The paper analyzes the results chronic disease prevalence in metallurgical workers based on the results of the periodic medical examinations over 1998-2015. A significant increase in chronic disease prevalence was observed (1.29 times on the average): from 70.1 % in 1998 to 90.5 % in 2015 with eye disorders accounting for the 3.6-fold increase, chronic circulatory system diseases accounting for the 1.5-fold increase, diseases of the nervous system accounting for the 2.9-fold increase in prevalence. It that prevalence of respiratory diseases has also been observed to decrease by 1.4 times, the prevalence rate of diseases of the digestive system decreased by 1.6 times, anemias rate decreased by 2.1 times, gynecological diseases rate decreased 1.2 times.

A comparative analysis of occupational health risk based on special evaluation of working conditions (SEWC), workplace inspection as well as medical and biological criteria (realized risk) showed occupational hazards to be underestimated during special evaluation of working conditions and the predicted risk (estimated using the SEWC technique) fail to correspond to the realized occupational risk. As a rule, the realized risk due to the exposure to chemicals, predominantly fibrogenic aerosols, the noise was higher than the risk predicted by using the Size-exclusion chromatography (SEWC) technique. Both the distorted reality of working conditions, inadequate real occupational risk assessment leads to the incomplete information for occupational disease identification, establishment of the causality for health conditions, as well lower quality and efficiency of measures aimed at the improvement of working conditions and preservation of employees’ health.