EASL clinical practice guidelines for the management of occupational liver diseases

The Clinical Practice Guidelines (CPG) on Occupational Liver Diseases (OLD) of the European Association for the Study of the Liver (EASL) have been developed to increase awareness, recognition and improve management of patients with OLD. Indeed, although workplace exposure has been associated with virtually the entire spectrum of acute and chronic liver diseases, data on the epidemiology of OLD are scarce. These diseases may be a result of high-level accidental exposure or prolonged lower level exposure to a variety of chemicals including solvents, pesticides, metals and other agents. While acute liver diseases related to OLD are uncommon and easily recognized, chronic liver diseases are relatively more frequent but often overlooked because of their asymptomatic course and an insidious onset which is often accompanied by comorbidities. Because of the absence of data in observational studies and meta-analyses or systematic reviews, the evidence and recommendations in these guidelines have been graded according to the Oxford Centre for Evidence-based Medicine, which assesses evidence according to diagnostic, prevalence, aetiological, prognostic or preventive categories. They can still generate grades of recommendation even when the evidence is inconclusive.