Sunday, 31 January 2016

Anna Suraya
Muchtaruddin Mansyur
Stainless steel welder  who had had chronic infection of hepatitis B will have two burden for his liver. First is fume of chrome from stainless stell welding process and second  is actifity of hepatitis B viral.   This  case is  liver cancer in 31 years old stainless steel welder, who work for 11 years as a welder and had a chronic hepatitis B. Is there any possibility that between HBV and the workplace exposure especially chronic chromium exposure could work in sinergic action in developing of liver cancer.
Relevant articles were searches in Pubmed and Proquest. Three articles were obtained, ranked according to relevance, validation and level of evidence after critical appraisal
From the 3 available studies, there was no article found  investigating  the possibility of sinergic action between hepatitis B and chromium in development of liver cancer.  However research Nobuhiro et al and Amr et al have tried to find the possibility of the sinergic action. Nobuhiro et al reported that liver cancer was observed less often among dentists than among medical doctors (p=0.047, OR=0.474, 95% CI=0.239-0.941).Amr et all6 reported that high relative risk of HCC was observed among HCV-infected individuals who were farmers (OR 9.60, 95% CI 3.72, 24.76), industrial workers (OR 12.90, 95% CI 4.33, 38.43) or active smokers (OR 5.95, 95% CI 2.20, 16.08). Ecological study from Athena et al reported that the SMR for primary liver cancer was 1104 (95% CI 405-2403, p-value < 0.001).
Occupational exposures may play an important role in development of liver cancer but there was no published research investigate the role of chromium in generating an excess risk of liver cancer among hepatitis B people. The role of chromium  in hasten the process is still unclear. Future research focusing on mechanism of chromium exposure among hepatitis B patients in this population is necessary.

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