[Biomarkers of hepatotoxic effects: their usefulness in occupational medicine]

Medical screening and the resultant monitoring of health effects induced by hepatotoxins present in workplaces become of still greater importance in the assessment of occupational health and safety. Health effects of occupational and nonoccupational hepatotoxic factors may be acute, subacute or chronic. Laboratory tests (biomarkers) used in screening for detection of asymptomatic damages of the liver should satisfy the following three criteria: 1. they should provide positive or negative predictive information, namely the information about possible development of clinically evident hepatopathy; 2. they should be very sensitive and specific in order to ensure a correct identification of the developing disease; and 3. they should provide information which of clinical biomarkers should be applied subsequently in order to confirm and facilitate the diagnosis of hepatopathy related to exposure to occupational hepatotoxins or to eliminate such a relationship. It should be also remembered that for assessing disorders in hepatic functions those biomarkers should be selected which are most effective in identifying both persons with hepatopathy induced by environmental hepatotoxins and those who are free from the liver damages. It should be stressed that to date none of the existing biomarkers is sensitive and specific enough to assess alone all the functional systems of the liver.