Lung cancer, tuberculosis and other lung diseases Statistics extremely common in Russia. For information on how to protect lung health, how to clean the air in the apartment, if you live in the city, as far as necessary to newborn children vaccinated with BCG, and how not to miss the start of pneumonia in children, we had a talk with Basil Shtabnitskim , physician-pulmonologist, candidate of medical sciences, expert help fund ALS patients, “The Power of Now.”

Basil Shtabnitsky

3Vasily Andreyevich, that you need to do to keep the lungs healthy?

Healthy people should first of all be aware of the risk factors. There are three factors.

First – it is smoking. Russia, unfortunately, is one of the first places on tobacco consumption. Therefore, we have a high percentage of pulmonary diseases.

This includes a negative factor, as the work on harmful plants, living near industries. Although it is not as harmful as smoking, however, on the effects on the lungs is similar.

Among the hazards are and major highways. Next to them is always increased level of dust and smoke. Negatively affect automobile exhaust.

The second factor – a variety of infections. In the first place, tuberculosis, which in our country, unfortunately, is still very common. It should be possible to try to minimize the presence in the places where you may encounter people who are sick. Alas, this is not always possible – as they say, from prison and from scrip does not renounce. The TB prisons very much, and if one got there, he has virtually no opportunity to protect themselves from exposure. We can interfere with TB patients in public transport – and here, again, very difficult to defend, because people can not go to work, to school, for some other cases. Wearing a mask here, alas, does not help. Rather, the mask is needed for those who are already sick – it is at least some kind of filter that can stop the spread of bacteria. For viruses, by the way, the mask is completely permeable, it is a known fact.

The third factor – a healthy lifestyle. This is a proper diet, regular walks, the right atmosphere in the apartment. All this affects the overall condition of the person and thus the health of his lung. If a person is properly nourished, do not walk, do not ventilate the apartment, does not exercise, it is, of course, it leads to a decrease in immunity.

You mentioned, among other factors, proximity to hazardous enterprises or major highways. What do the people who live near sources of pollution? Try to move to another place – especially if they have small children? And if you can not move?

We must understand that it is only one factor of several. There is no direct link – lived near the road, it means that in 10 years received a lung disease. However, it is important for people to know that this is a risk factor, and if possible try to consider it. Of course, good to live outside the city. But if this is not possible – so we must proceed from this and work on air quality in the house. Put good windows regularly do wet cleaning, purchase of air cleaning with high-quality filters.


air quality problem is very acute, for example, in China, which is almost all under the smog. They build special houses with centralized ventilation, and the air in them much cleaner than in the street.

How necessary newborns with BCG vaccination? You have said that the epidemiological situation of tuberculosis in Russia is unfavorable. That is tuberculosis – is a very real threat?

Yes. BCG should be done necessarily. This vaccine, which protects against lethal infection of tuberculosis from a form of tuberculosis, which do almost nothing is impossible. That is, it prevents death from tuberculosis at an early age. Plus vaccine in the fact that it makes the body more resistant to external influences tubercle bacillus. Vaccinated organism is already familiar with Mycobacterium tuberculosis, he has already won it and developed immunity. When a vaccinated person encounters with infection, he may have had it in an easy manner and gain a true immunity from tuberculosis.

If TB is still developing, it is usually associated with adverse factors. For example, if a person who was vaccinated as a child, as a result of certain circumstances appeared without adequate housing, in unfavorable social conditions, it can get TB. And it can be as a result of the activation of tuberculosis, of which he is a carrier, and a new infection.

And if the child for some reason did not BCG, how then to be?

In this case, you have to go to the clinic for a consultation with a doctor. Be sure to have to do Mantoux test – it will show whether the child has already met with tuberculous infection. If met, the vaccination has to do it does not make sense. And if the Mantoux test is negative, it is necessary to make the BCG.

In Europe, vaccination against pneumococcal infection is one of the mandatory, in Russia it is only for a fee. What do you think, does it make sense to make this vaccine is, and if so, to whom?

This vaccine protects against infection that causes pneumonia, upper respiratory tract infection. she did not in Russia among the mandatory – although we have no vaccinations are not required, but in the national calendar, it is not included. We recommend it to their patients. I would especially advise to vaccinate young children, the elderly and all those who have risk factors for lung disease.

In general, vaccination – this is one of the safest and most effective ways to prevent serious diseases. It is much better than antibiotics, and the side effects it has, incidentally, is also less.

A flu shot? Many refer to it is ambiguous, because the strains of influenza every year different …

The flu shot – a wonderful thing. After all, the flu – this is a very terrible disease. People die from the flu each year. As a result of the flu may develop serious complications that even with a favorable course require treatment in intensive care, a long recovery period, and lead to severe lung damage. It is better to be vaccinated.

And what about the strains – well, for this, and scientists are working to predict what will be the most common strain in the current year, and accordingly choose the vaccine.

When cough – is cause for treatment to the doctor?

Coughing – one of the most common symptoms and may be associated with various diseases. Coughing can be a symptom of tuberculosis, and may be a symptom of heartburn. Chronic cough is considered when it is repeated regularly, several times a year. And in any case it is a symptom that indicates some kind of disease and, therefore, they must be dealt with. Even heartburn – this is not a harmless phenomenon, as it may seem. Heartburn may result, for example, by metaplasia of the esophagus, which in turn may develop into cancer of the esophagus. And if a man will come in time to see a doctor, it can be prevented.


We have a very common chronic obstructive pulmonary disease – and in the world is on the 4th leading cause of death. One of the symptoms of the disease – coughing. But most smokers are getting used to the fact that they are coughing. Smoke and cough, and almost do not notice it. If such patients ask what he complains, he will answer that he had no complaints. And yet it is at the stage of cough these people can help: choose a replacement therapy for smoking cessation, medications, improve lung function and so on. Therefore, I believe that any chronic cough is a reason for referral to a specialist.

As for acute cough, it is usually a symptom of SARS and with SARS and passes.

Asthma – a congenital disease? What are the current recommendations for people suffering from this disease?

Asthma – a multifactorial disease. Genetic predisposition does exist: usually a child-asthmatic necessarily either one or both parents also suffer from asthma. Asthma – a reaction to allergens. To identify what specific, special tests can be done.

Treatment consists primarily in eliminating allergens. That is, if you are allergic to a cat – have, unfortunately, remove cat. If the dog – the dog away. If dust – to remove all the carpets, blankets and pillows replaced with an organic filler, wet cleaning and to do so on. If flowering – hence, it is necessary to leave the period of flowering in the region where flowering is over (or not yet started).

Also, there are drugs that suppress allergic inflammation. They should pick a doctor.

In general, the disease is widespread, but with adequate treatment of asthma in our time can usually be controlled, it does not require hospitalization and does not lead to death, as it was before, when dying from asthma.

How not to miss and how to treat pneumonia?

The first symptom of pneumonia can be a rise in temperature after a cold or respiratory diseases, when a person starts to recover. A second temperature rise is not characteristic for viral infections, and a jump it may indicate that the viral infection complicated by bacterial infection.

Pneumonia may develop hypothermia after – on the street, in a draft. For example, a person got wet in the rain, and it starts to shiver, high fever, cough begins, he feels a strong weakness, pain in the chest. This is a classic scenario of pneumonia.

There may be not quite typical cases: prolonged cough, fever, persisting more than a week, feeling unwell. It also may indicate pneumonia, although in this case the diagnosis is quite difficult to deliver.

In general, the alert should be two things: the temperature jumps and a long course of the disease. If the second week of treatment the person gets worse, it could be a symptom of pneumonia.

Treat pneumonia should be a doctor – a pediatrician, internist, pulmonologist. Any doctor can and should treat pneumonia. The diagnosis is confirmed only after X-ray examination of lungs – ie no wheezing, no sputum, no other tests are not able to confirm pneumonia without X-ray examination. Pneumonia is treated with antibiotics always so carries serious risk of various complications, including death.

And if the doctor heard wheezing and on this basis to prescribe antibiotics if it is justified?

There are different wheezing, including characteristic and uncharacteristic for pneumonia. There wheezing associated with sputum or stagnation associated with bronchospasm. It depends on what the doctor heard. Maybe he suspected pneumonia and wants, while x-rays have not done already to start antibiotics. Maybe he thinks it’s a bacterial exacerbation of bronchitis (eg, a smoker), which also requires antibiotics. In certain situations, early administration of antibiotics is justified. But not any wheeze requires immediate antibiotics.

Interview Alain Khmilevskaya