[Hepatotoxic occupational risk factors]

In this review the authors present a synthetic and critical analysis of the most recent epidemiological, clinical and experimental studies on the main risk factors thought to cause occupational liver diseases. The aim was to list the main occupational hepatotoxic substances in order to enable the earliest identification of possible occupational liver pathologies and the application of suitable means of prevention in the workplace. The following data emerge from a critical analysis of the studies reported. The list of potentially hepatotoxic substances is certainly very long and reliable evidence of specific toxicity only exists for some; many of these substances are used not only in the professional world, but often outside the workplace. The main route through which lesions occur is by inhalation and, in the case of many substances, also through the skin. In clinical terms, occupational liver pathologies may take an acute, subacute or chronic form, often with comparable symptoms to those found following non-occupational exposure. No particular histological features can be seen, nor are there specific diagnostic means to evaluate individual chemical substances. With regard to the data reported, the authors reach a few conclusions: when formulating an etiological diagnosis of occupational toxic hepatopathy, it is important to bear several aspects in mind such as the characteristics of the workplace (type of activity performed, products handled, working conditions, etc.), lifestyle (hobbies, use of drugs, etc.), varying individual susceptibility; each of these factors contributes to the onset of morbid conditions whose target is the liver.