Occupational risk and diagnostic problems of shoulder injuries in miners

Introduction. The problems of diagnosing occupational shoulder injuries in manual workers are caused by a number of reasons. These include the lack of objective and complete data on the severity of the labor process, determined by a special assessment of working conditions and reflected in the sanitary and hygienic characteristics of working conditions. There is an incomplete correspondence of the list of occupational shoulder injuries to the International Classification of Diseases of the 10^th revision. Doctors do not have enough information about the clinical manifestations and diagnostic techniques for shoulder injuries, and there are no criteria for early diagnosis of this pathology.

The study aims to assess occupational risk and improve the diagnosis of occupational shoulder injuries in miners.

Materials and methods. The authors assessed the a priori risk of developing shoulder lesions in underground miners based on an analysis of the severity of the labor process according to the sanitary and hygienic characteristics of working conditions and/or maps of a special assessment of working conditions, as well as the results of a specially designed questionnaire. Specialists have examined 224 underground miners, including a set of orthopedic diagnostic tests, ultrasound diagnostics of the shoulder joint and isokinetic dynamometry during shoulder rotation.

Results. Experts have identified an increased occupational risk of shoulder lesions in miners, the predominant form of which is shoulder rotator compression syndrome. A high diagnostic accuracy of clinical orthopedic tests for shoulder lesions and a positive correlation between the severity of clinical manifestations and ultrasound signs of shoulder lesions (r=0.7) have been established, which indicates the effectiveness of a comprehensive clinical and instrumental examination. Isokinetic dynamometry in the early stages of the formation of shoulder rotator compression syndrome revealed a decrease in the values of torque (VT) during external and internal rotation of the shoulder, which indicates a developing functional muscle deficiency at the preclinical stage. The criteria for early diagnosis are a progressive decrease in VT, a sharp decrease in VT at the "pain point", and an asymmetry of VT (more than 20 Nm).

Limitations. The study is limited to a sample of individuals from certain professional groups.

Conclusion. The results of the study made it possible to clarify the structure of occupational shoulder injuries in miners and determine the optimal complex of clinical examination with high diagnostic effectiveness. Criteria for the early diagnosis of pathology using isokinetic dynamometry have been established.

Ethics. The examination of patients was conducted in accordance with the Ethical standard of the Helsinki Declaration of the World Medical Association "Ethical principles of conducting scientific medical research with human participation". All the surveyed signed an informed consent to participate in the study. There is a conclusion of the Local Ethics Committee of the Izmerov Research Institute of Occupational Health (Protocol No. 8 dated 19.10.2022).

Contributions:
Shchetinina A.A. — collection and processing of material, statistical data processing, writing text;
Saarkoppel’ L.M. — research concept and design, statistical data processing, text editing;
Lagutina G.N. — concept and design of research, text editing;
Nepershina O.P. — collection and processing of material;
Lagutina A.P. — collection and processing of material.

Funding. The study had no funding.

Conflict of interest. The authors declare no conflict of interest.

Received: 19.06.2025 / Accepted: 02.07.2025 / Published: 05.08.2025

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