Liver Function Test
This liver function test Panel (LFT) can detect disorders of the liver, gallbladder and the biliary tract. The panel include:
- Alanine Aminotransferase
- Aspartate Aminotransferase
- Gamma Glutamyl Transferase
- Alkaline Phosphatase
- Total Bilirubin
- Albumin and prothrombin time.
- Total Protein
USPSTF does not recommend LFT for screening of asymptomatic population,
It recommends the use of serologic markers to screen high-risk groups and pregnant women for HBV and HCV (USPSTF 2014).
International standards
- Offshore medical: LFT is not a routine test; it may be requested at the discretion of the examining doctor.
- (Norwegian Directorate of Health 2012)
- Offshore medical: LFT is not a routine test; it can be requested by examining doctor for management of alcohol abuse; the individual must have evidence of an improving trend of liver function test.
(UK Offshore Oil and Gas 2008)
- Offshore medical: LFT is part of the routine test; ALT AST and GGTT.
- (GoM BP 2012)
- Firefighters; LFT is a required test - ALT, AST, direct and indirect bilirubin, alkaline Phosphatase (NFPA 2012).
- Firefighters, LFT is part of the minimum requirements and required for HAZMAT exposures (AFAC 2006).
- Divers LFT is not a routine test. (HSE UK, MA1, 2011)
- Hazardous occupations; the test is not routinely required, required for jobs involving arsenic exposure (Hong Kong 2004).
- OSHA Standard; Hazardous Waste Operations and Emergency Responses (HAZWOPER): LFT is required for HAZMAT team members and emergency response team and for occupation involving exposure to Methylenedianiline (MDA). (OSHA, 2009).
- Drivers; LFT is not a routine test; unless deemed necessary by the examining doctor (UK DVLA 2014).
Recommendation: for fire fighters, divers, offshore and other safety critical positons, LFT can be minimized to ALT, GGT and prothrombin time, which is more specific to liver abnormality.
References
- Kronick, R. (2014). The Guide to Clinical Preventive Services. USPSTF. Retrieved from http://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/guide/cpsguide.pdf
- Guidelines - health requirements for persons working on installations offshore. Norwegian Directorate of Health 2012.
- Medical Aspects of Fitness for Work Offshore ( 2008 The United Kingdom Offshore Oil and Gas)
- GoM Medical Aspects of Fitness for Offshore Work Safety Work Practice (BP 2012)
- NFPA 1582, Chapter 6 Medical Evaluations of Candidates - 2012
- Australasian Fire Authorities Council (AFAC) Medical Guidelines for Firefighters, 2006
- HSE UK, The medical examination and assessment of divers (MA1) 2011, http://www.hse.gov.uk/Diving/ma1.pdf
- Doctors’ Guide to Medical Examinations for Workers engaged in Hazardous Occupations in Industrial Undertakings - Occupational Safety and Health – 2004, Hong Kong.
- OSHA, Screening and Surveillance: A Guide to OSHA Standards, 2009 https://www.osha.gov/Publications/osha3162.pdf
- At a glance Guide to the current Medical Standards of Fitness to Drive'. Drivers Medical Group, DVLA, UK, May 2014
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Parent Category: Fitness for Work