RESPIRATORY DISTURBANCES IN SUBJECTS WHO CONDUCTED EMERGENCY REPAIR AFTER THE CHERNOBYL ACCIDENT

The authors performed this investigation to ascertain the role of radi oactive dust inhalation in the onset of respiratory diseases and deter mination of clinicomorphological features of such pathology. The autho rs have found that work in conditions of massive dust exposure, stay i n the dust zone for a month and longer in 1986-1987 were the desicive risk factors of respiratory impairment. The examination covered 28 pat ients who had acute symptoms of inhalation damage to respiratory syste m when performing their job in the comtaminated zone. Later on they de veloped chronic progressive respiratory affection having the following clinicomorphological characteristics: 1) persistent cough with hard t o expectorate sputum, addition of respiratory insufficiency, sluggish recurrent infection and inflammation, deterioration of working capacit y and quality of life, 2) isolated decline of specific diffuse capacit y of the lungs in combination with obstructive ventilation, 3) marked disturbances of cellular immunity (reduced fraction of T-helpers and i ncreased fraction of T-suppressors), 4) x-ray picture of diffuse pneum osclerosis and hyperairiness of the lung tissue, 5) endoscopic evidenc e of inflammation and atrophy of the bronchial tree mucose, 6) numerou s alveolar macrophages with foreign inclusions in the lavage fluid, su ch markers of Chernobyl dust inhalation as Sr, Zr, I, Cs, Ce, Np, Pu, Am, Cm registered in alveolar macrophages at roentgenospectral and roe ntgenofluorescent microtests, 7) defective functional activity of alve olar macrophages (free radical activation). Long-term persistence of t he Chernobyl dust in the lung tissue results in essential functional a nd morphological changes in cell composition of the alveolar area, lun g tissue undergoes structural alterations contributing to specific res piratory diseases with typical clinicomorphological characteristics.