Occupational and Environmental Hepatotoxicity

Occupational and environmental hepatotoxicity is an expanding problem not only in the United States but also worldwide. While some lessons have been learned from vinyl chloride contamination resulting in angiosarcoma in workers in rubber plants and from hydrocarbon contamination resulting in fatty liver disease in residents near a petroleum plant in Brazil, there is increasing concern about arsenic contamination of water sources in many countries, including the United States. The introduction of hydraulic fracturing in order to recover natural gas and oil from rock and shale formations has resulted in air and ground contamination with known hepatotoxins and carcinogens, which raises new concerns because of the lack of regulation of this industry. While the science of predicting acute hepatotoxicity has advanced greatly in terms of pathophysiologic mechanisms, testing models, and genetic susceptibility, little research has been done regarding low-dose chronic exposure to potential toxins. The politicizing of economic concerns versus health concerns has resulted in the financial undermining of the Environmental Protection Agency and Occupational Safety and Health Administration. For the near future, at least, public policy is being based on political ideology rather than science. While the long-term consequences have yet to be determined, it is hard to imagine that they will be of benefit to society.