30 Apr Over 80% of World Trade First Responders Have Fatty Liver Disease
MedicalResearch.com Interview with:
D. Debashis Reja
Mishal Reja, MD, MD
Resident in Internal Medicine
Robert Wood Johnson University Hospital
MedicalResearch.com: What is the background for this study?
Response: World Trade Center first responders were exposed to environmental toxicants that have resulted in negative health consequences.
Gastrointestinal aerodigestive disorders such as GERD and Barrett’s esophagus have been frequently reported in this population. Additionally, an increasing body of literature has shown that fatty liver disease is not only secondary to metabolic syndrome, diabetes, and obesity, as previously thought, but can also result from environmental and industrial toxicants. Chemicals such as Vinyl Chloride, Tetrachloroethylene, Perchloroethylene, and many others are frequently found in industrial occupations and have resulted in fatty liver disease, steatohepatitis, cirrhosis, and hepatocellular carcinoma. Many of these chemicals were also present at ground zero, thus exposing many of first responders to the hepatotoxic effects of these chemicals. To date this is the first study to look at liver disease in World Trade Center first responders.
MedicalResearch.com: What are the main findings?
Response: We found that 82.6% of first responders had fatty liver disease, compared to 24%-45% in the general United States population. This extremely high prevalence is concerning for an increased risk of liver disease in population.
MedicalResearch.com: What should readers take away from your report?
Response: Readers should take away that World Trade Center first responders should also be evaluated for liver disease. Unfortunately, fatty liver is not listed among the covered conditions for this population. Gastroenterologists and primary care physicians should also be aware of the increased prevalence in this population and routinely perform liver function laboratory tests as well as hepatic ultrasounds. Additionally, first responders should be cognizant that risk factors such as obesity and metabolic syndrome will compound their risk of fatty liver, and the patients should be hypervigilant in maintaining an active and healthy lifestyle.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Biopsy remains the gold standard for diagnosis of fatty liver disease. In the future, a prospective study should be done with pathologists to look at liver biopsies in first responders and a matched general population and compare prevalence as well as independent risk factors.
MedicalResearch.com: Is there anything else you would like to add?
Response: We did not receive any funding. I would like to thank the World Trade Center Health Program, Dr. Vinod Rustgi, MD MBA of the Department of Gastroenterology for his mentorship , the residents of the Internal Medicine Program at Robert Wood Johnson, as well as Rutgers University Biostatistics and Epidemiology Services for their efforts.
Citation:
DDW 2020 presentation and abstract:
Prevalence of suspected toxic alcohol fatty liver disease (TAFLD) in World Trade Center first responders: Findings from the World Trade Center health program
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Last Updated on April 30, 2020 by Marie Benz MD FAAD