Aim. To establish the strength and direction of the correlation between the comorbidity index depending on the combined impact of harmful production factors in men working at a large industrial enterprise in Tyumen. Materials and methods. A single-stage retrospective cohort study of working men in industrial conditions was carried out. Anamnestic, clinical, laboratory, biochemical, instrumental methods were used. Diagnoses were made on the basis of modern clinical guidelines criteria. The groups were comparable in age and formed depending on the number of harmful production factors. Study group n = 52 – men with multiple 3-5 harmful production factors (industrial noise, general vibration, height at work, exposure to welding aerosol, night shifts, static stress) as the number of the following professions increases: crane operators, bulldozer operators, and compressor installations, fitters, electricians for maintenance of electrical equipment, batchers of concrete components. mixtures, electric and gas welders, Kamaz drivers of the 2nd class, locksmiths, repairmen, molders of reinforced concrete products and structures, loaders, operators of the equipment control panel, installers, plumber on duty; their average age in the group was 44.8 ± 14.7. Control group n = 50 – men with 1-2 harmful production factors (industrial noise, static stress) as the number increases in the presence of the following professions: site managers, janitor, auxiliary workers, class 1 bus drivers, construction and installation work foremen, fitters for the repair and maintenance of gas equipment, concrete workers, carpenters; their average age in the group was 43.8 ± 16.2. Results. Between the combined effects of harmful production factors with the comorbidity index, a direct strong correlation was established r = 0.841 ***, p < 0.001 (95% CI 0.672-0.926) according to the Pearson method in the study group, whose experience was 2.2 years longer, then as in the control group, no statically significant correlation was found r = 0.339, p > 0.05 (95% CI -0.065-0.647) according to Pearson’s method. Conclusion. The combined effect of 3-5 harmful production factors is statistically significant with an increase in length of service increases the risk of developing comorbid pathology in men of working age working at a large industrial enterprise, which increases the 10-year risk of fatal complications.