Clinical and hygienic evaluation of patients with occupational polyneuropathy of upper extremities

Introduction. The article presents the results of a study of working conditions and the health status of patients with occupational polyneuropathy (PNP) of the upper limbs. Such a clinical and hygienic assessment of people with occupational PNP contributes to the optimal examination and treatment of patients with the preliminary diagnosis who are referred to occupational pathology centers.

Material and methods. The study included 236 patients of two main occupations (painters-plasterers and miners): 113 women and 123 men.

Results. The average age of patients at the time of the examination was: for painters-plasterers (women) - 55.5 ± 5.7 years, for miners (men) - 53.9 ± 6.3 years. Work experience of patients with physical overload at the time of diagnosis of occupational PNP accounted for plasterers - 25.1 ± 8.0 years, for miners - 20.4 ± 6.7 years. Working conditions of plasterers and miners were revealed to contribute to the development of occupational diseases of the peripheral nervous system and musculoskeletal system from the effects of physical overload and functional overstrain of the muscles of the upper extremities. Most often occupational PNP of the upper limbs is accompanied by the parallel development of professional chronic shoulder-scapular periarthrosis, epicondylosis, myofibrosis of the forearms, and shoulder girdle (a complex of occupational pathology of the «working hand»); radiculopathy of the cervical and lumbosacral levels.

Conclusions. The main common harmful factor in the examined patients is the severity of the labor process. In less than one-fourth of the examined patients (15,7%) occupational PNP of the upper limbs was the only occupational disease. In other cases, its development was accompanied by the appearance of other occupational diseases of the peripheral nervous system and the musculoskeletal system. Patients referred to the examination in occupational pathology centers with a diagnosis of “PNP of the upper extremities” need a comprehensive examination to verify a possible complex of occupational pathology.