Clinical-functional differentiation of patients with occupational respiratory diseases

Objective. To study is to perform a clinical and functional differentiation of patients with occupational respiratory diseases (ORD) based on an analysis of disease course characteristics and their role in the development of functional limitations.

Materials and methods. The study included 102 patients with ORD: chronic occupational bronchitis (COB, n = 34), occupational chronic obstructive pulmonary disease (OCOPD, n = 38), and pneumoconiosis (PC, n = 30), as well as 23 healthy workers exposed to occupational hazards (control group). Anthropometric parameters, pulmonary function, respiratory and peripheral muscle strength, and oxygen saturation (SpO₂) during the 6-minute walk test (6MWT) were evaluated.

Results. With the similarity of the clinical picture in the 3 groups of diseases, abdominal obesity predominated in individuals with COB (52.9 %) and COPD (44.8 %); in PC, normal weight (33.4 %) or overweight (40.0 %) was more often observed with a low incidence of obesity (26.6 %); in addition, a decrease in the main anthropometric indicators was detected in this group. All patient groups demonstrated reduced respiratory muscle strength and peripheral muscle endurance, most pronounced in OCOPD. During the 6MWT, COB and OCOPD showed gradual SpO₂ decline, while PC was characterized by early, fluctuating desaturation. PC was associated with functional class (FC) II and respiratory insufficiency (RI) grade I; OCOPD – with FC I and RI I; and COB – with FC 0 and RI 0.

Conclusion. ORD are characterized by systemic involvement of respiratory and peripheral skeletal muscles, distinct nutritional profiles, and disease-specific ventilatory responses to exercise, underscoring the need for personalized rehabilitation strategies that include assessment of muscle function, nutritional correction, and individualized physical activity programs.

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