Introduction. Occupation vibration is the main etiological factor of the vibration disease. Vibration disease disrupts the activity of different systems of the body (nervous, vascular, musculoskeletal, endocrine systems, etc.) which predisposes to the development of co-morbid conditions. Aim of the study. Based on the studying the prevalence and the structure of co-morbid pathology in vibration disease patients to identify the dependence of a polymorbidity on the duration of work experience and severity of vibration pathology, determine a prognosis of “10-year survival” according to the Charlson co-morbidity index. Material and methods. A retrospective analysis of 175 clinical charts of 83 patients of the clinic of the Research Institute for Complex Problems of Hygiene and Occupational Diseases for the period from 2013 to 2018 was carried out. All patients (40-60 years old men) were exposed to vibration in the course of the occupational activity for more than 10 years. Results. Co-morbid conditions in vibration disease were found in 90% of the patients. There most frequent were hypercholesterolemia (52%), dorsopathy (29%), arterial hypertension (27%), sensorineural hearing loss (24%), etc. The results confirm the previously described data on the predominance of co-morbid cardiovascular and metabolic disorders in vibration disease, which are interrelated by pathogenetic mechanisms. The Charlson co-morbidity index in the study group was 2.6 ± 1.04. Average statistical association of the polymorbidity prevalence (φ = 0.21) with the severity of the vibration disease was revealed. Conclusions. The vast majority of the vibration disease patients have co-morbid pathology. More severe damage in vibration pathology is associated with polymorbidity. This relationship is probably due to the mutual worsening of the course of associated diseases.

Introduction. Among the various methods of diagnosis and prediction of peripheral nerve injuries of the upper extremities, stimulation electroneuromyography plays a significant role. Occupational polyneuropathy of the upper extremities in coal miners is a common pathology. This pathology can lead to a disability of the active population, which makes the problem to be socially significant. Stimulation electroneuromyography is a method of choice in the diagnosis and prediction of peripheral nervous system diseases. Material and methods. 40 miners aged from 42 to 65 years, employed in hazardous working conditions (vibration, physical overload, gas pollution, adverse climatic conditions) were surveyed. As a control group, 12 healthy subjects of the same age without the signs of peripheral nervous system disease were examined. A clinical and electrophysiological study was conducted, including a clinical investigation, a quantitative assessment of subjective complaints on the Total Symptom Score (TSS) scale and stimulation electroneuromyography. Results. Occupational polyneuropathy developed in all surveyed workers employed in adverse working conditions; it was characterized mainly by myelinopathies of motor and sensory nerve fibers. In the clinical picture there were dominated sensitive (95%) and painful (45%) manifestations, moderately pronounced, the average score on the TSS scale was of 2.63 and 2.44, respectively; a correlation relationship between neurophysiological indices and subjective complaints (r-Pearson criteria value accounted of from 0.75 to 0.97) was revealed. Prenosological manifestations of electroneuromyography changes were detected in 5% of the examined subjects. Conclusion. The study of the functional state of peripheral nerves by using the method of stimulation electroneuromyography is an effective tool for the early diagnosis of occupational polyneuropathy.

Introduction. Vibration disease, affecting the autonomic-vascular regulation at different levels, disrupts the balance of sympathetic and parasympathetic influences with the formation of vasospasm. The development of cardiac autonomic neuropathy leads to a worsening of the prognosis for the life of patients, and therefore, the search for effective methods for correcting autonomic disorders is an urgent task in the treatment of vibration disease.The aim of the study is to evaluate the effectiveness of ischemic preconditioning for the correction of neurovegetative manifestations of vibration disease.Materials and methods. A comparative assessment of the initial parameters of heart rate variability was carried out in the main group of patients with an established diagnosis of vibration disease (32 people), and in the control group (25 people who had never worked under the influence of industrial vibration). The main group of patients underwent ischemic preconditioning of the upper extremities for 4 days, followed by monitoring of heart rate variability. The Mann-Whitney criteria were used to compare two independent samples and Wilcoxon to assess the significance of changes in indicators before and after exposure. Values at p<0.05 were considered statistically reliable.Results. An initial decrease in the power level of all spectral parameters of heart rate variability in the main group with the formation of relative sympathicotonia and a decrease in the values of the approximated entropy was revealed. After ischemic preconditioning, heart rate variability significantly increases, which indicates a decrease in the severity of autonomous neuropathy and an improvement in the prognosis for life.Conclusions. In patients with vibration disease, all parts of the peripheral and central autonomic nervous system are involved in pathogenesis with the formation of persistent sympathicotonia and violation of regulatory mechanisms. Ischemic preconditioning can affect the identified disorders by inducing an adaptive vagal response.The authors declare no conflict of interests.

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Introduction. Active coal mining in Kuzbass, with its unfavorable climatic and environmental conditions, necessitates the study of occupational diseases of workers in this industry. One of the most common occupationally caused diseases of miners is polyneuropathy of the upper extremities.The aim of the study is to assess the effect of autonomic disorders on the course of occupational upper limb polyneuropathy in workers of the Kuzbass coal industry using various methods of analyzing heart rate variability.Materials and methods. 52 employees of coal enterprises aged from 43 to 64 years with the established diagnosis of “polyneuropathy of the upper extremities” were examined. The control group consisted of 16 healthy volunteers of the same age, engaged mainly in mental or light physical labor. Electroneuromyography was performed to assess the degree of damage to peripheral nerve fibers. Spectral and nonlinear parameters of heart rate variability were used to determine the state of autonomic regulation. The Mann-Whitney criterion was used to assess the statistical significance of differences between the study groups.Results. 3 groups of patients with polyneuropathy were identified according to the severity of violations of impulse conduction in the peripheral nerves. In subjects with mild, initial disturbances of pulse conduction (n=8, 15.4%), a decrease in parasympathetic influence is determined, which is manifested by a statistically significant decrease in the power of high frequency oscillations of the heart rate variability spectrum. With moderate signs of polyneuropathy (28 cases, 53.9%), there is a shift in the autonomic balance towards sympathetic activation; a statistically significant increase in very low-frequency fluctuations in heart rate variability indicates an increase in the influence of suprasegmental autonomic centers. In subjects with gross violations of the peripheral nerve impulses (n=16, 30.7%), there is a decrease in the power of oscillations in all frequency ranges of heart rate variability.Conclusions. The obtained data confirm the influence of autonomic regulation on the course of occupational polyneuropathy.The authors declare no conflict of interests.