Le epatopatie professionali non infettive: una tematica vasta ed attuale per il medico competente

Liver diseases have a multifactorial aetiology, where occupational exposure plays a role in a causal complex. Interest in liver diseases is significantly increased during the second half of the last century. This has resulted, since the 1970s, in a large production of works about occupational infectious liver diseases and about specific toxigenic or neoplastic agents. Therefore, there is a limited number of studies about the occupational liver diseases as a whole. A clinical and diagnostic background of liver diseases is made difficult by the simultaneous presence of confounding factors (alcohol, diet, drugs, current or past liver disease, metabolic diseases, BMI, etc.), exposure to multiple hepatotoxins, synergy between different noxae and non-specific anatomic and clinical characteristics. In a such context, according to the Italian Legislative Decree 81/2008, we suggest to implement an integrated multidisciplinary management, with particular attention during preventive stages. A constant synergy between occupational medicine, epidemiology and industrial toxicology is, in this context, of utmost importance. We also recommend to the occupational physician to work out programs for health promotion both to prevent and to deter alcohol and drugs abuse, and make aware workers with the principles for a healthy lifestyle.