Objectives To evaluate relative contribution of hard manual labour, fluorides’ influence, co-morbid pathology on the prevalence and incidence of shoulder pain syndrome (SPS).

Method One-stage cross-sectional observation of prevalence SPS was investigated. The observed 6094 workers were divided into four groups. The first group was formed by 407 workers of an aluminium plant (elektroliz aluminium), whose professional activity (hard manual labour) is connected the quite big shoulder region loading and fluorides’ influence. The 2-nd group consisted of 369 workers with fluorides’ influence without manual labour. The 3-rd group consisted of 2078 workers, hard manual labour without influence of bone-seeking toxic factors (metalworker, painters, moulders etc.). The 4-th group - 3240 workers and employees of auxiliary departments not subjected to the influence of unfavourable industrial factors (engineer, command, economists etc.). The observed were divided into four age groups and three working experience groups.

Results In the observed population the prevalence of SPS was 9,6 (95% CI 8,9–10,7), among male - 8,6 (7,8–9,4), among female - 1,9 (10,5–13,5). The highest rates of SPS were aged 40 to 49 years - 11,0 (9,6–12,4) and older than 50 years - 11,9 (10,5–13,3). The highest prevalence index of SPS were registered in the B first group - 32, 9% (workers exposed to toxic effects of fluoride and physical strain), the lowest - in the 3-rd group - 6,9% (without the impact of toxic action). Rate of shoulder pain prevalence is authentically higher among the workers of hard manual labour and under the toxic influence of fluoride. The prevalence of SP in the 3rd group was similar to the index of the 4th group.

Conclusions The highest RR of SPS progress was observed in the 1st group in the relation to 4th (5,6) and 3rd groups (5,2), at the same time etiological fraction (EF) was 77.5% and 78,7%, it indicates very high influence of labour conditions on prevalence of SPS. Influence without the manual labour index of RR and EF is much higher in the 2nd group, than in 3rd and 4th groups.

It’s worth noting that the highest prevalence of SPS was found among patients with broncho-pulmonary system diseases - 24,8 (20,1–29,4), it is higher than among patients with neck pain - 23,4 (21,5–25,3). Among the analysed “nonmanufactoring” data co-morbid pathology of the respiratory system and neck pain increase the risk of the shoulder pain syndrome development.

The relative risk of SPS was higher among patients with neck pain (7,0) than with comorbidity of broncho-pulmonary system (2,6).