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        "resumen" => "<span id="as0005" class="elsevierStyleSection elsevierViewall"><p id="sp0005" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Enquadramento&#58;</span> A patologia respirat&#243;ria induzida pela exposi&#231;&#227;o a ru&#237;do de baixa frequ&#234;ncia &#40;RBF&#44; &#8804;<span class="elsevierStyleHsp" style=""></span>500<span class="elsevierStyleHsp" style=""></span>Hz&#44; incluindo os infra-sons&#41; n&#227;o constitui novidade dado que&#44; desde 1960&#44; no &#226;mbito dos programas espaciais dos EUA e da Uni&#227;o Sovi&#233;tica&#44; diversos autores divulgaram a sua exist&#234;ncia&#46; No contexto da doen&#231;a vibroac&#250;stica &#40;VAD &#8211; <span class="elsevierStyleItalic">vibroacoustic disease</span>&#41;&#44; uma patologia sist&#233;mica causada pela exposi&#231;&#227;o excessiva a RBF&#44; as les&#245;es respirat&#243;rias apresentam caracter&#237;sticas pr&#243;prias&#46; Inicialmente&#44; esta patologia respirat&#243;ria n&#227;o foi tida como uma consequ&#234;ncia da exposi&#231;&#227;o ao ru&#237;do&#59; no entanto&#44; hoje&#44; o RBF &#233; considerado um agente muito importante de doen&#231;a respirat&#243;ria&#46; O objectivo deste trabalho &#233; sistematizar e actualizar todos os dados sobre a patologia respirat&#243;ria observada na VAD&#46; <span class="elsevierStyleBold">M&#233;todos&#58;</span> Ao longo dos &#250;ltimos 25 anos&#44; reco-lheu-se informa&#231;&#227;o&#44; de modo continuado&#44; de indiv&#237;duos e modelos animais expostos a RBF&#46; Todos estes dados s&#227;o aqui compilados&#46; <span class="elsevierStyleBold">Resultados&#58;</span> Em indiv&#237;duos expostos a ru&#237;do no trabalho&#44; as queixas br&#244;nquicas aparecem nos primeiros 4 anos de actividade e&#44; nesta fase&#44; reduzem ou desaparecem quando de f&#233;rias ou removidos do seu local de trabalho por outros motivos&#46; Com a exposi&#231;&#227;o prolongada&#44; poder&#227;o surgir situa&#231;&#245;es mais graves&#44; como derrames pleurais&#44; insufici&#234;ncia respirat&#243;ria&#44; fibrose pulmonar e carcinomas do aparelho respirat&#243;rio&#46; N&#227;o existe correla&#231;&#227;o com h&#225;bitos tab&#225;gicos&#46; Em modelos animais expostos a RBF&#44; apresentavam-se altera&#231;&#245;es morfol&#243;gicas da pleura e perda da capacidade fagoc&#237;tica das c&#233;lulas mesoteliais &#40;explicando os derrames pleurais observados&#41;&#46; Foram observadas les&#245;es de fibrose e neovasculariza&#231;&#227;o ao longo de todo o aparelho respirat&#243;rio dos animais expostos&#46; Tamb&#233;m se identificaram les&#245;es pr&#233;-malignas&#44; metaplasia e displasia&#46; <span class="elsevierStyleBold">Conclus&#245;es&#58;</span> O RBF &#233; um agente de doen&#231;a e tem como alvo preferencial o aparelho respirat&#243;rio&#46; A patologia respirat&#243;ria associada &#224; VAD necessita&#44; ainda&#44; de muito estudo para que uma maior compreen&#231;&#227;o possa ser alcan&#231;ada e interven&#231;&#245;es farmacol&#243;gicas possam ser pensadas&#46;</p><p id="sp0010" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2007&#59; XIII &#40;1&#41;&#58; 129-135</span></p></span>"
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        "resumen" => "<span id="as0010" class="elsevierStyleSection elsevierViewall"><p id="sp0015" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Background&#58;</span> Respiratory pathology induced by low frequency noise &#40;LFN&#44; &#60;<span class="elsevierStyleHsp" style=""></span>500<span class="elsevierStyleHsp" style=""></span>Hz&#44; including infrasound&#41; is not a novel subject given that in the 1960&#8217;s&#44; within the context of U&#46;S&#46; and U&#46;S&#46;S&#46;R&#46; Space Programs&#44; other authors have already reported its existence&#46; Within the scope of vibroacoustic disease &#40;VAD&#41;&#44; a whole-body pathology caused by excessive exposure to LFN&#44; respiratory pathology takes on specific features&#46; Initially&#44; respiratory pathology was not considered a consequence of LFN exposure&#59; but today&#44; LFN can be regarded as a major agent of disease that targets the respiratory system&#46; The goal of this report is to put forth what is known to date on the clinical signs of respiratory pathology seen in VAD patients&#46; <span class="elsevierStyleBold">Methods&#58;</span> Data from the past 25 years of research will be taken together and presented&#46; <span class="elsevierStyleBold">Results&#58;</span> In persons exposed to LFN on the job&#44; respiratory complaints appear after the first 4 years of professional activity&#46; At this stage&#44; they disappear during vacation periods or when the person is removed form his &#47;her workstation for other reasons&#46; With long-term exposure&#44; more serious situations can arise&#44; such as&#44; atypical pleural effusion&#44; respiratory insufficiency&#44; fibrosis and tumours&#46; There is no correlation with smoking habits&#46; In LFN-exposed animal models&#44; morphological changes of the pleura&#44; and loss of the phagocytic ability of pleural mesothelial cells &#40;explaining the atypical pleural effusions&#41;&#46; Fibrotic lesions and neo-vascularization were observed along the entire respiratory tract&#46; Fibrosis lesions and neovascularisation were observed throughout the respiratory tract of the animals seen&#46; Pre-ma-lignant lesions&#44; metaplasia e displasia&#44; were also identified&#46; <span class="elsevierStyleBold">Discussion&#58;</span> LFN is an agent of disease and the respiratory tract is one of its preferential targets&#46; The respiratory pathology associated with VAD needs further in-depth studies in order to achieve a greater understanding&#44; and develop methods of pharmacological intervention&#46;</p><p id="sp0020" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2007&#59; XIII &#40;1&#41;&#58; 129-135</span></p></span>"
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Journal Information
Vol. 13. Issue 1.
Pages 129-135 (January - February 2007)
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Vol. 13. Issue 1.
Pages 129-135 (January - February 2007)
Artigo de Revisão / Revision Article
Open Access
O aparelho respiratório na doença vibroacústica: 25 anos de investigação
Respiratory pathology in vibroacoustic disease: 25 years of research
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Nuno A.A. Castelo Branco1, José Reis Ferreira2, Mariana Alves-Pereira3
1 Médico Anatomopatologista, presidente do Conselho Científico, Centro da Performance Humana, Alverca
2 Médico Pneumologista, Unidade de Estudo Funcional Respiratório, Hospital da Força Aérea, Lisboa
3 Engenheira Biomédica, ERISA – Universidade Lusófona
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Enquadramento: A patologia respiratória induzida pela exposição a ruído de baixa frequência (RBF, ≤500Hz, incluindo os infra-sons) não constitui novidade dado que, desde 1960, no âmbito dos programas espaciais dos EUA e da União Soviética, diversos autores divulgaram a sua existência. No contexto da doença vibroacústica (VAD – vibroacoustic disease), uma patologia sistémica causada pela exposição excessiva a RBF, as lesões respiratórias apresentam características próprias. Inicialmente, esta patologia respiratória não foi tida como uma consequência da exposição ao ruído; no entanto, hoje, o RBF é considerado um agente muito importante de doença respiratória. O objectivo deste trabalho é sistematizar e actualizar todos os dados sobre a patologia respiratória observada na VAD. Métodos: Ao longo dos últimos 25 anos, reco-lheu-se informação, de modo continuado, de indivíduos e modelos animais expostos a RBF. Todos estes dados são aqui compilados. Resultados: Em indivíduos expostos a ruído no trabalho, as queixas brônquicas aparecem nos primeiros 4 anos de actividade e, nesta fase, reduzem ou desaparecem quando de férias ou removidos do seu local de trabalho por outros motivos. Com a exposição prolongada, poderão surgir situações mais graves, como derrames pleurais, insuficiência respiratória, fibrose pulmonar e carcinomas do aparelho respiratório. Não existe correlação com hábitos tabágicos. Em modelos animais expostos a RBF, apresentavam-se alterações morfológicas da pleura e perda da capacidade fagocítica das células mesoteliais (explicando os derrames pleurais observados). Foram observadas lesões de fibrose e neovascularização ao longo de todo o aparelho respiratório dos animais expostos. Também se identificaram lesões pré-malignas, metaplasia e displasia. Conclusões: O RBF é um agente de doença e tem como alvo preferencial o aparelho respiratório. A patologia respiratória associada à VAD necessita, ainda, de muito estudo para que uma maior compreenção possa ser alcançada e intervenções farmacológicas possam ser pensadas.

Rev Port Pneumol 2007; XIII (1): 129-135

Palavras-chave:
Ruído de baixa frequência
infra-sons
fibrose
derrame pleural
broncoscopia
cancro do pulmão
sensibilidade ao CO2
Abstract

Background: Respiratory pathology induced by low frequency noise (LFN, <500Hz, including infrasound) is not a novel subject given that in the 1960’s, within the context of U.S. and U.S.S.R. Space Programs, other authors have already reported its existence. Within the scope of vibroacoustic disease (VAD), a whole-body pathology caused by excessive exposure to LFN, respiratory pathology takes on specific features. Initially, respiratory pathology was not considered a consequence of LFN exposure; but today, LFN can be regarded as a major agent of disease that targets the respiratory system. The goal of this report is to put forth what is known to date on the clinical signs of respiratory pathology seen in VAD patients. Methods: Data from the past 25 years of research will be taken together and presented. Results: In persons exposed to LFN on the job, respiratory complaints appear after the first 4 years of professional activity. At this stage, they disappear during vacation periods or when the person is removed form his /her workstation for other reasons. With long-term exposure, more serious situations can arise, such as, atypical pleural effusion, respiratory insufficiency, fibrosis and tumours. There is no correlation with smoking habits. In LFN-exposed animal models, morphological changes of the pleura, and loss of the phagocytic ability of pleural mesothelial cells (explaining the atypical pleural effusions). Fibrotic lesions and neo-vascularization were observed along the entire respiratory tract. Fibrosis lesions and neovascularisation were observed throughout the respiratory tract of the animals seen. Pre-ma-lignant lesions, metaplasia e displasia, were also identified. Discussion: LFN is an agent of disease and the respiratory tract is one of its preferential targets. The respiratory pathology associated with VAD needs further in-depth studies in order to achieve a greater understanding, and develop methods of pharmacological intervention.

Rev Port Pneumol 2007; XIII (1): 129-135

Key-words:
Low frequency noise
infrasound
fibrosis
pleural effusion
bronchoscopy
lung cancer
respiratory drive
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Copyright © 2007. Sociedade Portuguesa de Pneumologia/SPP
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