Alterações cardiorrespiratórias da exposição de sílica em mineradores: revisão integrativa
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Data
2022-06-27
Tipo de documento
Monografia
Título da Revista
ISSN da Revista
Título de Volume
Área do conhecimento
Ciências da Saúde
Modalidade de acesso
Acesso aberto
Editora
Autores
Lima, Ana Karoliny Silva de
Orientador
Carvalho, Fábio Luiz Oliveira de
Coorientador
Resumo
A Silicose é uma pneumoconiose causada pela exposição à sílica livre respirável,
composto abundante encontrado na costa terrestre na natureza em sua forma livre ou
combinada a outras matérias-primas cristalizadas, como o quartzo, amorfa e
cristobalita. A mineração é uma das principais atividades extrativistas que envolvem o
risco ocupacional para desenvolvimento da silicose. A pneumoconiose causada pela
inalação de sílica livre respirável acomete, principalmente, o sistema respiratório,
causando doenças como silicose, tuberculose, enfisema pulmonar e doença
obstrutiva crônica. Quando o trabalhador é exposto a altos níveis de partículas sílicas
livres, o processo de fisiopatologia da doença é caracterizado por um dano alveolar
de forma difusa e exsudação de material eosinófilo lipoproteináceo e formação de
processo inflamatório no espaço intersticial. Esse dano ocorre pela presença de
nódulos silicóticos, geralmente em áreas com lesões focais. Os efeitos da sílica no
organismo humano dependem do tempo e da intensidade de exposição a que o
minerador é submetido. O objetivo da pesquisa é discutir sobre as alterações
cardiorrespiratórias pela silicose, o efeito da exposição à sílica, diante das
manifestações cardiorrespiratórias, e como objetivos específicos descrever os
métodos de prevenção que podem ser utilizados contra essa doença, entender a
anatomofisiologia do sistema cardiorrespiratório, discutir as intervenções em geral e a
fisioterapêutica. O presente estudo trata de uma revisão integrativa, das publicações
utilizadas no período de 2006 a 2022. Para o processo de busca e seleção dos artigos
relevantes, que respondessem à questão de pesquisa, utilizaram-se descritores em
inglês, espanhol e português nas seguintes bases de dados: PubMed, da National
Library PF Medicine; BVS (Biblioteca Virtual da saúde), LILACS, SciELO, Medline
Science Direct. Destaca-se que a silicose é uma doença ocupacional, que necessita
ser bem avaliada através de exames de imagem, radiografias e tomografias, como
também a integração da avalição física, anamnese ocupacional, histórico de
exposição e questionários para ter um diagnóstico precoce. Como método de
diagnóstico dessa doença, a radiografia de tórax é um exame de imagem em que é
possível ver as lesões causadas pela doença que, geralmente, apresenta em forma
de pequenas ou grandes opacidades nesse exame. Com esse método diagnóstico
que se baseia no critério da diretriz OIT, tem melhor visualização quando a doença
está avançada, como na silicose crônica ou complicada. Sendo assim, a tomografia
de alta resolução é melhor na avalição das alterações iniciais e contribui para um
diagnóstico precoce. Dito isso, as alterações causam diminuição da capacidade
funcional do pulmão, dispneia que devem ser avaliadas por espirometria e a dispneia
pela escala de mMRC, assim como aplicação de questionários de qualidade de vida,
tendo em vista as limitações causadas. Assim, a prevenção é importante para diminuir
a exposição à sílica livre, com conscientização dos riscos ocupacionais, uso correto
de máscara e equipamentos de proteção, bem como o controle dos marcadores de
sílica no ambiente de trabalho, respeitando os limites de exposição. As intervenções
que envolvem a reabilitação pulmonar associadas a outras, como programas de
treinamento físico, têm mostrado resultados favoráveis no manejo do paciente com
silicose e a diminuição dos sintomas.
Silicosis is a pneumoconiosis caused by exposure to respirable free silica, an abundant compound found on the terrestrial coast in nature in its free form or combined with other crystallized raw materials, such as quartz, amorphous and cristobalite. Mining is one of the main extractive activities that involve occupational risk for the development of silicosis. The pneumoconiosis caused by inhalation of respirable free silica mainly affects the respiratory system, causing diseases, such as silicosis, tuberculosis, pulmonary emphysema and chronic obstructive disease. When the worker is exposed to high levels of free silica particles, the disease pathophysiology process is characterized by diffuse alveolar damage and exudation of lipoproteinaceous eosinophilic material and formation of an inflammatory process in the interstitial space. This damage happens due to the presence of silicotic nodules, usually in areas with focal lesions. The effects of silica on the human body depend on the time and intensity of exposure to which the miner is subjected. The objective of the research is to discuss the cardiorespiratory changes caused by silicosis, the effect of exposure to silica, front to the cardiorespiratory manifestations, and as specific objectives to describe the prevention methods that can be used against this disease, to understand the anatomophysiology of the cardiorespiratory system, to discuss interventions in general and physiotherapeutic ones. This study is an integrative review of publications used in the period from 2006 to 2022. For the process of searching and selecting the relevant articles that answered the research question, descriptors in English, Spanish and Portuguese were used in the following bases data: PubMed, from the National Library PF Medicine; VHL (Virtual Health Library), LILACS, SciELO, Medline Science Direct. It is noteworthy that silicosis is an occupational disease, which needs to be well evaluated through imaging tests, radiographs and tomography, as well as the integration of physical assessment, occupational anamnesis, exposure history and questionnaires to have an early diagnosis. As a method of diagnosing this disease, chest radiography is an imaging test in which it is possible to see the lesions caused by the disease, which usually present in the form of small or large opacities in this exam. With this diagnostic method, which is based on the criteria of the ILO guideline, it has better visualization when the disease is advanced, as in chronic or complicated silicosis. Therefore, high-resolution tomography is better in evaluating the initial changes and contributes to an early diagnosis. That said, the changes cause a decrease in the functional capacity of the lung, dyspnea that should be evaluated by spirometry and dyspnea using the mMRC scale, as well as the application of quality of life questionnaires, in view of the limitations caused. Thus, prevention is important to reduce exposure to free silica, with awareness of occupational risks, correct use of masks and protective equipment, as well as the control of silica markers in the work environment, respecting exposure limits. Interventions involving pulmonary rehabilitation associated with others, such as physical training programs, have shown favorable results in the management of patients with silicosis and the reduction of symptoms.
Silicosis is a pneumoconiosis caused by exposure to respirable free silica, an abundant compound found on the terrestrial coast in nature in its free form or combined with other crystallized raw materials, such as quartz, amorphous and cristobalite. Mining is one of the main extractive activities that involve occupational risk for the development of silicosis. The pneumoconiosis caused by inhalation of respirable free silica mainly affects the respiratory system, causing diseases, such as silicosis, tuberculosis, pulmonary emphysema and chronic obstructive disease. When the worker is exposed to high levels of free silica particles, the disease pathophysiology process is characterized by diffuse alveolar damage and exudation of lipoproteinaceous eosinophilic material and formation of an inflammatory process in the interstitial space. This damage happens due to the presence of silicotic nodules, usually in areas with focal lesions. The effects of silica on the human body depend on the time and intensity of exposure to which the miner is subjected. The objective of the research is to discuss the cardiorespiratory changes caused by silicosis, the effect of exposure to silica, front to the cardiorespiratory manifestations, and as specific objectives to describe the prevention methods that can be used against this disease, to understand the anatomophysiology of the cardiorespiratory system, to discuss interventions in general and physiotherapeutic ones. This study is an integrative review of publications used in the period from 2006 to 2022. For the process of searching and selecting the relevant articles that answered the research question, descriptors in English, Spanish and Portuguese were used in the following bases data: PubMed, from the National Library PF Medicine; VHL (Virtual Health Library), LILACS, SciELO, Medline Science Direct. It is noteworthy that silicosis is an occupational disease, which needs to be well evaluated through imaging tests, radiographs and tomography, as well as the integration of physical assessment, occupational anamnesis, exposure history and questionnaires to have an early diagnosis. As a method of diagnosing this disease, chest radiography is an imaging test in which it is possible to see the lesions caused by the disease, which usually present in the form of small or large opacities in this exam. With this diagnostic method, which is based on the criteria of the ILO guideline, it has better visualization when the disease is advanced, as in chronic or complicated silicosis. Therefore, high-resolution tomography is better in evaluating the initial changes and contributes to an early diagnosis. That said, the changes cause a decrease in the functional capacity of the lung, dyspnea that should be evaluated by spirometry and dyspnea using the mMRC scale, as well as the application of quality of life questionnaires, in view of the limitations caused. Thus, prevention is important to reduce exposure to free silica, with awareness of occupational risks, correct use of masks and protective equipment, as well as the control of silica markers in the work environment, respecting exposure limits. Interventions involving pulmonary rehabilitation associated with others, such as physical training programs, have shown favorable results in the management of patients with silicosis and the reduction of symptoms.
Palavras-chave
Sílica, Silicose, Trabalhador, Pneumoconiose