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Occupational liver injury

Present state of knowledge and future perspective

  • Review Article
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Summary

Epidemiological studies have mapped the occurrence of hepatitis B among health personnel with the use of specific serologic markers and thereby made rational preventive precautions possible. Follow-up studies have demonstrated the effect of this prevention, and the newly developed hepatitis B vaccine has further improved the possibilities for effective prophylaxis against occupational hepatitis B. On the other hand, there is the chemically induced occupational liver damage. Only a few of the thousands of industrially used chemicals have been sufficiently investigated for hepatotoxicity and the list of suspected and confirmed hepatotoxic agents is still growing. The worrisome example of vinylchloride-induced serious liver disease among PVC-workers, revealed after 42 years of industrial use by alert clinicians, calls for intensified activities in the field of occupational hepatotoxicity. However, the clinical, biochemical, and morphological features of liver disease are often vague and unspecific. A non-invasive, convenient quantitative liver function test is needed. Circumstantial evidence and a few epidemiological studies suggest that part of the so-called cryptogenic liver diseases, such as liver cirrhosis, may be caused by occupational exposure to chemicals. This should be further studied. Animal experiments have shown that one chemical agent may potentiate the hepatotoxic effect of another chemical agent. This should be the subject of investigations in the work environment, where exposure to various chemicals is the rule rather than the exception. Alcohol consumption may also interfere with the hepatotoxicity of occupationally used chemicals.

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References

  • Alsbirk KE, Mogensen CE, Husted SE, Geday E (1981) Liver and kidney function in stainless steel workers. Ugeskr Læg 143:112–116

    Google Scholar 

  • Anderson HA, Wolff MS, Fischbein A, Selikoff IJ (1978) Investigation of the health status of Michigan chemical corporation employees. Environ Health Perspect 23:187–191

    Google Scholar 

  • Alpfeldorf R, Infante P (1981) Review of epidemiologic study results of vinyl chloride-related compounds. Environ Health Perspect 41:221–226

    Google Scholar 

  • Austin SG, Schnatter AR (1983) A cohort mortality study of petrochemical workers. J Occup Med 25:304–312

    Google Scholar 

  • Axelson O, Dahlgren E, Jansson C-D, Rehnlund SO (1978) Arsenic exposure and mortality: a case referent study from a Swedish copper smelter. Br J Ind Med 35:8–15

    Google Scholar 

  • Axelson O, Gustavson J (1978) Some hygienic and clinical observations on styrene exposure. Scand J Work Environ Health [Suppl 4] 2:215–219

    Google Scholar 

  • Baranowska B (1965) Einschätzung der Haut als Resorptionsweg für Schwefelkohlenstoff. Int Arch Gewerbehyg 22:363–368

    Google Scholar 

  • Baranowska-Dutkiewicz B (1981) Skin absorption of phenol from aqueous solutions in men. Int Arch Occup Environ Health 49:99–104

    Google Scholar 

  • Barnes JM, Magee PN (1954) Some toxic properties of dimethylnitrosamine. Br J Ind Med 11:167–174

    Google Scholar 

  • Beattie Ad, Mullin P, Baxter B, Moore MR (1977) Acute lead poisoning — an unusual cause of hepatitis. Gut 18:A968

    Google Scholar 

  • Beaumont JJ, Breslow NE (1981) Power considerations in epidemoogy studies of vinyl chloride workers. Am J Epidemiol 114:725–734

    Google Scholar 

  • Bernardt MW, Mumford J, Taylor C, Smith D, Murray RM (1982) Comparison of questionnaire and laboratory tests in the detection of excessive drinking and alcoholism. Lancet I:325–328

    Google Scholar 

  • Bianchi L, Ohnacker H, Beck K, Zimmerli-Ning M (1972) Liver damage in heartstroke and its regression. Hum Pathol 3:237–248

    Google Scholar 

  • Blair A, Decoufle P, Grauman D (1979) Causes of death among laundry and cleaning workers. Am J Publ Health 69:508–511

    Google Scholar 

  • Blendis LM, Smith PM, Lawrie BW, Stephens MR, Evans WD (1978) Portal hypertension in vinyl chloride nonomer workers. Gastroenterol 75:206–211

    Google Scholar 

  • Bond GG, Ott MG, Brenner FE, Cook RR (1983) Medical and morbidity surveillance findings among employees potentially exposed to TCDD. Br J Ind Med 40:318–324

    Google Scholar 

  • Burrows GE (1980) Health care of people at work. Screening of workers in research laboratories. J Soc Occup Med 30:164–168

    Google Scholar 

  • Byren D, Engholm G, Englund A, Westerholm P (1976) Mortality and cancer morbidity in a group of Swedish VCM and PCV production workers. Environ Health Perspect 17:167–170

    Google Scholar 

  • Byrne EB (1966) Viral hepatitis: an occupational hazard of medical personnel. JAMA 195:362–364

    Google Scholar 

  • Chesner C (1950) Chronic pulmonary granulomatosis in residents of a community near a beryllium plant: three autopsied cases. Ann Int Med 32:1020–1040

    Google Scholar 

  • Chiazze L, Ference LD, Wolf PH (1980) Mortality among automobile assembly workers. J Occup Med 22:520–526

    Google Scholar 

  • Cisno F, Azalini M, Camagna MT (1971) Considerazioni su 16 casi di silicosi del fegato e della milza. Med Lav 62:378–385

    Google Scholar 

  • Clark CS, Bjornson AB, Schiff GM, Phair JP, Van Meer GL, Gartside PS (1977) Sewage workers syndrome. Lancet I:1009

    Google Scholar 

  • Coghlan JD (1981) Leptospirosis in man, British Isles, 1979–80. Br Med J 282:2066

    Google Scholar 

  • Connell WJ, Flinn R (1946) Summary of twenty-two trinitrotoluene fatalities in world War II. J Ind Hyg Toxicol 28:76–86

    Google Scholar 

  • Curney R (1943) Tetrachloroethane intoxication: early recognition of liver damage and means of prevention. Gastroenterol 1:1112–1116

    Google Scholar 

  • Davidson CS, Leevy CM, Chamberlayne EC (1979) Guidelines for detection of hepatotoxicity due to drugs and chemicals. U.S. Department of Health, Education and Welfare, NIH Publication no. 79–313

  • Decoufle P (1978) Further analysis of cancer mortality pattern among workers exposed to cutting oil mists. J Natl Cancer Inst 61:1025–1030

    Google Scholar 

  • Decoufle P, Walrath J (1983) Proportionate mortality among US shoeworkers. Am J Ind Med 4:523–532

    Google Scholar 

  • Deinhardt F (1980) Predictive value of markers of hepatitis virus infection. J Infect Dis 141:299–305

    Google Scholar 

  • Delzell E, Monson RR (1982) Mortality among rubber workers V. Processing workers. J Occup Med 24:539–545

    Google Scholar 

  • Dienstag JL (1983) Non A, non B hepatitis I. Recognition, epidemiology and clinical features. Gastroenterol 85:439–462

    Google Scholar 

  • Dienstag JL, Ryan DM (1982) Occupational exposure to hepatitis B virus in hospital personnel: infection or immunization? Am J Epidemiol 115:26–39

    Google Scholar 

  • Dupont HL, Hornick RB, Levin HS, Rapoport MI, Woodward TE (1971) Q fever hepatitis. Ann Int Med 74:198–206

    Google Scholar 

  • Durham KF, Wolfe HR, Elliot JW (1972) Absorption and excretion of parathion by spraymen. Arch Environ Health 24:381–387

    Google Scholar 

  • Døssing M (1982) Changes in hepatic microsomal enzyme function in workers exposed to mixtures of chemical agent. Clin Pharmacol Ther 32:340–346

    Google Scholar 

  • Døssing M (1983) Antipyrene clearance during occupational exposure to styrene. Br J Ind Med 40:224–228

    Google Scholar 

  • Døssing M (1984) Non invasive assessment of microsomal enzyme activity in occupational medicine. Int Arch Occup Environ Health 53:205–218

    Google Scholar 

  • Døssing M, Weihe P (1982) Hepatic microsomal enzyme function in technicians and anesthesiologists exposed to halothane and nitrous oxide. Int Arch Occup Environ Health 51:91–98

    Google Scholar 

  • Døssing M, Ranek L (1984) Isolated liver damage in chemical workers. Br J Ind Med 41:142–144

    Google Scholar 

  • Døssing M, Arlien-Søborg P, Petersen LM, Ranek L (1983a) Liver damage associated with occupational exposure to organic solvents in house painters. Eur J Clin Invest 13:151–157

    Google Scholar 

  • Døssing M, Bælum J, Lundqvist GR (1983b) Antipyrine clearance during experimental and occupational exposure to toluene. Br J Ind Med 40:466–499

    Google Scholar 

  • Døssing M, Bælum J, Hansen SH, Lundgvist GR (1984) The effect of ethanol, cimetidine, and propranolol on toluene metabolism in man. Int J Occup Environ Health 54:309–315

    Google Scholar 

  • Elofsson S-A, Gamberale F, Hindmarch T, Iregren A, Isaksson A, Johansson I, Knave D, Lydahl E, Mindus P, Persson HE, Philipson B, Steby M, Struwe G, Søderman E, Wennberg A, Widen L (1980) Exposure to organic solvents. Scand J Work Environ Health 6:239–273

    Google Scholar 

  • Ensberg IFG, de Bruin A, Zielheuis RL (1974) Health of workers exposed to a cocktail of pesticides. Int Arch Arbeitsmed 32:191–201

    Google Scholar 

  • Favaro MS, Maynard JE, Leger RT, Graham DR, Dixon RE (1979) Guidelines for the care of patients hospitalized with viral hepatitis. Ann Int Med 91:872–876

    Google Scholar 

  • Fishbein A, Wolff MS, Lilis R, Thornton J, Selikoff IJ (1979) Clinical findings among PBCexposed capicitor manufacturing workers. Ann NY Acad Sci [USA] 320:703–715

    Google Scholar 

  • Folland DS, Schaffner W, Ginn HE, Crofford OB, McMurray DR (1976) Carbon tetrachlorides toxicity potentiated by isopropyl alcohol. J Am Med Ass 236:1853–1859

    Google Scholar 

  • Forycki Z (1979) State of health of shipyard painters as index of exposure to the action of organic solvents. Bull Inst Marit Toop Med Gdynia 30:259–268

    Google Scholar 

  • Fox AJ, Collier PF (1976) A survey of occupational cancer in the rubber and cablemaking industries: analysis of deaths occurring in 1972–74. Br J Ind Med 33:249–264

    Google Scholar 

  • Freund HA (1937) Clinical manifestations and studies in parenchymatous hepatitis. Ann Int Med 10:1144–1155

    Google Scholar 

  • Goldman PJ, Theiss M (1976) Berufsbedingte Viteligo durch paratertiar-Butylphenol, eine Trias von Viteligo, Hepatose und Struma. Hautarzt 27:155–159

    Google Scholar 

  • Goodman RA, Carder CC, Allen JR, Orenstein WA, Finton RJ (1982) Nosocomial hepatitis A transmission by an adult patient with diarrhoea. Am J Med 73:220–225

    Google Scholar 

  • Grandjean E, Munchinger R, Turrian V, Hass PA, Knoepfel H-K, Rosenmund H (1955) Investigation into the effect of exposure to trichloroethylene in mechanical engineering. Br J Ind Med 12:131–147

    Google Scholar 

  • Greech JL, Johnson MN (1974) Angiosarcoma of the liver in the manufacture of polyvinyl chloride. J Soc Occup Med 16:150–151

    Google Scholar 

  • Grist NR (1981) Hepatitis infection in clinical laboratory staff. Med Lab Sci 38:103–109

    Google Scholar 

  • Halevy J, Pitlik S, Rosenfeld J (1980) 1,1,1 Trichloroethane intoxication: a case report with transient liver and renal damage: review of the literature. Clin Toxicol 16:467–472

    Google Scholar 

  • Hamilton A (1931) Benzene poisoning. Arch Pathol 11:434–454

    Google Scholar 

  • Hane M, Axelson O, Blume J, Hogsted C, Sundell L, Yderborg B (1977) Psychological function changes among house painters. Scand J Work Environ Health 3:91–99

    Google Scholar 

  • Hardell L, Bengtsson NO, Jonsson U, Eriksson S, Larsson LG (1984) Aetiological aspects on primary liver cancer with special regard to alcohol, organic solvents and acute intermittent porphyria — an epidemiological investigation. Br J Cancer 50:389–397

    Google Scholar 

  • Harkonen H, Lehtniemi A, Aitio A (1984) Styrene exposure and the liver. Scand J Work Environ Health 10:59–61

    Google Scholar 

  • Hernberg S, Korkala M-L, Asikainen U, Riala R (1984) Primary liver cancer and exposure to solvents. Int Arch Occup Environ Health 54:147–153

    Google Scholar 

  • Ikeda M, Watanabe T, Hara I, Tabuchi T, Nakamura S-I, Kosaka H, Minami M, Sakurai Y (1977) A field survey on the health status of workers in dye-producing factories. Int Arch Occup Environ Health 39:219–235

    Google Scholar 

  • Ivanovich E, Kazakova B (1977) Enzymic and ultrastructural changes in rat liver due to whole body vibration. Int Arch Occup Environ Health 39:249–254

    Google Scholar 

  • Janzen J, Tripatzis I, Wagner U, Schlicter M, Muller-Dethard E, Wolters E (1978) Epidemiology of hepatitis B surface antigen (HBsAg) and antibody to HBsAg in hospital personnel. J Infect Dis 137:261–265

    Google Scholar 

  • Jhaveri SS (1959) A case of cirrhosis and primary carcinoma of the liver in chronic industrial arsenical intoxication. Br J Ind Med 16:248–250

    Google Scholar 

  • Kader A, Emara AM, Kamel G, Habib A, El-Samra GH, Abdel-Halim S (1971) Chemicopathological changes in the liver of industrial workers chronically exposed to cotton dust. J Egypt Med Ass 54:489–501

    Google Scholar 

  • Kew M, Bersohn I, Seftel H, Kent G (1970) Liver damage in heartstroke. Am J Med 49:192–202

    Google Scholar 

  • Klatskin G, Kimberg DV (1969) Recurrent hepatitis attributable to halothane sensitization in an anaesthetist. New Engl J Med 280:515–522

    Google Scholar 

  • Klemmer HW, Wong L, Sato MM, Reichert EL, Korsak RJ, Rashad MN (1980) Clinical findings in workers exposed to pentachlorophenol. Arch Environ Contam Toxicol 9:715–725

    Google Scholar 

  • Klingensmith JS, Mehendale HM (1982) Potentiation of CCl4 lethality by chlordecone. Toxicol Lett 11:149–154

    Google Scholar 

  • Kolmodin-Hedman B (1974) Exposure to lindane and DDT and its effect on drug metabolism and serum lipoproteins. Doctoral Thesis, University of Stockholm

  • Kramer CG, Ott MG, Fulkerson JE, Hicks N (1978) Health of workers exposed to 1,1,1-trichloroethane: a matched-pair study. Arch Environ Health 37:331–342

    Google Scholar 

  • Kurppa K, Husman K (1982) Car painters exposure to a mixture of organic solvents. Serum activities of liver enzymes. Scand J Work Environ Health 8:137–140

    Google Scholar 

  • Lauwerys RR, Kivits A, Lhoir M, Rigolet P, Houbeau D, Buchet JP, Roels HA (1980) Biological surveillance of workers exposed to dimethylformamide and the influence of skin protection on its percutaneous absorption. Int Arch Occup Environ Health 45:109–203

    Google Scholar 

  • Lee FI, Harry DS, Adams GF, Litchfield M (1977) Screening for liver disease in vinyl chloride workers. Br J Ind Med 34:142–147

    Google Scholar 

  • Levin DM, Baker AL, Riddell RH, Rochman H, Boyer JL (1979) Nonalcoholic liver disease. Am J Med 66:429–234

    Google Scholar 

  • Lewin K, Millis RR, Calif S (1973) Human radiation hepatitis. Arch Pathol 96:22–26

    Google Scholar 

  • Lilis R, Anderson H, Nicholson WJ, Daum S, Fischbein AS, Selikoff IJ (1975) Prevalence of disease among vinyl chloride and polyvinyl chloride workers. Ann NY Acad Sci 246:22–41

    Google Scholar 

  • Little RE, Schultz FA, Mandell W (1977) Describing alcohol consumption. J Stud Alc 38:554–562

    Google Scholar 

  • Livingstone-Learmonth A (1916) The effects of trinitro-toluene on women workers. Lancet II:261–269

    Google Scholar 

  • Lloyd JW, Decoufle P, Salvin LG (1977) Unusual mortality experience of printing pressmen. J Occup Med 19:543–550

    Google Scholar 

  • Lorimer WV, Lilis R, Fischbein A, Daum S, Anderson H, Wolff MS, Selikoff IJ (1978) Health status of styrene — polystyrene polymerisation workers. Scand J Work Environ Health [Suppl 4] 2:220–226

    Google Scholar 

  • Lüchtrath H (1972) Cirrhosis of the liver in chronic arsenical poisoning of vintners. Germ Med 2:127–128

    Google Scholar 

  • Lyle WH, Spence TWM, McKinneley WM, Duchers K (1979) Dimethylformamide and alcohol intolerance. Br J Ind Med 36:63–66

    Google Scholar 

  • Maddrey WC, Boitnott JK (1977) Drug-induced chronic liver disease. Gastroenterol 72:1348–1353

    Google Scholar 

  • Maroni M, Colombi A, Cantoni S, Ferioli E, Foa V (1981) Occupational exposure to polychlorinated biphenyls in electrical workers. I. Environmental and blood polychlorinated biphenyls concentrations. Br J Ind Med 38:49–54

    Google Scholar 

  • Marsch GM (1983) Mortality among workers from a plastic producing plant. A matched casecontrol study nested in a retrospective cohort study. J Occup Med 25:219–230

    Google Scholar 

  • Maynard JE (1978) Viral hepatitis as an occupational hazard in the health care profession. In: Vyas GN, Cohen SN, Schmid R (eds) Viral hepatitis. Franklin Institute Press, Philadelphia, pp 321–331

    Google Scholar 

  • McGill DB, Motto JD (1974) An industrial outbreak of toxic hepatitis due to methylenedianiline. New Engl J Med 291:278–282

    Google Scholar 

  • Meigs JW, Sciarini LJ, Van Sandt WA (1954) Skin penetration by diamines of the benzidine group. Arch Ind Hyp Occup Med 9:122–132

    Google Scholar 

  • Menzer RE (1970) Effect of chlorinated hydrocarbons in the diet on the toxicity of several organophosphorus insecticides. Toxical Appl Pharmacol 16:446–452

    Google Scholar 

  • Morgan RW, Kaplan SD, Gaffey WR (1981) A general mortality study of production workers in the paint and coatings manufacturing industry. J Occup Med 23:13–21

    Google Scholar 

  • Morinaga K, Oshima A, Hara I (1982) Multiple primary cancers following exposure to benzidine and beta-naphthylamine. Am J Ind Med 3:243–246

    Google Scholar 

  • Morley R, Eccleston DW, Douglas CP, Greville WEJ, Scott DJ, Anderson J (1970) Xylene poisoning: a report on one fatal case and two cases of recovery after prolonged unconsciousness. Br Med J II:422–443

    Google Scholar 

  • Morris JS, Schmid M, Newman S, Scheuer PJ, Path MRC, Sherlock S (1974) Arsenic and noncirrhotic portal hypertension. Gastroenterol 66:86–94

    Google Scholar 

  • Morrison AS, Jick DW, Ory HW (1977) Oral contraceptives and hepatitis. Lancet I:1142–1143

    Google Scholar 

  • Mosley JW, Edwards VM, Casey G, Redeker AG, White E (1975) Hepatitis B virus infection in dentists. New Engl J Med 293:729–734

    Google Scholar 

  • Müller G, Spassowski M, Henchler D (1975) Metabolism of trichloroethylene in man. III. Interaction of trichloroethylene and ethanol. Arch Toxicol 33:173–189

    Google Scholar 

  • Mulley AG, Silverstein MD, Dienstag JL (1982) Indication for use of hepatitis B vaccine, based on cost effectiveness analysis. New Engl J Med 307:644–652

    Google Scholar 

  • Mullick FG, Ishak KG, Mahabir R, Stromeyer FW (1981) Hepatic injury associated with paraquat toxicity in humans. Liver 1:209–221

    Google Scholar 

  • O'Brian ET, Yeoman WB, Hobby JAE (1971) Hepatorenal damage from toluene in a “glue sniffer”. Br Med J II:29–30

    Google Scholar 

  • Ott MG, Langner RR, Holder BB (1975) Vinyl chloride exposure in a controlled industrial environment. Arch Environ Health 30:333–339

    Google Scholar 

  • Ott MG, Skory LK, Holder BB, Bronson JM, Williams PR (1983) Health evaluation of employees occupationally exposed to methylene chloride. Scand J Work Environ Health [Suppl 9] 1:17–25

    Google Scholar 

  • Paganini-Hill A, Glazer E, Henderson BE, Ross RK (1980) Cause-specific mortality among newspaper web pressmen. J Occup Med 22:542–544

    Google Scholar 

  • Pascale LR, Waldstein SS, Engbring G, Dubin A, Szanto PB (1952) Chromium intoxication with special reference to hepatic injury. J Am Med Ass 149:1385–1389

    Google Scholar 

  • Pass RF, August AM, Dworsky M, Reynolds DW (1982) Cytomegalovisus infection in a daycare center. New Engl J Med 307:427–429

    Google Scholar 

  • Peers FG, Gilman GA, Linsell CA (1976) Dietary aflatoxins and liver cancer. Br J Cancer 27:473–481

    Google Scholar 

  • Peters M (1978) The kepone episode: another warning. New Engl J Med 298:277–278

    Google Scholar 

  • Petersen P, Bredahl E, Lauritsen O, Laursen T (1970) Examination of the liver in personnel working with liquid rocket propellant. Br J Ind Med 27:141–146

    Google Scholar 

  • Pimentel JC, Menezes P (1977) Liver disease in vineyard sprayers. Gastroenterol 72:275–283

    Google Scholar 

  • Pimentel JC, Menezes AP (1978) Pulmonary and hepatic granulomatous disorders due to inhalation of cement and mica dusts. Thorax 33:219–227

    Google Scholar 

  • Pointdexter CA, Greene CH (1934) Toxic cirrhosis of the liver. JAMA 102:2015–2017

    Google Scholar 

  • Plaa GL, Hewitt WR (1982) Quantitative evaluation of indices of hepatotoxicity. In: Plaa GL, Hewitt WR (eds) Toxicology of the liver. Raven Press, New York, pp 103–120

    Google Scholar 

  • Polednak (1979) Long-term effects of radium exposure in female dial workers: liver function and liver disease. Environ Res 18:454–465

    Google Scholar 

  • Popper H, Gerber MA, Schaffner F, Selikoff IJ (1979) Environmental hepatic injury in man. In: Popper H, Schaffner F (eds) Progress in liver disease. Grune & Stratton, New York San Francisco London, pp 605–638

    Google Scholar 

  • Regelson W, Kim U, Ospina J, Holland JF (1968) Hemangioepithelial sarcoma of the liver from chronic arsenic intoxication by fowlers solution. Cancer 21:514–522

    Google Scholar 

  • Report of a WHO Expert Committee (1981) Health effects of combined exposures in the work environment. ISBN 924120662. 4. World Health Organization, Schuler SA, Geneva

  • Riihimaki V, Savolainen SM, Pfäffli, Pekari K, Sippel HW, Laine A (1982) Metabolic interaction between m-xylene and ethanol. Arch Toxicol 49:253–263

    Google Scholar 

  • Roberts RJ, Plaa GL (1965) Potentiation and inhibition of alpha-naphthylisothiocyanateinduced hyperbilirubinemia and cholestasis. J Pharmacol Exp Ther 150:499–506

    Google Scholar 

  • Rushton L, Alderson MR (1981) An epidemiological survey of eight oil refineries in Britain. Br J Ind Med 38:225–234

    Google Scholar 

  • Rushton L, Alderson MR (1983) Epidemiological survey of oil distribution centers in Britain. Br J Ind Med 40:330–339

    Google Scholar 

  • Rushton L, Alderson MR, Nagarajah CR (1983) Epidemiological survey of maintenance workers in London transport executive bus garages and Chiswick works. Br J Ind Med 40:340–345

    Google Scholar 

  • Sato A, Nakajima T, Koyama Y (1980) Effects of chronic ethanol consumption on hepatic metabolism of aromatic and chlorinated hydrocarbons in rats. Br J Ind Med 37:282–286

    Google Scholar 

  • Saunders JB, Walters JRF, Davies D, Paton A (1981) A 20-year prospective study of cirrhosis. Br Med J 1:263–266

    Google Scholar 

  • Scarisbrick DA, Martin JC (1981) Biochemical changes associated with chloracne in workers exposed to tetrachlorazobenzene and tetrachlorazoxybenzene. J Soc Occup Med 31:158–163

    Google Scholar 

  • Scheuplein RJ (1977) Permeability of the skin. In: Lee DHK, Falk HL, Murphy SD, Geiger SR (eds) Handbook of physiology. Section 9. Reactions to environmental agents. Williams & Wilkins, Bethesda, Maryland, pp 299–322

    Google Scholar 

  • Schuttmann W (1968) Chronische Lebererkrankungen nach beruflicher Einwirkung von Dichlordiphenyltrichlorathan (DDT) und Hexachlorcyclohexan (HCH). Int Arch Gewerbepathol Gewerbehyg 24:193–210

    Google Scholar 

  • Sharonova ZV, Kryzhanovskaya (1976) On occupational pathology of the liver provoked by toluene diisocyanate. Gig Sanit 5:27–31

    Google Scholar 

  • Skinbøj P, Hollinger FB, Hovind-Hougen K, Lous P (1981) Infectious liver diseases in three groups of Copenhagen workers: correlation of hepatitis A infection to sewage exposure. Arch Environ Health 36:139–143

    Google Scholar 

  • Skinhøj P, Søeby M (1981) Viral hepatitis in Danish health care personnel 1974–78. J Clin Pathol 34:408–411

    Google Scholar 

  • Smith AB, Schloemer J, Lowery LK, Smallwood AW, Ligo RN, Tanaka S, Stringer W, Jones M, Hervin R, Geneck CJ (1982) Metabolic and health consequences of occupational exposure to polychlorinated biphenyls. Br J Ind Med 39:361–369

    Google Scholar 

  • Sotaniemi EA, Sutinen S, Sutinen S, Arranto AJ, Pelkonen RO (1982) Liver injury in subjects occupationally exposed to chemicals in low doses. Acta Med Scand 212:2007–2215

    Google Scholar 

  • Stemhagen A, Slade J, Altman R, Bill J (1983) Occupational risk factors and liver cancer. Am J Epidemiol 117:443–454

    Google Scholar 

  • Sterling TD (1978) Does smoking kill workers or working kill smokers? or the mutual relationship between smoking, occupation, and respiratory disease. Int J Health Ser 8:437–452

    Google Scholar 

  • Stewart MJ (1917) Toxic jaundice in munition workers and troops. Br Med J 1:155–158

    Google Scholar 

  • Stewart RD, Dodd HC (1964) Absorption of carbon tetrachloroethylene, methylchloride and 1,1,1, trichloroethane through human skin. Am Ind Hyg Ass J 25:439–446

    Google Scholar 

  • Stewart JS, Farrow LJ, Clifford RE (1978) A three-year survey of viral hepatitis in West London. Q J Med 187:365–384

    Google Scholar 

  • Stille WT, Tabershaw IR (1982) The mortality experience of upstate New York talc workers. J Occup Med 14:480–484

    Google Scholar 

  • Strauss N (1944) Hepato-toxic effects following occupational exposure to halowax (clorinated hydrocarbons). Rev Gastroenterol 11:381–395

    Google Scholar 

  • Szadkowski D, Peiffer D, Angerer J (1976) Beurteilung einer beruflichen Toluolexposition hinsichtlich ihrer hepatotoxischen Relevanz. Med Wochenschr 30:25–28

    Google Scholar 

  • Szmuness W (1978) Hepatocellular carcinoma and hepatitis B virus: evidence for a causal association. Prog Med Virol 24:40–69

    Google Scholar 

  • Tahti H, Karkkainen S, Pyykko K, Rintala E, Kataja M, Vapaatalo H (1981) Chronic exposure to toluene. Int Arch Occup Environ Health 48:61–69

    Google Scholar 

  • Tamburro CH (1979) Chemical hepatitis, pathogenesis, detection and management. Med Clin N Am 63:545–566

    Google Scholar 

  • Tamburro CH, Greenberg R (1981) Effectiveness of federally required medical laboratory screening in the detection of chemical liver injury. Environ Health Perspect 41:117–122

    Google Scholar 

  • Thiele DL, Eigenbrodt EH, Ware AJ (1982) Cirrhosis after repeated trichloroethylene and 1,1,1-trichloroethane exposure. Gastroenterol 83:926–929

    Google Scholar 

  • Tiku ML, Beutner KR, Carmody P, Sultz HA, Kaul BL, Ogra PL (1976) Hepatitis B infection in health care personnel of an institution for mentally handicapped children and adults. J Clin Microbiol 3:469–473

    Google Scholar 

  • Tola S, Nordman C-H (1977) Serum creatinine concentration, S-GOT and S-GPT activities and lead exposure. Int Arch Occup Environ Health 39:37–44

    Google Scholar 

  • Trepo CG, Zuckerman AJ, Bird RC, Prince AM (1974) The role of circulating hepatitis B antigen/antibody immune complexes in the pathogenesis of vascular and hepatic manifestations in polyarteritis nodosa. J Clin Pathol 27:863–868

    Google Scholar 

  • Tsuzuki M (1955) Erfahrungen über radioaktive Schädigung der japanischen Fischer durch Bikini-Asche. Münch Med Wochenschr 97:988–994

    Google Scholar 

  • Upton AC (1973) Etiology of cancer: radiation. In: Holland JF, Frei E (eds) Cancer medicine. Lea and Febiger, Philadelphia, pp 90–99

    Google Scholar 

  • Villa E, Rubbiani L, Barchi T, Feretti I, Grisend A, DePalma M, Bellentani S, Manenti F (1982) Susceptibility of chronic symptomless HBsAg carriers to ethanol-induced hepatic damage. Lancet II:1243–1244

    Google Scholar 

  • Waldron HA, Cherry N, Venables H (1982) Solvent exposure and liver function. Lancet II:1276

    Google Scholar 

  • Waxweiler RJ (1981) Epidemologic problems associated with exposure to several agents. Environ Health Perspect 42:51–56

    Google Scholar 

  • Waxweiler RJ, Stringer W, Wagner JK, Jones J (1976) Neoplastic risk among workers exposed to vinyl chloride. Ann NY Acad Sci [USA] 271:40–46

    Google Scholar 

  • Weisburger EK (1980) Metabolism and activation of chemical carcinogens. Mol Cell Biochem 32:95–114

    Google Scholar 

  • Wen CP, Tsai SP, McClellan WA, Gibson RL (1983) Long term study of oil refinery workers. Am J Epidemiol 118:526–542

    Google Scholar 

  • Willcox WH (1915) An outbreak of toxic jaundice of a new type amongst aeroplane workers. Trans Med Soc [Lond] 38:129–156

    Google Scholar 

  • Williams DMJ, Smith PM, Taylor KJW, Crossley IR, Duck BW (1976) Monitoring liver disorders in vinyl chloride monomer workers using greyscale ultrasonography. Br J Ind Med 33:152–157

    Google Scholar 

  • Wilson HK, Robertson SM, Waldron HA, Gomperetz D (1983) Effect of alcohol on the kinetics of mandelic acid excretion in volunteers exposed to styrene vapour. Br J Ind Med 40:75–80

    Google Scholar 

  • Witzleben CL, Pitlick P, Bergmeyer J, Benoit R (1968) Acute magnanese overload: a new experimental model of intrahepatic cholestase. Am J Pathol 53:409–422

    Google Scholar 

  • Yamamura Y (1969) N-Hexane polyneuropathy. Folia Psychiath Neurol Jpn 23:45–47

    Google Scholar 

  • Zimmerman HJ (1978) Occupational toxicity. In: Zimmerman HJ (ed) Hepatotoxicity: the adverse effect of drugs and other chemicals on the liver. Appleton-Century-Croft, New York, pp 303–318

    Google Scholar 

  • Zober A, Schaller KH, Grosler K, Krekeler HJ (1981) Pentachlorphenol und Leberfunktion: Eine Untersuchung an beruflich belasteten Kollektiven. Int Arch Occup Environ Health 48:347–356

    Google Scholar 

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Authors and Affiliations

  1. Medical Department F, Gentofte University Hospital, University of Copenhagen, 65 Niels Andersens Vej, DK-2900, Hellerup, Denmark

    Martin Døssing

  2. Medical Department A, Division of Hepatology, Rigshospitalet, University of Copenhagen, 9 Blegdamsvej, DK-2100, Copenhagen, Denmark

    Peter Skinhøj

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  1. Martin Døssing
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Døssing, M., Skinhøj, P. Occupational liver injury. Int Arch Occup Environ Health 56, 1–21 (1985). https://doi.org/10.1007/BF00380696

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  • DOI: https://doi.org/10.1007/BF00380696

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