Siderosis

SIDEROSIS (from Greek sideros- iron), a concept relating to a special type of pneumoconiosis (see) caused by the inhalation of iron-containing dust; under the same name, the disease is known in clinical practice as affecting both the eyeball and the eye mucosa (siderosis bulbi, siderosis conjunctivae) [S. of the spleen - see separate table (art. 20₃) and pure iron (Fe) contain no Si0₂, and the dust obtained from grinding metals usually contains a great deal of it, depending on the nature of the grinding stone (emery), the character and circumstances of the production process (location of grinding apparatus, ventilation system); second, that pure iron dust is incapable of stimulating the growth of fibroblastic elements, which is why there is no fibrosis in the lungs, but only proliferation of alveolar epithelium, passing perivascular inflammatory phenomena, and relatively rapid elimination of dust from the lungs (Carleton); third, that in combination with silicon, iron dust has the ability to significantly reduce the harmful action of the silicate parts of the dust "due to the exceptional degree of phagocytosis caused by this dust, which is even higher than phagocytosis from ultramarine," which is accepted as harmless to the organism as a standard (Peisakhovich, Vilensky). The above disagreement among researchers is explained by the insufficient consideration of these data obtained experimentally. Podkaminsky proposes in clinical practice to proceed from different types of S, distinguishing the harmful action of dust when grinding metals containing iron (according to his terminology silico-siderosis gravis, s. abrasiva) from S. in workers of iron ore mines (silico-siderosis levis, s. ferrariarum) and from S. of polishers (siderosis pura, s. chromatica). The requirement that when studying occupational pathology of the lungs in persons engaged in the development of iron ore mines, grinding of metals, etc., one should proceed from a precise analysis of the content of both silicate parts and iron in the corresponding dust is undoubtedly correct. Thus, the harmful influence of metal grinding has been established and almost unanimously accepted both by those researchers who convinced themselves of this on their own material (Teleky-Lochtkemper), and by those who prognostically evaluated the influence of this dust as particularly harmful, despite the relatively favorable data obtained by them (Sheinin and Morozovsky). Sheinin, Gottlieb, and Podkaminsky require a series of legislative measures for the improvement of labor, to which should first be referred the removal of grinding stones from the room where grinders work, or the hermetic sealing of the stone with a special cover, the installation of a rationally acting ventilation system, a special arrangement of the grinding stone opening in relation to the place of work, the most thorough, systematically conducted medical examination of already working persons, and the strictest occupational selection when hiring for this work, taking into account first of all the condition of the lungs and upper respiratory tract. Similarly, appropriate measures for the improvement of labor in the iron ore industry should be taken, although the research of many authors has not confirmed the above data obtained by Hart and Fleming-Moller. Thus, according to data from Sheinin, Gottlieb, and Podkaminsky, among experienced workers-drillers in the iron ore mines of Krivoy Rog, neither forms of sharply expressed silico-siderosis nor especially severe forms of coniotuberculosis were found. The clinical and radiological picture in these workers did not differ in pneumoconiotic cases from slightly expressed pneumoconiosis from other types of dust. As in the course and in auscultation data, so in the radiological picture nothing differentiating the picture of silico-siderosis from other conioses could be found, and the radiological picture also testified to the slight expression of fibrosis in the lungs (Podkaminsky). Correspondingly, the working capacity of these workers in iron ore mines is much less disturbed than among metal grinders, where the fibrosis is much more sharply expressed and cases of coniotuberculosis occur much more frequently.--S. of the eye (see Eye) is caused either by the deposition of iron oxide particles during prolonged lubrication of the eye mucosa with crystals of iron vitriol (siderosis conjunctivae) or by the dissolution of tiny iron particles during prolonged presence of intraocular fragments, due to the action of carbon dioxide of the tissues of the eye (siderosis bulbi). As for siderosis conjunctivae, it is no longer encountered in recent times because iron vitriol has gone out of use in ophthalmological practice. Siderosis bulbi is characterized by changes in the color of the iris and degenerative changes in the retina and choroid of the eye, leading to a gradual decrease in visual function.