Exposure to Chemical Substances as an Independent Cause of Nonalcoholic Fatty Liver Disease in Workers who are in Direct Contact with the Coke Production Process and the Purification of Raw Coke Gas

Background: A doubt that occupational medicine specialists face is whether exposure to solvents is an independent risk factor for non-alcoholic fatty liver disease. Aim: The present study investigates the connection between the length of work experience (exposure) at workplaces that are exposed to organic volatile substances with eventual changes in the morphological structure of the liver parenchyma or laboratory parameters of liver function, and to investigate whether organic volatile substances, as an independent factor can lead to liver steatosis or changes in laboratory parameters of liver function.  Methods: A prospective study was conducted from January to April 2023. and included 62 coke industry workers who were divided into two groups of 31 workers each (experimental with workers exposed to organic volatile substances at the workplace and control with workers who were not exposed). Laboratory parameters of liver function were monitored, as well as ultrasound findings of liver parenchyma in coke industry workers undergoing examination. Exclusion criteria were known history of liver disease, blood transfusion, alcohol consumption and diabetes mellitus. Results: Changes in laboratory parameters of liver function and ultrasound findings of liver steatosis were found with high statistical significance in the workers of the experimental group, for which no statistically significant association with elevated values of lipid status was found. With diabetes as an exclusion factor and the insignificant prevalence of hypertension in the examined workers, it can be concluded that metabolic syndrome is not related to our results. During the correlation analysis, it can be concluded that organic volatile substances are an independent cause and trigger for fatty infiltration of the liver parenchyma and changes in the laboratory findings of liver function parameters. Conclusions: Exposure to organic volatile substances at the workplace as an independent factor causes liver steatosis with elevated values of laboratory parameters of liver function and it can be said that it is an independent cause of non-alcoholic fatty liver disease.