Morphological Study Of Small Opacities And Hilus Pulmonis And Pulmonary Markings Of Different Type Cement Workers' Pneumoconiosis On High-thousand-volt Chest X-ray

ObjectiveCement is synthetic silicate,it's raw material are limestone and clay,and the blast furnace slag.Cement pneumoconiosis is classified as silicate pneumoconiosis.In cement production process,the concentration and composition of all kinds of dust are great different,which caused the different characteristics on chest X-ray image changes.Cement pneumoconiosis is due to long-term inhalation of productive dust in cement production process and the dust produced the pneumoconiosis.Productive dust is the main occupational hazards in cement production operations. Because the cement production process is complex,dust in the production process is different,the dust that the workers contact in different phases are not the same, therefore,the cement of pneumoconiosis is not only relate with dust concentration and the job seniority and individual factors,but also relate with the chemical composition of cement.Cement pneumoconiosis has the characteristics of low incidence,long job seniority of disease,slow progression of the disease,the average time from contacting with cement powder to falling ill is more than 20 years,due to the end product has low content of free SiO₂,and the characteristics of cement pneumoconiosis,early literature thought of the cement production raw material has greater damage than cement products,and cement products would not cause pneumoconiosis.In the early 1990s, China launched large-scale cement pneumoconiosis census,which confirmed that all kinds workers contact dust particles are suffering from pneumoconiosis in different stages of cement production process.The incidence of domestic and overseas cement pneumoconiosis is lower than coal miner's pneumoconiosis and pneumoconiosis,and the number of cases of pneumoconiosis is relatively less than aforementioned two type of pneumoconiosis,the imaging analysis and research of cement pneumoconiosis chest X-ray has failed to penetrate deeply,the description of the characteristics of cement pneumoconiosis chest X-ray is too general.Our research mainly focuses on the occupational hazards in principal cement production technology process,have analyzed the imaging findings of small opacities and hilus pulmonis and pulmonary markings of cement pneumoconiosis on high-thousand-volt chest X-ray caused by raw cement material dust and ready cement materials dust and the end cement product dust,moreover we clarify the difference and characteristics on chest X-ray of the pneumoconiosis caused by the three kinds of dust,so as to provide imageology evidences for imaging diagnosis and differential diagnosis of cement pneumoconiosis.MethodsWe select the workers who suffered cement pneumoconiosis and suspected cement pneumoconiosis of Liaoning Gongyuan cement group as the research object,and have 498 samples after quality controlling,including three worker type:(1) raw materials workers(2) ready materials workers(3) end product workers.According to the GBZ1-2002 "the standard design of industrial enterprises",we tasted the dust in air of the operating point.We tested the dust concentration and the free SiO₂ content and the dispersity of the dust according to the national standard GB5748-85,the determination method of dust in workplaces.In the testing,we have the sampling measurement jobs by IFC-2 dust sampling instrument which produced in Beijing,and take the high-thousand-volt chest X-ray by American GE Proteus XP - 50 type 800mA X-ray machine.The radiography are analyzed by three doctors who has obtained qualification of occupational disease diagnosis according the pneumoconiosis disease diagnosis standard(GBZ70-2002).Compared the concentration of the small opacities and the frequency of different small opacities and the rate of changing of hilus pulmonis and pulmonary markings in high-thousand-volt chest X-ray according to the three worker type of raw materials workers and ready materials workers and end product workers respectively.ResultsThe highest concentration of contacting dust of three worker types is the dust in end product workplaces,which ranged from 50.84 to 59.70 mg/m³,followed by the dust concentration in raw materials workplaces,which ranged from 33.90 to 34.66 mg/m³,the dust concentration of ready materials workers contacted is lowest,ranged from 13.79 to 16.81 mg/m³.The free SiO₂ contend of raw materials workplaces is highest in the three types workers' workplace over the years,reaches 6.08%.The free SiO₂ contend of ready materials workers' workplace is 4.32%,and the lowest free SiO₂ contend appears at end product workers' workplace,which is 1.81%,all these value of free SiO₂ contend are less than 10%.In all kinds of objects,the average concentration of small opacities in high thousand volts X-ray radiography of raw materials workers is significantly higher than end product workers'.Over all,the average concentration of small opacities of raw materials workers' and ready materials workers' and end product workers' appears a decrease progressively tendency.We find that the irregular small opacities appear at the left-middle lung field early period mostly,and then extend to lower lung field or to upper lung field,it can cloud all the lung field atâ…¡period pneumoconiosis,this moment,we can find "u" type small opacities,the left lung are more serious than the right lung,and we have not find accumulative small opacities.The round small opacities and irregular small opacities are appear on all kinds of radiography in this study,the number of lung area that "p" opacities and "q" opacities appear of raw materials workers' radiography is more than the number of ready materials workers' and end product workers' of the same pneumoconiosis period,and the "s" opacities and the "t" opacities in end product workers' radiography are more than the raw materials workers'.The changes of hilus pulmonis and pulmonary markings of all kinds of workers' radiography have not significant difference in 0+ andâ…¡period.Inâ… andâ… ⁺period, the changes of hilus pulmonis and pulmonary markings of raw materials workers' are more serious than ready material workers' and end product workers'.Conclusion1 The average concentration of small opacities on high-thousand-volts chest X-ray of each kinds cement pneumoconiosis worker in the same period,the highest is the raw material worker's,and the second is the ready materials worker's,then is the end product worker's.2 Small round opacities and small irregular opacities appear in all kinds workers' high-thousand-volts chest X-ray,and the round small opacities are dominant in raw materials workers' radiography.The irregular small opacities are dominant in end product workers' radiography.The dominant of round small opacities are replaced by the irregular small opacities gradually in ready materials workers' radiography along of the promoting of pneumoconiosis' period.3 The changes of hilus pulmonis and pulmonary markings in high thousand volts X-ray radiography of raw materials workers' and ready materials workers' are more serious than end product workers' inâ… andâ… +pneumoconiosis period.