Occupational Hepatocellular carcinoma : A review

Abstract

Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related deaths. The relationship between occupation and liver cancer has not been extensively studied however. Approximately 80% of HCC patients have had an established history of chronic liver disease and infection with hepatitis B virus (HBV) and hepatitis C virus (HCV). Nonalcoholic steatohepatitis (NASH), obesity, diabetes and smoking also increase the risk of HCC development significantly. Currently, only vinyl chloride monomer (VCM) and trichloroethylene (TCE) have been documented with carcinogenic effect on human liver. Very limited evidences on HCC risk factors such as pesticides, polychlorinated biphenyls, asbestos and arsenic. More detailed investigations in this regard are required for assessing the actual risk of accidental/occupational carcinogen exposures. Proper health surveillances should be at place, for target workers in a particular setup, focusing on detection of any changes in key enzymes like alkaline phosphatase, gamma-glutamyl transferase and transaminase, and bilirubin levels. In the event of considerable alterations in these, hepatic ultrasound examination and alpha-fetoprotein level measurements should be implemented to facilitate the early detection of toxic liver diseases such as HCC in workers. This article provides a brief review of current knowledge about potential carcinogens and the risks associated with each, as regards to occupational HCC in particular.