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Semin Liver Dis 2025; 45(02): 148-166
DOI: 10.1055/a-2540-2861
Review Article

Environmental Pollutants, Occupational Exposures, and Liver Disease

Juliane I. Beier
1   Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
2   Pittsburgh Liver Research Center, University of Pittsburgh, Pittsburgh, Pennsylvania
,
Jianzhu Luo
3   Department of Medicine, University of Louisville School of Medicine, Louisville, Kentucky
,
Charis-Marie Vanderpuye
1   Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
,
Paxton Brizendine
4   Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, Kentucky
,
Pooja Muddasani
1   Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
,
Oluwanifemiesther Bolatimi
4   Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, Kentucky
,
Shannon A. Heinig
1   Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
,
Frederick A. Ekuban
3   Department of Medicine, University of Louisville School of Medicine, Louisville, Kentucky
,
Hamda Siddiqui
1   Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
,
Abigail Ekuban
3   Department of Medicine, University of Louisville School of Medicine, Louisville, Kentucky
,
Tyler C. Gripshover
3   Department of Medicine, University of Louisville School of Medicine, Louisville, Kentucky
,
Banrida Wahlang
3   Department of Medicine, University of Louisville School of Medicine, Louisville, Kentucky
4   Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, Kentucky
,
Walter H. Watson
3   Department of Medicine, University of Louisville School of Medicine, Louisville, Kentucky
4   Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, Kentucky
,
Matthew C. Cave
3   Department of Medicine, University of Louisville School of Medicine, Louisville, Kentucky
4   Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, Kentucky
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Abstract

Environmental pollutants significantly impact liver disease development, progression, and outcomes. This review examines the complex relationship between environmental exposures and liver pathology, from malignant conditions like hepatocellular carcinoma to steatotic and cholestatic liver diseases. Key environmental factors include air pollutants, volatile organic compounds, persistent organic pollutants, heavy metals, and per- and polyfluoroalkyl substances. These compounds can act through multiple mechanisms, including endocrine disruption, metabolic perturbation, oxidative stress, and direct hepatotoxicity. The impact of these exposures is often modified by factors such as sex, diet, and genetic predisposition. Recent research has revealed that even low-level exposures to certain chemicals can significantly affect liver health, particularly when combined with other risk factors. The emergence of exposomics as a research tool promises to enhance our understanding of how environmental factors influence liver disease. Importantly, exposure effects can vary by demographic and socioeconomic factors, highlighting environmental justice concerns. Implementation of this knowledge in clinical practice requires new diagnostic approaches, healthcare system adaptations, and increased awareness among medical professionals. In conclusion, this review provides a comprehensive examination of current evidence linking environmental exposures to liver disease and discusses implications for clinical practice and public health policy.

Keywords

environmental liver disease - occupational and environmental hepatology - toxicant-associated steatohepatitis - metabolism disrupting chemicals


Publication History

Article published online:
21 March 2025

© 2025. Thieme. All rights reserved.

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