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Elevated serum liver enzymes and fatty liver changes associated with long driving among taxi drivers.

Lippmann SJ; Richardson DB; Chen-J-C

Am J Ind Med 2011 Aug; 54(8):618-627

https://doi.org/10.1002/ajim.20969

20039428

Background: Previous studies suggested increased morbidities and mortalities of liver diseases in drivers. Methods:To examine whether driving (monthly driving distance; tenure) is associated with elevated alanine aminotransferase (ALT), aspartate aminotransferase (AST), or chronic fatty liver (FL) changes, we performed a cross-sectional, secondary analysis of the Taxi Drivers' Health Study (n equals 1,355), adjusting for clinical, demographic, and lifestyle factors. Results: Prevalence of elevated ALT, elevated AST, and fatty liver changes were 22.0 percent, 5.1 percent, and 9.3 percent, respectively. Driving distance had a positive association with elevated ALT with a prevalence ratio of 1.35 (95 percent CI: 0.98, 1.89) comparing the highest versus lowest driving quartile. This association differed by alcohol use, with a corresponding prevalence ratio of 2.08 (95 percent CI: 1.30, 3.33) among ''past/current'' drinkers but no association among ''never'' drinkers. Similar patterns were found for AST, but estimates were less stable. We found a curvilinear response pattern for fatty liver changes; prevalence first increased with years as a taxi driver and then receded in the highest ranges of driving tenure, regardless of the alcohol history. Conclusions: Our results provide evidence that long driving is associated with both short-term and chronic liver insults, although alcohol use appears to modify this putative effect.

Service-industries; Drivers; Transportation; Transportation-industry; Transportation-workers; Liver-disorders; Enzyme-activity; Enzymes; Liver-enzymes; Fatty-acids; Amino-acids; Demographic-characteristics; Alcoholic-beverages; Work-intervals; Liver-damage; Author Keywords: fatty liver disease; professional driving; occupational epidemiology; taxi drivers; alanine aminotransferase

Steven J. Lippmann, MSPH, Department of Epidemiology, CB#7435, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599

AJIMD8

20110801

Journal Article

slippmann@unc.edu

Grant

2011

Grant-Number-T42-OH-008673

8

0271-3586

American Journal of Industrial Medicine

NC; CA

University of North Carolina, Chapel Hill