Essential elements role in pathogenesis of occupational chronic lumbosacral radiculopathy in coal miners.

Abstract

The problem of diagnosis in the early and preclinical stages of diseases is important in the prevention of occupational diseases and their complications, because  this is the key to the timely initiation of treatment, the implementation of preventive measures. Chronic lumbosacral radiculopathy (CLSR) or low back pain (LBP) is one of the most common diseases in the structure of occupational pathology in Ukraine, which usually develops in those of working professions associated with physical activity, forced work posture, effect of high levels of general vibration, etc. The highest levels of occupational morbidity are recorded in the coal industry, which accounts for about 80% of occupational pathology in Ukraine. Above 1600 cases of CLRS are diagnosed annually in the country. A risk factor for the development of the CLSR is osteoporosis, which arises due to the impairment of quantitative and qualitative characteristics of bone tissue and is characterized by a decrease in its strength, animpairment of microarchitecture with a further increase in risk of fractures. One of the modern methods of assessing condition of bone tissue is determination of  the content of macro- and trace elements (MaE and ME) in the biological environments of patients. Ca, Al, Mg, B, P are the most important in the formation and development of bone and connective tissue. To date, studies of bone tissue status in patients with CLSR of professional etiology have not been conducted (small in numbers). Goal – to determine the role of essential elements Ca, Al, Mg, B, P in serum and urine in the formation of occupational CLSR in miners. The research was conducted in 20 miners with CLRS (slaughterer, mining worker of a clearing face (MWCF), drifter) of coal mining industry of Donbass and Lviv-Volyn basins. The results were analyzed in two groups: І group consisted of patients with 10-15 years of work experience (n=10), II group with 16-32 years of work experience (n=10). The control group included 22 patients without pathology of the musculoskeletal system and connective tissue. The inductively coupled plasma atomic emission spectroscopy method (ICPAE) was used to determine the MaE and ME concentrations. The study revealed that the average serum aluminum (Al) concentration in miners with occupational CLSR (115.07 μmol/l) exceeded control group level (3.3 μmol/l) by almost 30 times (p<0.05). Serum boron (B) concentration in both age groups (25.90 μMol/l and 19.43 μMol/l, respectively) were lower than in the control (62.90 μMol/l), (p<0.05). The average serum calcium (Ca) concentration in patients with occupational CLSR (2.82 mmol/l) was 1.3 times higher than the same indicator in the control group (2.16 mmol/l), with a significant difference between the two age groups (p<0.05). It was revealed that the average level of phosphorus (P) in the urine of patients with occupational CLSR (19.0 mmol/l) significantly exceeded its content in patients of control group (11.96 mmol/l) (p<0.05). The concentration of Al in the urine of patients with CLSR in both age groups (1.26 μMol/l and 1.334 μMol/l, respectively) was higher that in control (0.85 μMol/l), (p<0.05). Reduction of Ca and Mg levels in the serum of miners in increasing work experience in harmful working conditions, exceeding average concentration of aluminum in patients' blood compared to the normative value and indicators of the control group patients was established.