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№4' 2015

OCCUPATIONAL DISEASES

International Medical Journal, Vol. 21., Iss. 4, 2015, P. 92−96.

LABORATORY DIAGNOSIS OF LIVER DISEASE IN PERSONS WORKING AT EXPOSURE TO CHEMICAL SUBSTANCES

Federal Research Center of Medical Preventive Technologies of Population Health Risk Management, Perm, Russian Federation
Acad. E. A. Wagner Perm State Medical University. Ministry of Health of Russian Federation, Perm, Russian Federation

The persons working in contact with chemicals may develop pathological process in the liver, irrespective of the nature of the substance and pathways in the body. The aim of this work was to evaluate the functional state of the liver as the main target organ exposed to industrial chemicals using laboratory parameters. Employees of oil and metallurgical industry, working in conditions of exposure to chemical factors, were investigated. Working conditions and occupational exposure were evaluated; chemical−toxicological diagnosis was made, specific markers of toxicant load were determined; epidemiological analysis was performed. The likelihood of early response of the liver to chemical exposure was assessed by disorders of polymorphism of genes responsible for detoxification of CPOX and enzymes CYP−450. The causal relationship between the adverse factors in the production process and the frequency of certain types of responses were investigated. The basic laboratory syndromes, reflecting the reaction of the liver in response to exposure to any chemical substance in the organism of the employee while in the working area even below the maximum allowable concentration were investigated: increased activity of oxidative processes; depletion of the functional status of the antioxidant protection system; imbalance of protein spectrum of blood serum with hypoalbuminemia; disturbance of lipid (hypercholesterolemia in combination with hypertriglyceridemia) and disorders of carbohydrate metabolism. Metabolic disorders of those working in conditions of exposure to chemical substances are formed on the genetic basis of disturbed polymorphism of genes responsible for detoxification (CPOX and CYP−450), which should be considered at formation of risk groups. The use of complex analysis of gene polymorphisms in the survey of workers exposed to chemicals can prevent the risk of developing pathology in workers most sensitive to the action of xenobiotics.

Key words: laboratory syndromes, xenobiotics, occupational hepatotoxins, individual sensitivity.