Nonalcoholic steatohepatitis : a toxic liver disease in industrial workers.
Occupational/environmental exposure to hepatotoxins has recently been implicated in nonalcoholic steatohepatitis (NASH).
The aims of this study were to determine the presence and frequency of NASH in a large group of workers chronically exposed to several volatile petrochemical products in an industrial area in north-east Brazil and to observe its course in workers removed from the work environment.
1500 asymptomatic workers were screened with standard liver blood tests during 1994-5.
Those with elevated transaminases (>3x normal) on 3 occasions were evaluated further both clinically and with serum HBsAg, anti-HCV, ferritin, lipids and autoantibody determination.
Patients with either no etiological diagnosis, positive HBsAg/anti-HCV serology and/or excess alcohol intake underwent liver biopsy.
Those with obesity, diabetes or an isolated abnormal GGT were excluded.
Of workers diagnosed as having NASH (compatible histology and no excess alcohol intake), a proportion were removed from the work environment and evaluated monthly with liver blood tests and a repeat liver biopsy 8-14 months later.
112 workers had abnormal transaminases and 32 fulfilled the criteria for liver biopsy. 20 of these were classified as NASH, the remainder had viral hepatitis (n=6), alcoholic liver disease (n=5) or portal vein thrombosis (n=1). (...)
Mots-clés Pascal : Stéatose, Foie, Cytotoxicité, Exposition professionnelle, Composé volatil, Pétrochimie, Dépistage, Exploration, Homme, Triglycéride, Appareil digestif pathologie, Foie pathologie, Toxicologie, Médecine travail
Mots-clés Pascal anglais : Steatosis, Liver, Cytotoxicity, Occupational exposure, Volatile compound, Petrochemistry, Medical screening, Exploration, Human, Triglyceride, Digestive diseases, Hepatic disease, Toxicology, Occupational medicine
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0393004
Code Inist : 002B03L02. Création : 22/03/2000.