State Institution «Kundiiev Institute of Occupational Health of the NAMS of Ukraine, Kyiv
Introduction. In the structure of occupational morbidity in Ukraine, the pathology of the musculoskeletal apparatus takes the second place, after diseases of the broncho-pulmonary system, and constitutes its fifth part, reaching 601-604 cases per year. In particular, this concerns the category of miners, the morbidity of which makes up near 80% in the structure of occupational pathology, due to the fact that in most cases working conditions for miners are dangerous and extreme, and a significant part of the total pathology of the musculoskeletal apparatus is chronic radiculopathy. At present, the role of macro- and microelements (MaE and ME) in development of pathological processes that affect the formation of bone and connective tissue diseases has not yet been fully studied.
Purpose. To determine the role of the essential elements Ca, Al, Mg, B, P in the blood serum and in urine in formation of chronic lumbosacral radiculopathy (LSR) in miners, working in dangerous conditions. To define the part of ionized forms of calcium and magnesium in plasma and saliva of patients with osteoporosis.
Materials and methods. The survey of the state of the motor system was carried out in a group of miners of main professions (miners, clearing face miners, sinkers of the coal mining industry in Donbass and Lviv-Volyn regions, who suffer from LSR. The analysis of the results was conducted in two experienced groups: the first group consisted of patients with experience of work in harmful conditions from 10 to 15 years (senior group), the second (junior group) - from 16 to 32 years. The control group included 22 patients without pathology of the musculoskeleal system. To determine the concentrations of MaE and ME, we used a method of atomic emission spectroscopy with inductively coupled plasma (AES-ICP).
The content of ionized calcium and magnesium was determined in 13 patients aged 21-47 years with a diagnosis of osteoporosis, using a flame-atomic adsorption spectrophotometry (FAAS). The control group consisted of 12 men who did not have systemic diseases of the bone and connective tissue.
Results. Based on the analysis of MaE and ME concentrations in the biological media of patients with LSR, a significant difference in the indices was found as compared with the control group. The average aluminum concentration in the blood of miners with chronic radiculopathy (115.07 µmol / l) was higher than in the control group (3.3 µmol / l) for more than 30 times. The decline in the level of boron in the blood serum was found in two experienced groups (25.91 µmol / l and 19.43 µmol / l), respectively, in comparison with the control (62.90 µmol / l). The average calcium content in the blood serum in patients with LSR of occupational etiology (2.82 mmol / l ) was by 30% higher than the same indicator in the control group (2.16 mmol / l), while it was by 60% higher in the junior experienced group (3.20 mmol / l) than in the senior (1.98 mmol / l). The average content of phosphorus in the urine of patients with radiculopathy (19.0 mmol / l) exceeded its content in patients of the control group (18.3 mmol / l) by 58% in the average, and reached 19.1 mmol / l in the group of miners with work experience from 16 to 32 years.
Conclusion. The study presents the results that clarify the understanding of the pathogenesis of osteoporosis and chronic lumbosacral radiculopathy in worker in conditions of significant physical activity, based on the concentration of Ca, Al, Mg, P, B as biomarkers of early bone structure disorders, as a risk factor of development of osteoporosis. The dependence of concentrations Ca and Mg in blood serum of patients with chronic lumbosacral radiculopathy from the patient's work experience in hazardous working conditions was diagnosed. The resulting data can be used to improve the diagnostic system and prevention of occupational diseases.
Кey words: chronic lumbosacral radiculopathy, osteoporosis, musculoskeletal apparatus, occupational pathology, macro- and mic roelements.
ORCID ID of co-authors and their contribution to preparation and writing of the article:
Basanets A.V. (ORCID ID 0000-0001-8236-4251) – idea of the investigation, analysis of certain principles, substantiation of the conclusions.
Andrusyshyna I.N. (ORCID ID 0000-0001-5827-3384) - idea of the investigation, analysis of certain principles, substantiation of the conclusions.
Lashko О.N. (ORCID ID 0000-0001-7938-5887) – tables, analysis of the results, writing of the article.