Substantiation of criteria of professional suitability in patients with polyneuropathies of the upper limbs from functional overvoltage

Abstract

Occupational polyneuropathy of the upper extremities from the effects of physical overload in the Russian Federation is a common occupational disease that leads to a long-term decrease in the occupational capacity of patients. But at the same time, the current regulatory documents do not contain any detailed recommendations for the examination of professional suitability in patients with this disease. The aim of the study is to substantiate the ways of improving expert approaches to determining the professional suitability of patients with occupational polyneuropathy caused by physical overload. The adequacy of two alternative approaches to assessing the professional suitability of patients with occupational polyneuropathy was assessed, the first of which allowed the patients to continue working under the influence of physical overload, and the second indicated the need to employ these patients at work without the influence of physical overload. The adequacy of labor recommendations was assessed by the dynamics of the health status of workers in different employment options. According to the dynamic observation of a group of 412 patients with occupational polyneuropathy, it was found that when they continued to work under conditions of physical overload, an unfavorable course of occupational pathology in the form of progression of polyneuropathy was regularly noted (36,1%), less often the development of new occupational diseases of the musculoskeletal system from physical overload. Among patients employed at work without physical overload, cases of progression of occupational pathology were not observed. Among patients with occupational polyneuropathy, in the majority (61.9%) this disease was combined with occupational pathology of the musculoskeletal system, occupational radiculopathies of the cervical and lumbosacral levels. Periodic exacerbations of these diseases can also lead to the need to establish contraindications for admission to physically demanding work. During dynamic observation of patients with occupational polyneuropathy in 39.5% of patients, due to the unfavorable course of cardiovascular diseases, there were grounds for determining contraindications to work under the influence of all harmful industrial factors. As a justification for contraindications to continue working under conditions of physical overload and other harmful production factors (general and local vibration, general hypothermia), the probability of progression of an occupational disease should be considered. When choosing the types of work, one should consider the presence of concomitant occupational and general diseases.