{"title":"Occupational exposure and risk of complications in MASLD patients:updates from a case:control study","authors":"","doi":"10.1016/j.dld.2024.08.014","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>Pollutants are increasingly being evaluated as possible contributors to the progression of liver damage in metabolic dysfunction-associated steatotic liver disease (MASLD). Recently, we published a case-control study showing that patients with MASLD-related advanced chronic liver disease (ACLD) and/or hepatocellular carcinoma (HCC) were more likely to report workplace toxicant exposure compared to those with uncomplicated MASLD. Consequently, an extension of the accrual and a transition to a multicenter study were decided.</p></div><div><h3>Aim</h3><p>To provide updated evidence following the first extension of the cohort from our original study, which aimed to assess the prevalence of self-reported occupational exposure to toxicants in patients with MASLD.</p></div><div><h3>Methods</h3><p>After the extension, this hospital-based prospective pilot study include 224 patients with MASLD. Data on workplace toxicant exposure were collected systematically using a structured questionnaire. Subsequently, patients with ACLD and/or HCC (n = 65) were compared to controls (n = 159). Logistic regression analysis and propensity score models were used to investigate the associations between self-reported occupational exposure and ACLD and/or HCC.</p></div><div><h3>Results</h3><p>The updated data confirmed that patients with ACLD/HCC are more likely to report exposure to metals, halogenated refrigerants, paint/resins, and fuel emissions than the controls. Durations of 21-30 years and >30 years of occupational exposure to toxicants were also more frequently associated with ACLD/HCC, with odds ratios (ORs) of 2.42 (95% confidence interval [CI]: 1.11-4.94, p = 0.020) and 4.21 (95% CI: 2.36-7.53, p < 0.001), respectively. These associations were confirmed after corrections for demographics and other confounders.</p></div><div><h3>Conclusions</h3><p>The extension of our cohort confirms that patients with MASLD complications are more likely to report workplace toxicant exposure than controls. A transition to a multicenter effort is underway. If confirmed, our results may help in developing prevention policies to reduce the risk of life-threatening diseases among exposed populations.</p></div>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":null,"pages":null},"PeriodicalIF":4.0000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Digestive and Liver Disease","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1590865824009332","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction
Pollutants are increasingly being evaluated as possible contributors to the progression of liver damage in metabolic dysfunction-associated steatotic liver disease (MASLD). Recently, we published a case-control study showing that patients with MASLD-related advanced chronic liver disease (ACLD) and/or hepatocellular carcinoma (HCC) were more likely to report workplace toxicant exposure compared to those with uncomplicated MASLD. Consequently, an extension of the accrual and a transition to a multicenter study were decided.
Aim
To provide updated evidence following the first extension of the cohort from our original study, which aimed to assess the prevalence of self-reported occupational exposure to toxicants in patients with MASLD.
Methods
After the extension, this hospital-based prospective pilot study include 224 patients with MASLD. Data on workplace toxicant exposure were collected systematically using a structured questionnaire. Subsequently, patients with ACLD and/or HCC (n = 65) were compared to controls (n = 159). Logistic regression analysis and propensity score models were used to investigate the associations between self-reported occupational exposure and ACLD and/or HCC.
Results
The updated data confirmed that patients with ACLD/HCC are more likely to report exposure to metals, halogenated refrigerants, paint/resins, and fuel emissions than the controls. Durations of 21-30 years and >30 years of occupational exposure to toxicants were also more frequently associated with ACLD/HCC, with odds ratios (ORs) of 2.42 (95% confidence interval [CI]: 1.11-4.94, p = 0.020) and 4.21 (95% CI: 2.36-7.53, p < 0.001), respectively. These associations were confirmed after corrections for demographics and other confounders.
Conclusions
The extension of our cohort confirms that patients with MASLD complications are more likely to report workplace toxicant exposure than controls. A transition to a multicenter effort is underway. If confirmed, our results may help in developing prevention policies to reduce the risk of life-threatening diseases among exposed populations.
期刊介绍:
Digestive and Liver Disease is an international journal of Gastroenterology and Hepatology. It is the official journal of Italian Association for the Study of the Liver (AISF); Italian Association for the Study of the Pancreas (AISP); Italian Association for Digestive Endoscopy (SIED); Italian Association for Hospital Gastroenterologists and Digestive Endoscopists (AIGO); Italian Society of Gastroenterology (SIGE); Italian Society of Pediatric Gastroenterology and Hepatology (SIGENP) and Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD).
Digestive and Liver Disease publishes papers on basic and clinical research in the field of gastroenterology and hepatology.
Contributions consist of:
Original Papers
Correspondence to the Editor
Editorials, Reviews and Special Articles
Progress Reports
Image of the Month
Congress Proceedings
Symposia and Mini-symposia.