The article presents results of the examination of workers of phthalic anhydride manufacture with work experience more than 10 years underwent impact of complex of harmful factors of production including chemical substances, noise, difficulty and intensity of working process. The group of comparison consisted of employees of administration department. The study established exceeding of both maximum permissible concentration (MPC) of phthalic anhydride (2.2-6.3 mg/m3 at MPC 1.0 mg/m3) and level of total and local vibration and thermal load at work places that corresponds to class 3.2-3.3 of work conditions on indicator of harmfulness and danger of industrial environment. The equivalent levels of noise with maximal values at work places of machinery operators of oxidation (84.6 dBA) are identified. The study established decreasing of phagocytic activity (relative phagocytosis, phagocytic number and phagocytic index in 1.13, 1.39 and 1.26 times correspondingly) relative to group of comparison and also decreasing of level of serum immunoglobulin G in relation of standard. On the basis of flow cytometry, the reliable decreasing of expression of CD95 T-cell receptors is established. The results of allergen-sorbent testing demonstrated increasing of the level of specific sensitization to phthalic anhydride by its metabolite of phthalic acid in 79.2% of workers. The indices of immune regulation CD95, phagocytic activity, specific to anhydride IgE, reflecting characteristics of immune regulation in workers of phthalic anhydride manufacture are recommended to be applied as markers of effect during assessment of health risk in people working in conditions of combined impact of physical and chemical factors.