Recent findings in occupational medicine have demonstrated that common pathology is one of the main factors determining poor health of workers in hazardous industries. Non-occupational pathology also has a significant effect on timing of occupational disease onset. Our objective was to conduct a comparative analysis of comorbidities in patients with different occupational diseases. The study was conducted retrospectively. We created a database of medical records of aluminum and refractory workers and analyzed all diagnoses and systemic disorders identified during the clinical examination of these patients using SPSS Statistics 23. The comorbidity index was used to determine the degree of somatic burden of the subjects. We assessed transnosological and transsystemic multimorbidity, as well as the relationship between multimorbidity and the diagnosed occupational disease. The hypothesis for normality of the indicators under study was tested by carrying out calculations using the Kolmogorov-Smirnov test, which allowed the use of parametric sample estimates, Student's t-test and one-way analysis of variance for data analysis. We established comorbidities that were significantly more frequent among the patients suffering from fluorosis or silicosis. Exposure to occupational hazards in different industries affects the profile of comorbidity. We observed a pronounced polysystemic nature of lesions in aluminum production workers and the predominance of comorbid diseases of the respiratory system in refractory workers. The level of multimorbidity among the workers of the refractory industry was significantly lower than that in the aluminum production, which allows a conclusion on a more pronounced negative impact of a combination of hazards in the latter on workers’ health.