Functional disorders of the peripheral nervous system in metallurgical workers

Introduction. Early detection of functional changes in the nervous system makes it possible to clarify the etiopathogenetic effect of a whole set of adverse industrial factors, form a group at risk of occupational diseases, and develop preventive programs for given the main structural targets. The purpose of the study was to identify characteristics of functional disorders of the peripheral nervous systems in metallurgists exposed to occupational hazards. Materials and methods. We examined two cohorts of workers: a control cohort of forty men unexposed to occupational risk factors and a case cohort of 60 male employees of a metallurgical plant situated in the Sverdlovsk Region. The cohorts were matched by age (mean: 38.8±7.6 years) and work experience (5.1±4.7 years). The mean duration of exposure to occupational hazards was 7.1±6.0 years. We included 38 cases in the program of in-depth neurophysiological examination that consisted of assessment of neurological status, electroneuromyography (ENMG). Results. 73.9 % of the cases had no complaints. Functional disorders of peripheral nerves were diagnosed as distal polyneuropathy of the upper and lower extremities (47.4 %), median neuropathy (42.1 %), ulnar neuropathy (23.7 %), and radiculopathies (9.6 %). Noteworthy is the presence of additional damages of the median nerve at the carpal tunnel in 55.6 % of the cases having signs of distal polyneuropathy. Conclusions. A comprehensive neurophysiological examination, not required by the current order for periodic medical examinations, helps to identify dysfunctions of the nervous system at their early stages. It is necessary to form high-risk groups of patients to monitor the development of work-related nervous diseases.