

.#'latent period from 4&5 to 32 hours

3#Appearance of lung oedema:

alarm trias: tachicardia& tachipnea& trombocitosis&

cyanosis


8/78

C*roni, oi&onin3

-# chronic inflammation of upper breathing passages

.# chronic bronchitis3# lung emphysema

8# asthma5# egetatie disfunction

O4ONE

Colourless or blue gas with a pungent odour

Ozone i& ro#,e )+ t*e %,tion o" #$tr%5io$et $i*t 6n7 8-$%!&97 e$e,tri, i&,*%re 6$i*tnin7

%r, 0e$in9 or ioni&in r%i%tion 6!et%$ ete,tor&7 !ei,%$ #&%e9 on t*e %t!o&*eri, o/ien

E""e,t to or%ni&!

Appreciable solubility in lipids tend to be deposited in terminal broncioles and aleoli as well as in

upper airways degradation of cellular proteins and oxidation of lipids

C$ini,%$ "e%t#re&A,#te oi&onin3

irritation of eyes& nasal and upper airways mucous membrane

- pulmonary oedema usually delayed for up to 34 h

- systemic effects drowsines and headache (by relatiely high exposure)

C*roni, e/ore3


9/78

- may lead to emphysema and increased ris% of infection

NITROGEN7 ARGON7 SO(E FEL GASES 6*+roen7 ro%ne et,9

Compressed inert gases (nitrogen& argon) are used:- for welding

- for purging storag essels and pipelines- in the heat treatment of metals

'i>uid forms

- to free6e and presere foods and other materials- for situations where ery low temperatures are re>uired

?he flammable simple asphyxiants (hydrogen& propane)- as fuels- in many industrial processes

$ffects to human body and clinical features are the same li%e by !$?"AN$

(ETHANE


constitutional part of =mines gas= @4

pillboxes for coal sorting decomposition of organic matters (Bmud gas)

in production of crude petroleum



10/78

syndrome of oxygen insufficiencyC$ini,%$ "e%t#re

A,#te oi&onin

headache&di66iness& sleepiness& accelerated pulse and breathing& disorder in moement co

ordination

omiting& loss of consciousness 0b+ectiely: coldness and pale s%in

hipotonia

- CNS changes

- leucocitosis (,imphocitopenia)

CARBON IOXIE

$xtent and professional ris% in combustion of organic matters with oxygen presence

in fernientatie processes (cellars& grain eleators)

in foundries& refrigeration plants


irritable effect to s%in and mucous membranes

depressiely to breathing centre (in high concentrations)

due to decreased oxygen anoxemia

C$ini,%$ "e%t#re

A,#te "or!&3

Hi*er t*%n3 .: headache& wea%ness& sleepiness

5 D : irritation of mucous membrane of upper breathing passages& bu66ing in ears&

di66iness& irritability& psychical disorders

-4 : loss of consciousness (anoxemia)


11/78

A"ter oi&onin3retrograde amnesia& headache& wea%ness& bronchitis and bronchopneumonia#

CARBON (ONOXIE


in combustion of matters without sufficient oxygen presence:

coal combustion& co%e plants& iron and steel foundries& coal mines& electric and autogenic welding


?oxic effect conse>uence is hypoxia

-# Concerning blood it is connected to hem towards which has.44 344 times greater affinity and produce carboxichenioglobine (C0"b)#

.. Concerning tissues

a) is connected to mioglobine producing carboximioglobin 6CO()9 which decreases oxygen

transfer to muscle mythohondries& particularly miocard#

b) influences the en6ymes that hae hem group: c itohrom a 3 and p854 thatparticipate in cell

respiration#

Clinical feature:

Acute poisoning:

Slight degree: (.434 C0"b): headache& di66iness& ear bu66ing& chest oppression& nausea

omiting& wea%ness& accelerated pulse& retarded reactions#


12/78

!edium hard degreeE (3435 C0"b): loss of consciousness& organic damage of CNS& wea%ness&

muscle slac%ness

"ard degree: (5424 C0!b): coma and symptoms of diffuse cerebrum damage(tonic cramps in

extremities&epileptifermal attac%s& pathologic reflexes)& accelerated breathing& accelerated pulse&hipotonia#

Chronic poisoning:

appears as a result of close C0 influence to CNS Functional cumulation damage of centre in

meninx Symptom: headache& di66iness& asthenia& ear bu66ing& heart palpilation&fatigue&irritability&

wea%ened memory

Cerebroascular& cardioascular disorders& atherosclerosis (C0"b to --)#

H:ROGEN C:ANIE AN C:ANIES

$xtend and professional ris%

in desinsection and deratisation

manufacture of "ydrogen cyanide acid& salts and other compounds

$n manufacture of siler& gold and mercury from minerals

galanisation

fertiliser production

bensol& toluol& pesticide production

Gays of penetration:

respiratory tract digestie tract s%in

mucous membranes


13/78

$xcretion

through lungsthrough %idneys (rodanide)


bloc%ade of respiratory ferments& citochromoxidasis tissue anoxia CNS& respiratory and

asomotor centre

direct toxic effect to central nerous system

Clinical featureAcute poisoning:

Slight form: headache& di66iness& chest pain& accelerated breathing

"ard form: loss of consciousness& widen pupil of eye& eg6oftalmia& dispnea& cramps& paralysis of

respiratory centre

,nitial stadium: metal taste and tic%ing in mouths& irritation of eye mucous membrane& wea%ness&

headache& di66iness& nausea and omiting#

*ispnoic stadium: disorder in respiratory rhythm& bradicardia& heatt pains#Conulsie stadium: clonic and tonic conulsions& +aw trismus& loss of consciousness#

Paralytic stadium: loss of consciousness& areflaxia& unwillingly urination& defecation& paralysis of

respiratory centre and stoppage of heart function exitus#

H:ROGEN SLPHI



14/78

manufacture of sulphur types of petroleum sewage system& waste water pools

in sugar refineries& breweries& tanneries

copper& nic%el& cobalt extraction from minerals


-# intensie irritable effect to mucous membrane of eyes and

breathing passages

.# general toxic effect inhibition of Garburg;s breathing ferment

tissue anoxia

Clinical feature

Acute poisoning:

Slight degree : irritable symptoms at mucous membrane of eyes and breathing passages

!edium degree: symptoms of respiratory effects: headache& di66iness& wea%ness& nausea&

omiting& disorder in motoric coordination& irritability or loss of consciousness& bronchitis&

bronchopneumonia& tahicardia& cyanosis& increased temperature#

"ard degree: disorder in respiratory and cardioascular system& coma and death#

Superacute and apoplectiform degree: paralysis of respiratory and cardioascular centre& loss of

consciousness death#

Subacute form: headache& di66iness& wea%ness& fatigue& perspiration& irritation of nasal and throat

mucous membrane& cough& nausea& omiting#


15/78

ARSENIC H:RIE 6ARSINE9

$xtend and professional ris% in treatment of metals with acids

,n production of metals

,n manufacture of acetylene melting of lead alloys

Arsenic hydride is released wheneer hydrogen in status nascenti appears in presence of arsenic#

$ffect to human bodyChemolitic effect hemoglobinuria& anaemia& reticulocitosis& +aundice& damage of %idneys#

Clinical feature

Acute form:

'atent period 3D hours wea%ness& shiering& headache& obstructed breathing& dispnea& tahicardia&

extended lier and spleen& oliguria& reddish urine& anaemia& leucocitosis& reticulocitosis&

hiperbilirubinemia,n urine: albumens& eritrocites& cylinders# *isorder of central nerous system

Conse>uences: arsenic polyneuritis& disorder in fat metabolism& damage of %idneys& lier& heart and

nerous system#

Chronic poisoning:

pale s%in& di66iness& fatigue& obstructed breathing& anaemia& changes on s%in#


16/78

PHOSPHIN

Phosphine is a colourless& flamable gas with a caracteristic& unpleasant odour associated with the

gas due to other phosphorus compounds which are always present

$xtend and professional ris%

,n treatment of grain as a grain fumigant

,n electronics industry as a dopant& mixed with nitrogen ,n manufacture of acetylene as a unwanted byproduct


P*o&*ine i& % &+&te!i, %n %n irrit%nt. P*o&*ine7 ro)%)$+ )$o,;& t*e re&ir%tor+ ,*%in )+in*i)itin ,+to*ro!e o/i%&e in t*e &%!e 0%+ %& ,+%nie. It in*i)it& ot*er enz+!e&7 %n re%,t 0it*

*%e! %n ,oer ,ont%inin rotein&.

Clinical feature

Acute form:

Ner5o#&7 %&trointe&tin%$ %n re&ir%tor+ &+!to!&3 5ertio7 *e%%,*e7 tre!or7 i!%ire

!#&,#$%r ,oorin%tion7 ro0&ine&&7 n%#&e%7 5o!itin7 $i5er +&"#n,tion7 ;ine+ in"$%!!%tion7 ,*e&t

%in7 &*ortne& o" )re%t* %n ,o#*. e%t* i& o"ten ,%#&e )+ e$%+e #$!on%r+ oee!%.

Chronic form:

?here is scarcity of symptoms of chronic exposure#

$xcreted in urine


17/78

FOR(ALEH:E

Formaldehyde is a colourless& flamable gas with a pungent odour& ery soluble in water#

$xtend and professional ris%:

- in manufacture of pharmaceuticals& cosmetics& household cleaners& photographic solutions& dyes&

paper& rubber& fertilisers etc#

- as a desinfectant and fumigant

- for the preseration of biological and anatomical specimens- in manufacture of polymeric resins

,t is ubi>uitous in enironment (oxidation of methane in $arths troposphere& burning of wood&

decomposition of egetation etc)

,t is normally present in animal tissues (endogenous and exogenous)


Formaldehyde is a s%in& eye and respiratory irritant


18/78

uid or gas& highly reactie

$xtend and professional ris%:

- in manufacture of ethylene glycol (for antifree6e and polymeric resins) non ionic surfactants and

ethanolamines

- sterilising agent in hospitals and medical products


Acute exposure is relatiely rare symptoms: nausea& omiting& headache& dyspnoa& irritation of the

eyes& nose and throat& and later pulmonary oedema& bronchitis and $C abnormalities#

Chronic exposure is relatiely high symptoms (low leels) numbing of the sense of smell& slighteye irritation& and aderse effects on a number of organs& including the lier& %idneys& adrenal gland&

testes and CNS

Carcinogenic effect


19/78

.# "ydrocarbon halogen deriaties3# Aliphafle hydrocarbons

8#Alcohols

5#$thers

2#$stersH#Aldehydes

D#Ietones@#Carbon disulphide

-4#Alicyclic hydrocarbons

C"A


20/78

P$N$?


21/78

BEN4ENE HO(OLOGES

BEN4ENE CONENSES

*$


22/78

,n lier phenol& triphenol& catehol& hydrochinol& in con+ugation with " .S08 and glucuronic acid

are deeloped organic sulphates and glucuronates#

Pathophysiological mechanism of effect:

"ipoxia (without 0.)*ecreased ascorbic acid synthesis& C hypoitaminosis

*isturbance of oxidoreductie processes


23/78

?"$


24/78

Application: plastic mass

GAM 0F $N?


25/78

as before mentioned

?0K,C,?M:

Acute: Narcotic effect& eneral symphatomology of CNS& lier& heart& %idneys

Chronic: $ffect to CNS (tox# encephalopathy)& gastrointestinal& lier

ALIPHATIC H:ROCARBONS

BEN4INE3

Structure hydrocarbon mixture

Application: fuel& solent& in rubber industty& in colour andanish industiy& oil extraction from seed

GAM 0F $N?


26/78

eneral symptoms& depression& tremor& irritation of eyes& respiratory system and s%in#

F,


27/78

APP',CA?,0N: !anufacture of iscose fibbers& cellophane& optical glass& glue& in chemical

industry& solent& pesticide etc#

- GAM 0F $N?


28/78

"ard form: *amage of nerous system

-En,e*%$o%t*+

$ncephaloneuritis

*amage of peripheral nerous system Polyneuritis

"ard sensibility disorder up to anaesthesia& wea%ened tendinous reflexes

$xtreme egetatie simpt#

*amage of endocr# system (adrenal gland& thyreoidea& testis)

Lascular disorders arteriosclerosis& most fre>uently on cerebral and renal bloodessels

?


29/78

-#,nhalatory

.# S%in and mucous membrane3# astrointestinal (rare)

$',!,NA?,0N:

Jnchanged through lungs

?hrough urine in compound with " .S0 8 or glucuron acid#

POISONING3

,rritable effect (s%in& mucous membrane& respirat#& gastroint# and urin# system)#

"ematopoiesis damage

Parenh# org#(lier& %idneys)

CNS

ETIOLOG:3

*irect toxic effect of none or metabolites

"ypoxia (met# and9or sulph# "b)

(ET- H)

Normally: -

Conditioned by en6ymatic system of met "breductases which re>uire *PN" and ?PN" as coen6ymes&

and nonen6ymatic glutation


30/78

SJ'P" "b

Fe loses capacity of connection with 4 .but not C0# !et and Sulph "b result in cyanosis # Cyanosis

appears when 5gr# "b is reduced at -44 ml of blood# *eath appears when 22 of "b is transformed in

!et "b#

Githin blood are present:"ein6;s bodies

"emolysis

"ypoplasia& aplasia (marrow)*amage of lier

*amage of %idneys

CNS (palidostrial syst# n#opticus)

NITRO ERI8ATI8ES

NITROBEN4ENE

Characteristics (flaour of bitter almond)Application (colours& explosies& soap md#)

Gay of entrance$liminationPoisoning

Acute

,rritable symptom

*amage of CNS with parestes#epylept# conuls# Coma& death as a result of breath

paralysis


31/78

*amage of lier

Chronic

,rritation (s%in& respiratory and d&gestie system)!et"b

*amage of lier and CNS

?reatment:

?a%e out poisoned person

S%in decontamination

0xygen therapy

?reatment of !et ,lb with ascorbic acid methylene blue

?ransfusion

"epatoprotectie therapy

?


32/78

"ypoplas# aplas# of bone marrow"epatocyte necrosis

?oxic nephrosis

?reatment

A(INO ERI8ATI8ES

ANILINE

Characteristics: colourless oil li>uid& characteristic smell& water insoluble

Application: colour industry& explosie& perfume& pharmac#industiy& rubber and pesticide md#

Gay of entrance:

$limination: ,n human body it is oxidised in phenyl hydroxilamme and this in pam aminophenol which is

con+ugated with " .S48# glucuronic acid and is eliminated with urine#

P%t*oene&i&3$ffect of noxa itself is minimal it is effect of metabolism#

Causes:

P$

"emolysis


33/78

!et"b

"ein6 bodies

Poisoning:Acute: euphoria& loss of consciousness& di66iness& headache& wea%ness& sight disorder& s%in and

mucous membrane liidity& cyanosis& dar% urine#

Chronic: wea%ness& atonia& anaemia& P$

FA

ploughing (cultiation of land)

sowing


34/78

plant disease protection (pesticide spraying)

manureing

harest

etc

Gor% conditions:

often wor% alone

wor% under all weather conditions

long hours wor% with few brea%s

hard wor% (rarely)

dust (organic and9or inorganic)

pesticides apoursmanure dust

noise

ibrations

exhaust gasses

ery powertul e>uipment (in+ury possibility)

F


35/78

dust (organic and9or inorganic)

pesticides apourQs and dustQs

manure dust

much rarely (specially on big plantages)

noise

ibrations

exhaust gasses

ery powertul e>uipment (in+ury possibility)

CA??'$


36/78

6oonoses

in+ury possibility

Access to emergency serices and trauma treatment is ery often poor in rural farming areas#

?hey share a common home and wor% enironment and often are in business with relaties

and inlaws#

S,N,F,CAN? "$A'?" P


37/78

?


38/78

in the air

passenger aiation

cargo aiation

business aiation (f#e# airspraying& airmanureing)

sport and pleasure aiation

national destinations

international destinations

intercontinental destinations


39/78

ery powertul e>uipment

personal conflicts etc

S,N,F,CAN? "$A'?" P


40/78

exhaust gasses

noise

ibrations

ery powertul e>uipmentlocal traffic (fre>uently stops)


S,N,F,CAN? "$A'?" P


41/78

R%io %n R%%r ,re0

S%i$or et,

G0uipment (shipengine& ship power plant& ships crane etc)


S,N,F,CAN? "$A'?" P


42/78

Ooonoses

A,< ?


43/78

S,N,F,CAN? "$A'?" P


44/78

-5o$#!e

-inten&it+

-"re=#enz+

-,o$or

-et,.

OCCPATIONAL HEARING LOSS

0ccupational hearing loss can be defined as a partial or complete hearing loss in one or both ears araising

in& or during the course of& and as the result of oneQs employment#

?his includes acustic traumatic in+ury

noise induced hearing loss

Acustic traumatic in+ury araising out of traumatic in+uri such as explosions or a blow to the head#

Noise leels much lower than those producing acoust ic trauma may produce hearing loss if the exposuresuffitiently intense and prolonged#

?herm Noise induced hearing loss is generally used to denote the cumulatie& permanent loss of hearing

that deelops gradually after months or years of exposure to high leel of noise#

Pathophysiological matter of hearing loss

bloodessel spasamor

neuromechanical damage


45/78

$arli signs of hearing loss include:

*ifficulty in anderstanding spo%en words in a noisy enironment

Need to be near or loo% at the person spea%ing to help understand words

Familiar sounds are muffled

Complaints that people do not spea% clearly


46/78

Wor;in ,%%)i$it+3

it depends from grade of hearing loss

Noi&e !e%re!ent

Sound consists of small& rapid& local fluctuations in atmospheric pressure which can be detected by humanear

'i%e human ear microfon is capable to detect the small fluctuations in atmospheric pressure and transform

them in electrical impulses which are corresponding to pressure leel

,nstruments are sound leel meters

!esurement units are decibelQs d

*ecibel scale& which is logaritmic& express the magnitude of atmospheric pressure fluctuations

"earing range is 4 -84 d (pain limit)

!aximal allowable noise leel D5 d(A) S


47/78

SAGE3

detection of underwater ob+ects sonarinestigation of underwater relieffor measurement of depth7 s

remote controllers for home and other e>uipments (alarm&garage doors etc)

for metal cutting and welding in !ei,ine *opler;s effect and in therapy thermal actiity in stomatology remoing of layers mechanical actiity

C$ini,%$ "e%t#re&3

Symptoms of exposure to high fre>uency JS can appear only in case of direct contact among body(body parts) and source of ultrasound#

$xposure to low fre>uency JS can cause local and oerall symptoms

A wide range of symptoms can be present in accordance with transfered energy

Symptoms can be localegetati polyneuritispartial paralysis of fingers& hands& forearmetc

and oerallinflamations


48/78

haemorrhagiasnecrosis

INFRASON

is sound $'0G -2 or .4 "6

,n nature it appears during wae actiity and their stri%ing of the coast& in case of aalanchemoements& in earth>ua%es etc#

,n industry it appears together with low fre>uent noise and ibrations of great power machines& atsmall number of rotations& actiities and stri%ing of moing parts& in fans& gas turbines& compressors&ships and helicopters#

E""e,t on *#!%n )o+3

- ,S D "6 most dangerous for human7s correspond with brain alpha wae7s di66ines& loss ofconsciousness& een coma

- ,S -3 "6 can cause breathlessnes and disturbances in respiration rhythm- ,S 5@ "6 can cause chest pain and pain in low abdomen- ,S D-. "6 can cause loins pain- ,S -. .4 "6 can cause mouthpain& pain in throat& bladder& rectum& some muscles etc

C$ini,%$ "e%t#re&3'ong term exposure: cause wea%ness

irritabilityfatiguesleep disturbanceswor%ing capabillity reduction


49/78

BARO(ETRIC PRESSRE 6BP9

is a pressure performed by atmospheric air on eerything on the earth

P is expressed in mm"g or milibars (mbar) 1 !)%r > ? !!H

P


50/78

0N ?"$ S$A '$L$' pressure is

1@1'72 !)%r > @!!H > 1@17';P% > 1 At!

EFFECTS OF ECREASE BARO(ETRIC PRESSRE

6HIGH ALTITE SICDNESS 6HAS9 SD: ISEASE9

At the sea leel partial oxygen (0.)pressure is -5@&- mm"g&

At 3444 m --4mm"g& which means saturation of oxyhaemoglobine @3@8#

Further decrease of partial pressure results in stepwise hipoxia oer 8444m#

For deelopment of clinical picture of disease more significant is partial 0 .pressure in aleolus;s&

which is in correlation to partial pressure of C0 . and water apour#

Partial C0.pressure in aleolus;s is 3484 mm"g& and that of water apour is 8H mm"g#

?he increase of pressure of gas mixture (e#g# air his components) cousese the increase of partial

pressure of each component of the mixture& and this increases the solubili ty of each component found the

mixture in the body fluids#

?his means if total barometric pressure is decreased to DH mm"g& (C0 ./ water apour 1 DH)#

$ntrance of air in lungs becomes impossible this can be preented by breathing in pure 0 .(-44) but blood oxygenation up to @3 is possible only up to heights of -4 %m#

At -4#444 m barometric pressure is -@D mm"g& which is -98 of pressure at sea leel#

?here gasses spreading 8 times more in body caities (sinuses& ear& gastrintest# tract)

Spreading of gases results in s%y meteorism& sinusitis& otitis and =aerodentalgia=#


51/78

,n >uic% decompression melted gas releases in the form of bubbles#

ECO(PRESSION ISEASE is classified to:

&;in "or! t*e ,ree& usualy mild and of minor significance tingling or itching inlocali6ed areas (area of limbs or chest& thighs) o&teo!io%rtr%$i, "or! the commonest manifestation (in more than H4 of cases) pain is

centered around a %nee& shoulder& elbow& wrist or an%le (hips are much less affected)# %r%$+ti, "or! ery rare (R- of cases) but can inole any part of central nerous system wide range and localisations of paresthesias & localised anesthesias and een paralysis and

conulsions are possible ,%rio#$!on%$ "or! appears in about 8 of cases but t*e+ %re o" &erio#& i!ort substernal pain& constriction in the chest and epigastrium with general and increasing wea%ness

can lead to death,*roni, !%ni"e&t%tion& (aseptic bone necrosis)

TREAT(ENT

AS S00N AS P0SS,'$ RECO(PRESSION&

thenECO(PRESSION

(in accordance with prescribed protocol (time table))

E.G - T0o roto,o$& o" e,o!re&&ion


52/78

e5en =r%#%$

eery . min to to decrease p# to half

decrease p# then pause

for -4 %Pa

ESTI(ATION OF WORD ABILIT:

*epending on form and difficulty of decompression disease

PRE8ENTION

-#


53/78

wor%ers in tunnel wor%

diers

wor%ers in geological inestigations of flora and fauna caes

Appearance of caisson

EFFECTS OF INCREASE AT(OSPHERIC PRESSRE

A *irectly physically

,ndirectly biological and metabolical

WATER

RI8ER

BOTTO(

A pre chamber

central chamber

C tubus

* wor%ing chamber

$ compressor unit


54/78

A# ,n >uic% compression or in case of fall of dier in depth or when air supply in scafander stops&

appears phenomenon of succinum, with difficult fractures& or e+ection of dier and drowning at enormous air

addition in scafander#

# Simultaneously with increasing of common atmospheric pressure& the partial preassures ofcomponents of inhaled medium (gas mixtures for diing) incresing also#

0xigen Neurotoxicity

Pulmonary toxicity

Nitrogen Narcotic effect =deep sea drun%enness=

Carbondioxid lood hypercapnia

IN CASE OF ICD E(ERGE 6I8ERS7 CAISSON WORDERS9 OR FAST TADE-OFF 6PILOTS9

WILL E8ELOP THE

ECO(PRESSION ISEASE

PRE8ENTIONPROFESSIONAL OR WORD-RELATI ISEASES CASE B:

NON-PH:SIOLOGICAL WORD CONITIONS

A(AGES OF LOCO(OTORI(

Periarthritis of shoulder +oint

Prof bursitis


55/78

?endoaginitis crepitans Professional miositi s

Flat foot

Inee +oint deformations

Spinal deformations

Laricous eins

Abdominal hernia

*escensus and prolaps in genital organs Professional neuri tis

Coordinat ional neuroses

Professional lung emphysema Professional laryngit is

*isorders in s ight sense

Nistagmus at miners Prof stigmata

CJ!J'A?,L$ ?


56/78

!illions of wor%ers are reported to be suffering from the deelopment of cumulatie

trauma disorders (C?*s) or are wor%ing in +obs which hae been considered by arious

authorities to be associated with an increased ris% of C?*s# "oweer& a great deal of

controersy exists about:

the definicion of C?*s&

the true incidence of the diseases&

+obs and +ob tas%s at ris% of causing C?*s&

treatment issues&

ergonomic interentions& and

preention strategies#

'ow bac% pain ('P)

'P is one of the oldest occupational health problems in history

(


57/78

'P is one of the most common health problem

(D4 of wor%ers will expirience 'P sometime during their actie wor%ing life#

At any gien moment -4-5 of adult population of the JSA expiriences 'P

-- Americans report ' impairment or a reduced ability to function

$ery year . of the employed lose time from wor% because of 'P

A!0N !$*,CA'


58/78

PA?0P"MS,0'0M

Pain in the lubosacral spine can result from inflammatory& degeneratie& neoplastic&gynecologic& traumatic& metabolic and other types of disorders#

?he great ma+ority of 'P remain nonspecific and un%nown cause


59/78

!any theories regarding the origin of nonspecific 'P hae been proposed& but so far

no one has been able to proe how and where the pain arises#

!ultifactorial aetiology of bac% pain


60/78

*iagnosis& !enagment& Prognosis !edical


61/78

P


62/78

Carpal tunnel sindrome (C?S)

It i& ,%#&e )+ in#r+ to t*e !ei%n ner5e in t*e 0ri&t


63/78

C?S often presents in early stages with intemietent paresthesias& hyperesthesia& or

hypoesthesia in the sensory distribution of the median nere in the hand# 0ften& symptomsare first noted in the dominant hand and may be bilateral# 0ccasionally& complaints are

restricted to one or two fingers& usually the middle finger or index and middle fingers#

Complaints of pain and numbness may occur later& with up to -5 of affected indiiduals


64/78

experiencing pain radiating to the upper arm or shoulder# !otore deficits in the abductor

pollicis breis& opponens pollicis& or flexor pollicis breis may be found in more seere cases

of C?S

Wri&t "$e/ion te&t Tine$& te&t

Po&iti5e n#)ne& %nor tin$in

NONOCCPATIONAL RISD FACTORSF0< ?"$ E8ELOP-(ENT OF CTS

Female sex&


65/78

hemodialysis& 0besity& Neop'asia (including benign tumors and lesions)& 0steoarthritis&

Aberrant muscle bodies& Acute trauma& Coiles7 fracture& Grist fractures and dislocations

,mproper immobili6ation of the wrist& Congenitally small carpal tunnel canal

?"$


66/78

?his is an intlammation of the tendon or the tendon sheath causing inflammation and pain#

Ghen inflammation precludes free moement of a finger tendon& the result is stenosing

tenosynoitis& or trigger finger# *e uerain7s disease results from stenosing tenosynoitis of

the abductor poilicis longus and extensor poilicis breis# !oements which may precipitatethese effects include flexion of finger tendons with a flexed wrist (finger flexor tendons)T

ulnar deiation wich outward rotation as in L*? users (finger extensor tendons)T or repeated

radial or ulnar deiations as the wrist& particularly in combina tion with force of the thumb

(de uerain7s disease)# ?he chronic use of a screwdrier or pliers may result in de

ueratn7s disease#


67/78

icipicatal9uiring abduction with or without rotation& as

well as constant or repetitie forward eleation of the arm at the shoulder#

$picondylitis


68/78

Athloetic moements and wor% tas%s may be associated with medial (Bgolfer7s elbow=) or

lateral (=tennis elbow=) epicondylitis# Contributing actiities include wrist9finger extension

wich elbow extension& abrupt elbow extension or forearm supinacion as in lifting and

pushing up (lateral epicondylitis)& or wrist9finger filexion with forearm pronation (medial

epicondylitis)#

anglionic Cysts

?hese may arise arfter acute trauma or in a degeneratie or diseased +oint or tendon#

Pronator Syndrome

Proximal forearm pain with pronation of a tightly clenched fist against resistance may be

assotiated with median nere sensory loss when the median nere is compressed under the

pronator muscle#


69/78

interosseous muscles# ?as%s associated with repetitie elbow tlexion (e#g#& hammering&

shoeling& lifting) or repeated tauma or pressure to the ulnar grooe (e#g#& leaning elbows on

a des% or wor%bench) are possible causal factors#

Jlnar Neuropathy

!otor and sensory symptoms may occur in the hand from in+ury to the palmar branch of the

ulnar nere at the hand9wrist# Jsing the hand as a hammer or putting pressure on the

hypothenar eminence (as in using pliers& staplers& or pneumatic drills) can result in this

in+ury# Ghen the deep motor branch is affected& wea%ness of the interossei and the third and

fourth lumbricales occurs without any sensory findings# ?his is seen most often in

electronics assembly wor%ers& +ewelers& and machinists#

Supinator or Posterior ,nterosseous Nere Syndrome

Single or repeated forceful pronacion& supinacion& radial deiacion& or abrupt elbow

extension can result in radial nere compression and in+ury in the supinator muscle&

Affected indiiduals hae wea% hand grip and wea% wrist9finger extension without sensory

symptoms# !usicians& pitchers who throw screwballs# and construction wor%ers who

hammer with a straight arm or lift with extended arms are at ris%#


70/78

?horacic 0utlet Syndrome

?horacic outlet syndrome may result from either impingement of the blood supply or the

neres to the arm as they pass from the nec% to the shoulder# Compression may occur in the

scalene muscle& from cerical ribs# fibrous bands& or transerse CH errebral processes#

Symptoms ary with ascular or neurologic compression but may include lateral arm pain&

paresthesias of the ring and small fingers& hand swelling or wea%ness& and a causalgiali%e

syndrome# A 3minute eleated arm stress test is helpful in diagnosis# Adson7s maneuer is

often positie but may be seen in -4 of the normal population# $lectrodiagnostic studiesare helpful if they demonstrate a bloc% across the brachial plexus& between the axilla and

$rb7s point& or between $rb7s point and the CH nere root# Larious actiities and postures

hae been associated with this disorder& including pulling the shoulders bac% and down& as in

military personnel standing at attencionT carrying heay loads in the hand& as in painters&

welders& or persons carrying suitcasesT and wor%ing oerhead with repetitie abduction and


71/78

adduction of the shoulder and arm& as in automotie or aircraft repair wor%ers# 0nce

commonly diagnosed in wor%ing populations& thoracic outlet syndrome is now felt by some to

be oerdiagnosed#


72/78


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75/78

PROTECTION OF WORDING WO(AN

0ccupational noxae haing negatie influence to:

-# men and women e>ually noise prof# hearing los&sight strain prof# myopio

.# women more than men& but not disturbing reproductie functionphysical strains of bone and +oints neuromuscular system&

s%in

3# reproductie function (toxic substances& radiation)

In"$#en,e o" o,,#%tion%$ no/%e on 0o!%n& *e%$t*7 e&eti%$$+ #rin ren%n,+7 $%,t%tion %n

!eno-%#&e7 i& #e to

*isorder in lier function& increased permeability of capillaries& irritability of egetatie nerous

system& spasm of smooth musculature& increased metabolism& lung entilation& blood circulation& 0*i,*

%,,e$er%te& %)&ortion o" to/i, )&t%n,e&.

$##

-# *isorder in menstrual cycle (lead& mercury& arsenic& yellow phosphorus& gasoline& ben6ene& " .S&

phenol& ?N?& formaldehyde causing:


76/78

.# Sterility (pb& mercury& arsenic& gasoline)

3# Pathological pregnancy due to penetration through placental membrane (Pb& mercury& Cd& P#

"&S& petrol& nicotine& pesticides)#

8# Penetration of toxic substances in mil% (decreased >uantity& taste)

5# $mbryogenesis disorder (!n& formaldehyde& hloropren&pesticides)

PH:SICAL STRAINS3

carrying of load

ibrations and wor% in standing position result in:

- disorder in menstrual cycle&

- incontinence of urine

- prolapse ofgenital organs

HIGH TE(PERATRE AN- RAIATION 6IONISE9 re$t in3

- disorder in oarial 9 menstrual function

PRE8ENTI8E (EASRES

technical

hygienic

legislatie administratie

social care medical

HEALTH CARE OF :ONG PEOPLE


77/78

1J-1K :EARS OF AGE

- increased neuroendocrinal function (pituitary gland& thyroid gland&

adrenal glands& sex glands)

deelopment of musculosceletal system is not finished rapid changes in cardioascular and nerous system

accelerated methabolism instability of egetatie nerous system

instability of stomach secretion function

:ONG PEOPLE NER 1K :EARS OF AGE

CANNOT WORD3

in 6one of ionised radiationin increased atmospheric pressure

with toxic substances (Pb& mercury& !n& ben6ene& pesticides)

in raised dust (>uart6& asbestos)oertime and night wor%

- physical wor% in -8-5 aged person represents -9. of physical power of adult person& and .93 in -2-H

aged person#

!%/i!%$ %$o0e $o%3

-constant up to 8 %g

- single& occurring once men -2%g from -2 to -D

women -4%g years of age


78/78

from -5 -2 years of age . times less

noi&e !%/i!%$3

-5.4d less than adult persons&if not possible& up to @5d short time exposition

PRE8ENTION

technical

hygienic

legislatie administratie

social care medical

PROFESSIONAL ORIENTATION

professional poisoning with toxic gases

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