Analysis of clinical and functional characteristics of COPD and comorbid pathology in clean-up workers of Chornobyl NPP accident in a remote post-accident period
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», Kyiv, Ukraine
Summary. The aim of the study: to analyze the clinical and functional characteristics of the course of chronic obstructive pulmonary disease (COPD) and concomitant diseases in clean-up workers of Сhornobyl NPP (СhNPP) accident in dynamics. Research object and methods. According to the inclusion criteria were selected for 172 patients with COPD varying severity: major group — 142 clean-up workers of СhNPP accident (mean dose of ionizing radiation 41.89±9.3 cSv, M±SD) and a group а nosological control — 30 patients not exposed to ionizing radiation. On the basis of the pulmonology department of the department of treatment of radiation consequences of Institute for Clinical Radiology of the National Research Center for Radiation Medicine, a prospective general clinical and functional examination of patients was carried out. Long-term observation for 8 years was carried out in 40 patients with COPD. Results. It was found that in the absence of a difference in the indicators characterizing the stage of COPD, the clean-up workers of СhNPP accident had more pronounced dyspnea on the Medical Research Council scale. In the main group, concomitant diseases were more often observed, in particular ischemic heart disease, arterial hypertension, non-malignant diseases of the thyroid gland, diseases of the gastrointestinal tract and the nervous system. During the dynamic observation, a tendency to an increase in the frequency of detection of clinical signs of impairment of the state of the bronchopulmonary system in all patients with COPD was noticed, but a more pronounced negative dynamics was in the group of participants of the clean-up workers of СhNPP accident.
- Feshchenko Yu.I. (2019) Adapted clinical guidelines: chronic obstructive pulmonary disease (part 1). New edition of the global COPD initiative. Ukr. Pulmonol. J., 2: 5–18. (In Ukr.).
- GBD 2013 (2015) Mortality and Causes of Death Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease study 2013. Lancet, 385: 117–171 (www.who.int/respiratory/copd/burden/en/index.html).
- Shvaiko L.I. (2015) Risk factors and prevention of chronic bronchopulmonary diseases. Proceedings of the scientific conference with international participation «Implementation of the National Action Plan on Noncommunicable Diseases in accordance with the European Strategy» Health 2020: Fundamentals of European policy in support of state and society in the interests of health and well-being», 30–31 Mar., 14 p. (In Ukr.).
- Makhlouf H.A., Sadek S.H., Nafady A. (2018) Comorbidome, pattern, and impact of asthma-COPD overlap syndrome in real life. Clin. Respir. J., 12: 48–56.
- van den Akker M., Buntinx F., Metsemakers J.F. et al. (1998) Multimorbidity in general practice: prevalence, incidence, and determinants of co-occurring chronic and recurrent diseases. J. Clin. Epidemiol., 51(5): 367–375. doi: 10.1016/s0895-4356(97)00306-5.
- Shvaiko L.I., Bazyka K.D., Sushko V.O., Masyuk S.V. (2018) Chronic obstructive pulmonary disease in participants in the liquidation of the consequences of the Chernobyl accident in the remote post-accident period (clinical study). Probl. Rad. Med. Radiobiol., Kyiv, 490–499 p. (In Ukr.).
- Sushko V.O., Nechaev S.Yu., Shvaiko L.I. et al. (2011) Bronchopulmonary system. Medical consequences of the Chernobyl disaster: 1986–2011. ТSMU, Ternopil, 460–506 p. (In Ukr.).
- Sushko V.O., Shvaiko L.I., Bazyka K.D. et al. (2016) The results of a thirty-year study of the state of the bronchopulmonary system in participants in the aftermath of the Chernobyl disaster. NAMS of Ukraine J., 2: 193–197. (In Ukr.).
- Sushko V.O., Shvaiko L.I., Bazyka K.D. et al. (2016)Defeat of the bronchopulmonary system in the participants of the liquidation of the consequences of the Chernobyl accident (1988–2016). Thirty years of the Chernobyl disaster: radiological and medical consequences. National report of Ukraine. Kyiv, 126–130 p. (In Ukr.).