medecolМедицина и экологияMedicine and ecology2305-60452305-6053Карагандинский медицинский университет10.59598/ME-2305-6053-2025-116-3-27-34medecol-1035Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWSПринципы реабилитации и профилактики профессиональных пылевых заболеваний бронхолегочной системыPRINCIPLES OF REHABILITATION AND PREVENTION OF OCCUPATIONAL DUST-RELATED DISEASES OF THE BRONCHOPULMONARY SYSTEMШевелеваН. И.ShevelevaN. I.

100008, г. Караганда, ул. Гоголя, 40

100008, Karaganda c., Gogolya str., 40

info@qmu.kzАманбековаА. У.AmanbekovaA. U.

100012, г. Караганда, ул. Мустафина, 15

100012, Karaganda c., Mustafina str., 15

priemnaya@ncgtpz.kzДосмагамбетоваР. С.DosmagambetovaR. S.

010000, г. Астана, ул. Достык, 13/3

010000, Astana c., Dostyk str., 13/3

sanborovoe@mail.kzОтаровЕ. Ж.OtarovE. Zh.

100012, г. Караганда, ул. Мустафина, 15

100012, Karaganda c., Mustafina str., 15

priemnaya@ncgtpz.kzГребеневаО. В.GrebenyevaO. V.

100012, г. Караганда, ул. Мустафина, 15

100012, Karaganda c., Mustafina str., 15

priemnaya@ncgtpz.kzШадетоваА. Ж.ShadietovaА. Zh.

100012, г. Караганда, ул. Мустафина, 15

100012, Karaganda c., Mustafina str., 15

priemnaya@ncgtpz.kzАлексеевА. В.AlekseevA. V.

100012, г. Караганда, ул. Мустафина, 15

100012, Karaganda c., Mustafina str., 15

priemnaya@ncgtpz.kzСабировЖ. Б.SabirovZh. B.

100012, г. Караганда, ул. Мустафина, 15

100012, Karaganda c., Mustafina str., 15

priemnaya@ncgtpz.kzОкасовД. Б.OkassovD. B.

Дидар Бекежанович Окасов

100012, г. Караганда, ул. Мустафина, 15

Didar Bekezhanovich Okassov

100012, Karaganda c., Mustafina str., 15

okassovdb@gmail.comНАО «Карагандинский медицинский университет»КазахстанKaraganda Medical University NC JSCKazakhstanНАО «Национальный центр гигиены труда и профессиональных заболеваний»КазахстанNational Center for Occupational Health and Diseases NC JSCKazakhstanРГП на ПХВ «НИИ Курортологии и медицинской реабилитации»КазахстанResearch Institute of Balneology and Medical Rehabilitation Republican State Enterprise on the Right of Economic ManagementKazakhstan202527092025032734Copyright © Шевелева Н.И., Аманбекова А.У., Досмагамбетова Р.С., Отаров Е.Ж., Гребенева О.В., Шадетова А.Ж., Алексеев А.В., Сабиров Ж.Б., Окасов Д.Б., 20252025Шевелева Н.И., Аманбекова А.У., Досмагамбетова Р.С., Отаров Е.Ж., Гребенева О.В., Шадетова А.Ж., Алексеев А.В., Сабиров Ж.Б., Окасов Д.Б.Sheveleva N.I., Amanbekova A.U., Dosmagambetova R.S., Otarov E.Z., Grebenyeva O.V., Shadietova А.Z., Alekseev A.V., Sabirov Z.B., Okassov D.B.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://medecol.qmu.kz/jour/article/view/1035

Осуществлен обзор современных подходов к профилактике, лечению и реабилитации профессиональных пылевых заболеваний легких, включая хроническую обструктивную болезнь легких, с акцентом на сохранение трудоспособности. Проведен анализ научной литературы, включая статьи, руководства и рекомендации профессиональных ассоциаций, с оценкой уровней доказательств. Описаны патогенетические принципы лечения, медикаментозные и немедикаментозные методы (легочная реабилитация, физиотерапия, бальнеотерапия), их эффективность в улучшении функции дыхания, качества жизни и снижении нетрудоспособности. Профилактика включает технические, гигиенические и медицинские меры.

Хроническая обструктивная болезнь легких профессиональной этиологии остается глобальной проблемой, требующей комплексного подхода. Существующие методы эффективны, но необходимы новые решения для профилактики и реабилитации.

A review of modern approaches to the prevention, treatment and rehabilitation of occupational dust-related lung diseases, including chronic obstructive pulmonary disease, with an emphasis on maintaining working capacity, is realized. The analysis of scientific literature, including articles, guidelines and recommendations of professional associations, with an assessment of the levels of evidence, is carried out. The pathogenetic principles of treatment, medicinal and non-medicinal methods (pulmonary rehabilitation, physiotherapy, balneotherapy), their effectiveness in improving respiratory function, quality of life and reducing disability are described. Prevention includes technical, hygienic and medical measures.

Chronic obstructive pulmonary disease of occupational etiology remains a global problem requiring an integrated approach. Existing methods are effective, but new solutions for prevention and rehabilitation are needed.

профессиональные заболеванияпылевые заболевания легкиххроническая обструктивная болезнь легкихлегочная реабилитацияпрофилактикапатогенетическое лечениефизиотерапиябальнеотерапиятрудоспособностьoccupational diseasesdust-related lung diseaseschronic obstructive bronchitispulmonary rehabilitationpreventionpathogenetic treatmentphysiotherapybalneotherapywork capacityРабота выполнена в рамках Программно-целевого финансирования Министерства науки и высшего образования Республики Казахстан по проекту BR27199517 «Комплексный подход к медицинской профилактике и реабилитации профессиональных заболеваний бронхолегочной системы пылевой этиологии» на 2024 – 2026 годы.ReferencesSigsgaard T. ERS position paper: work-related respiratory diseases in the EU. Eur. Respir. J. 2010; 35: 234-238.Sigsgaard T. ERS position paper: work-related respiratory diseases in the EU. Eur. Respir. J. 2010; 35: 234-238.Losacco C., Perillo A. Particulate matter air pollution and respiratory impact on humans and animals. Environ. Sci. Pollut. Res. 2018; 25 (34): 33901-33910. https://doi:10.1007/s11356-018-3344-9Losacco C., Perillo A. Particulate matter air pollution and respiratory impact on humans and animals. Environ. Sci. Pollut. Res. 2018; 25 (34): 33901-33910. https://doi:10.1007/s11356-018-3344-9Visonà S.D., Capella S., Bodini S., Borrelli P., Villani S., Crespi E. Inorganic fiber lung burden in subjects with occupational and/or anthropogenic environmental asbestos exposure in Broni (Pavia, Northern Italy): a sem-eds study on autoptic samples. Int. J. Environ. Res. Public Health. 2021; 18 (4): 2053. https://doi:10.3390/ijerph18042053Visonà S.D., Capella S., Bodini S., Borrelli P., Villani S., Crespi E. Inorganic fiber lung burden in subjects with occupational and/or anthropogenic environmental asbestos exposure in Broni (Pavia, Northern Italy): a sem-eds study on autoptic samples. Int. J. Environ. Res. Public Health. 2021; 18 (4): 2053. https://doi:10.3390/ijerph18042053Philippova A., Aringazina R., Kurmanalina G., Beketov V. Epidemiology, clinical and physiological manifestations of dust lung disease in major industrial centers. Emerg. Themes Epidemiol. 2022; 19 (1): 3. https://doi:10.1186/s12982-022-00111-0Philippova A., Aringazina R., Kurmanalina G., Beketov V. Epidemiology, clinical and physiological manifestations of dust lung disease in major industrial centers. Emerg. Themes Epidemiol. 2022; 19 (1): 3. https://doi:10.1186/s12982-022-00111-0Величковский Б. Т. Патогенетическая терапия и профилактика хронического пылевого бронхита с обструктивным синдромом. Пульмонология. 1995; 3: 6-19.Velichkovskij B. T. Patogeneticheskaja terapija i profilaktika hronicheskogo pylevogo bronhita s obstruktivnym sindromom. Pul'monologija. 1995; 3: 6-19.Ульмер В. Патофизиологические основы обструктивных заболеваний дыхательных путей и терапевтическая тактика. Ингаляционный бронхоспазмолиз. М.; 1990: 1-22.Ul'mer V. Patofiziologicheskie osnovy obstruktivnyh zabolevanij dyhatel'nyh putej i terapevticheskaja taktika. Ingaljacionnyj bronhospazmoliz. M.; 1990: 1-22.Хронический бронхит. Клинические рекомендации. Межрегиональная общественная организация «Российское Респираторное Общество», 2023. https://spulmo.ru/upload/kr/HB_2023.pdfHronicheskij bronhit. Klinicheskie rekomendacii. Mezhregional'naja obshhestvennaja organizacija «Rossijskoe Respiratornoe Obshhestvo», 2023. https://spulmo.ru/upload/kr/HB_2023.pdfNici L., Donner C., Wouters E. American Thoracic Society/European Respiratory Society statement on pulmonary rehabilitation. Am. J. Respir. Crit. Care Med. 2006; 173: 1390-413.Nici L., Donner C., Wouters E. American Thoracic Society/European Respiratory Society statement on pulmonary rehabilitation. Am. J. Respir. Crit. Care Med. 2006; 173: 1390-413.Ries A.L., Bauldoff G.S., Carlin B.W. Pulmonary Rehabilitation: Joint ACCP/AACVPR Evidence-Based Clinical Practice Guidelines. Chest. 2007; 131: 40-42.Ries A.L., Bauldoff G.S., Carlin B.W. Pulmonary Rehabilitation: Joint ACCP/AACVPR Evidence-Based Clinical Practice Guidelines. Chest. 2007; 131: 40-42.El Moussaoui R. Short-course antibiotic treatment in acute exacerbations of chronic bronchitis and COPD: a meta-analysis of double-blind studies. Thorax. 2008; 63 (5): 415-422.El Moussaoui R. Short-course antibiotic treatment in acute exacerbations of chronic bronchitis and COPD: a meta-analysis of double-blind studies. Thorax. 2008; 63 (5): 415-422.Mahler D.A. Pulmonary rehabilitation. Chest. 1998; 113: 263-268.Mahler D.A. Pulmonary rehabilitation. Chest. 1998; 113: 263-268.Spruit M., Singh S., Garvey C. ATS/ERS task force on pulmonary rehabilitation. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am. J. Respir. Cri.t Care Med. 2013; 188 (8): e13-64.Spruit M., Singh S., Garvey C. ATS/ERS task force on pulmonary rehabilitation. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am. J. Respir. Cri.t Care Med. 2013; 188 (8): e13-64.Rochester C.L., Vogiatzis I., Holland A.E., Lareau S.C., Marciniuk D.D., Puhan M.A. An Official American Thoracic Society/European Respiratory Society policy statement: enhancing implementation, use, and delivery of pulmonary rehabilitation. Am. J. Respir. Crit. Care Med. 2015; 192: 1373-1386. https://doi:10.1164/rccm.201510-1966STRochester C.L., Vogiatzis I., Holland A.E., Lareau S.C., Marciniuk D.D., Puhan M.A. An Official American Thoracic Society/European Respiratory Society policy statement: enhancing implementation, use, and delivery of pulmonary rehabilitation. Am. J. Respir. Crit. Care Med. 2015; 192: 1373-1386. https://doi:10.1164/rccm.201510-1966STGordon C.S., Waller J.W., Cook R.M., Cavalera S.L., Lim W.T., Osadnik C.R. Effect of Pulmonary Rehabilitation on Symptoms of Anxiety and Depression in COPD: A Systematic Review and Meta-Analysis. Chest. 2019; 156 (1): 80-91.Gordon C.S., Waller J.W., Cook R.M., Cavalera S.L., Lim W.T., Osadnik C.R. Effect of Pulmonary Rehabilitation on Symptoms of Anxiety and Depression in COPD: A Systematic Review and Meta-Analysis. Chest. 2019; 156 (1): 80-91.Spruit M.A., Singh S.J. ATS/ERS Task Force on Pulmonary Rehabilitation. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am. J. Respir. Crit. Care Med. 2013; 188 (8): e13-64.Spruit M.A., Singh S.J. ATS/ERS Task Force on Pulmonary Rehabilitation. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am. J. Respir. Crit. Care Med. 2013; 188 (8): e13-64.Garber C.E., Blissmer B., Deschenes M.R., Franklin B.A., Lamonte M.J., Lee I.M., Nieman D.C., Swain D.P. American College of Sports Medicine. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med. Sci. Sports Exerc. 2011; 43 (7): 1334-1359.Garber C.E., Blissmer B., Deschenes M.R., Franklin B.A., Lamonte M.J., Lee I.M., Nieman D.C., Swain D.P. American College of Sports Medicine. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med. Sci. Sports Exerc. 2011; 43 (7): 1334-1359.Horowitz M.B., Littenberg B., Mahler D.A. Dyspnea ratings for prescribing exercise intensity in patients with COPD. Chest. 1996; 109 (5): 1169-1175.Horowitz M.B., Littenberg B., Mahler D.A. Dyspnea ratings for prescribing exercise intensity in patients with COPD. Chest. 1996; 109 (5): 1169-1175.Sharma B.B., Singh V. Pulmonary rehabilitation: An overview. Lung India. 2011; 28 (4): 276-284.Sharma B.B., Singh V. Pulmonary rehabilitation: An overview. Lung India. 2011; 28 (4): 276-284.Agustí A.G., Sauleda J., Miralles C., Gomez C., Togores B., Sala E., Batle S., Busquets X. Skeletal muscle apoptosis and weight loss in chronic obstructive pulmonary disease. Am. J. Respir. Crit. Care Med. 2002; 166 (4): 485489.Agustí A.G., Sauleda J., Miralles C., Gomez C., Togores B., Sala E., Batle S., Busquets X. Skeletal muscle apoptosis and weight loss in chronic obstructive pulmonary disease. Am. J. Respir. Crit. Care Med. 2002; 166 (4): 485-489.Mahler D.A. Pulmonary rehabilitation. Chest. 1998; 113: 263-2688.Mahler D.A. Pulmonary rehabilitation. Chest. 1998; 113: 263-2688.Casaburi R., Mahler D., Jones P.A long-term evaluation of once-daily inhaled tiotropium in chronic obstructive pulmonary disease. Eur. Respir. J. 2002; 19 (2): 217-224. https://doi:10.1183/09031936.02.00269802Casaburi R., Mahler D., Jones P.A long-term evaluation of once-daily inhaled tiotropium in chronic obstructive pulmonary disease. Eur. Respir. J. 2002; 19 (2): 217-224. https://doi:10.1183/09031936.02.00269802Shenoy M.A., Paul V. Pulmonary Rehabilitation. https://www.ncbi.nlm.nih.gov/books/NBK563166/Shenoy M.A., Paul V. Pulmonary Rehabilitation. https://www.ncbi.nlm.nih.gov/books/NBK563166/Chen M., Chen P., Zhong N. The Chinese national guidelines on diagnosis and management of cough (December 2010). Chinese Med. J. 2011; 124 (20): 3207-3219. https://doi:10.3760/cma.j.issn.0366-6999.2011.20.002Chen M., Chen P., Zhong N. The Chinese national guide-lines on diagnosis and management of cough (December 2010). Chinese Med. J. 2011; 124 (20): 3207-3219. https://doi:10.3760/cma.j.is sn.0366-6999.2011.20.002Окороков А.Н. Руководство по лечению внутренних болезней. М.; 2013: 560.Okorokov A.N. Rukovodstvo po lecheniju vnutrennih boleznej. M.; 2013: 560.Пономаренко Г.Н. Физическая и реабилитационная медицина. М.; 2024: 912.Ponomarenko G.N. Fizicheskaja i reabilitacionnaja medicina. M.; 2024: 912.Магнитотерапия в лечебно-реабилитационных и профилактических программах: клинические рекомендации. М.; 2015: 47.Magnitoterapija v lechebno-reabilitacionnyh i profilakticheskih programmah: klinicheskie rekomendacii. M.; 2015: 47.Никитин В.А., Васильева Л.В., Карпухина Е.П., Попов А.В. Оценка эффективности лазерно-ультразвуковой терапии в комплексном лечении хронической обструктивной болезни легких с сопутствующей артериальной гипертензией. Пульмонология. 2019; 29 (1): 43-51. https://doi:10.18093/0869-0189-2019-29-1-43-51Nikitin V.A., Vasil'eva L.V., Karpuhina E.P., Popov A.V. Ocenka jeffektivnosti lazerno-ul'trazvukovoj terapii v kompleksnom lechenii hronicheskoj obstruktivnoj bolezni legkih s soputstvujushhej arterial'noj gipertenziej. Pul'monologija. 2019; 29 (1): 43-51. https://doi:10.18093/08690189-2019-29-1-43-51Martín-Valero R., Cuesta-Vargas A.I., Labajos-Manzanares M.T. Evidence-Based Review of Hydrotherapy Studies on Chronic Obstructive Pulmonary Disease Patients. International Journal of Aquatic Research and Education. 2012; 6: 8. https://doi:10.25035/ijare.06.03.08Martín-Valero R., Cuesta-Vargas A.I., Labajos-Manzanares M.T. Evidence-Based Review of Hydrotherapy Studies on Chronic Obstructive Pulmonary Disease Patients. International Journal of Aquatic Research and Education. 2012; 6: 8. https://doi:10.25035/ijare.06.03.08Khaltaev N., Solimene U., Vitale F., Zanasi A. Balneotherapy and hydrotherapy in chronic respiratory disease. J. Thorac. Dis. 2020; 12 (8): 4459-4468. https://doi:10.21037/jtd-gard-2019-009Khaltaev N., Solimene U., Vitale F., Zanasi A. Balneotherapy and hydrotherapy in chronic respiratory disease. J. Thorac. Dis. 2020; 12 (8): 4459-4468. https://doi:10.21037/jtd-gard-2019-009Ohsawa I., Ishikawa M., Takahashi K., Watanabe M., Nishimaki K., Yamagata K. Hydrogen acts as a therapeutic antioxidant by selectively reducing cytotoxic oxygen radicals. Nat. Med. 2007; 13: 688-694.Ohsawa I., Ishikawa M., Takahashi K., Watanabe M., Nishimaki K., Yamagata K. Hydrogen acts as a therapeutic antioxidant by selectively reducing cytotoxic oxygen radicals. Nat. Med. 2007; 13: 688-694.Wang S.T., Bao C., He Y., Tian X., Yang Y., Zhang T., Xu K.F. Hydrogen gas (XEN) inhalation ameliorates airway inflammation in asthma and COPD patients. QJM Int. J. Med. 2020; 113: 870-875. https://doi:10.1093/qjmed/hcaa164Wang S.T., Bao C., He Y., Tian X., Yang Y., Zhang T., Xu K.F. Hydrogen gas (XEN) inhalation ameliorates airway inflammation in asthma and COPD patients. QJM Int. J. Med. 2020; 113: 870-875. https://doi:10.1093/qjmed/hcaa164Авдеев С.Н., Демко И.В., Зайцев А.А., Игнатова Г.Л., Кравченко Н.Ю., Лещенко И.В., Овчаренко С.И., Синопальников А.И., Французевич Л.Я. Хронический бронхит: федеральные клинические рекомендации по диагностике и лечению. Пульмонология. 2022; 32 (3): 448-472. https://doi.org/10.18093/0869-0189-2022-32-3-448-472Avdeev S.N., Demko I.V., Zajcev A.A., Ignatova G.L., Kravchenko N.Ju., Leshhenko I.V., Ovcharenko S.I., Sinopal'nikov A.I., Francuzevich L.Ja. Hronicheskij bronhit: federal'nye klinicheskie rekomendacii po diagnostike i lecheniju. Pul'monologija. 2022; 32 (3): 448472. https://doi.org/10.18093/0869-0189-2022-32-3-448-472World Health Organization. Geneva: World Health Organization; 2020. Disease burden and mortality estimates [Internet] [cited 2020 Jun 14]. Available from: https://www.who.int/healthinfo/global_burden_disease/estimates/en/World Health Organization. Geneva: World Health Organization; 2020. Disease burden and mortality estimates [Internet] [cited 2020 Jun 14]. Available from: https://www.who.int/healthinfo/global_burden_disease/estimates/en/Bolton C.E., Bevan-Smith E.F., Blakey J.D., Crowe P., Elkin S.L., Garrod R., Greening N.J., Heslop K., Hull J.H., Man W.D., Morgan M.D., Proud D., Roberts C.M., Sewell L., Singh S.J., Walker P.P., Walmsley S., British Thoracic Society Pulmonary Rehabilitation Guideline Development Group. British Thoracic Society Standards of Care Committee. British Thoracic Society guideline on pulmonary rehabilitation in adults. Thorax. 2013; 68 (2): 1-30.Bolton C.E., Bevan-Smith E.F., Blakey J.D., Crowe P., Elkin S.L., Garrod R., Greening N.J., Heslop K., Hull J.H., Man W.D., Morgan M.D., Proud D., Roberts C.M., Sewell L., Singh S.J., Walker P.P., Walmsley S., British Thoracic Society Pulmonary Rehabilitation Guideline Development Group. British Thoracic Society Standards of Care Committee. British Thoracic Society guideline on pulmonary rehabilitation in adults. Thorax. 2013; 68 (2): 1-30.

The authors declare that there are no conflicts of interest present.