Liver Function Test

This liver function test Panel (LFT) can detect disorders of the liver, gallbladder and the biliary tract. The panel include:

  1. Alanine Aminotransferase
  2. Aspartate Aminotransferase
  3. Gamma Glutamyl Transferase
  4. Alkaline Phosphatase
  5. Total Bilirubin
  6. Albumin and prothrombin time.
  7. 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

  1. Offshore medical: LFT is not a routine test; it may be requested at the discretion of the examining doctor.
  2. (Norwegian Directorate of Health 2012)
  3. 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)

  1. Offshore medical: LFT is part of the routine test; ALT AST and GGTT.
  2. (GoM BP 2012)
  3. Firefighters; LFT is a required test - ALT, AST, direct and indirect bilirubin, alkaline Phosphatase (NFPA 2012).
  4. Firefighters, LFT is part of the minimum requirements and required for HAZMAT exposures (AFAC 2006).
  5. Divers LFT is not a routine test. (HSE UK, MA1, 2011)
  6. Hazardous occupations; the test is not routinely required, required for jobs involving arsenic exposure (Hong Kong 2004).
  7. 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).
  8. Drivers; LFT is not a routine test; unless deemed necessary by the examining doctor (UK DVLA 2014).
  9.  

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

  1. Kronick, R. (2014). The Guide to Clinical Preventive Services. USPSTF. Retrieved from http://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/guide/cpsguide.pdf
  2. Guidelines - health requirements for persons working on installations offshore. Norwegian Directorate of Health 2012.
  3. Medical Aspects of Fitness for Work Offshore ( 2008 The United Kingdom Offshore Oil and Gas)
  4. GoM Medical Aspects of Fitness for Offshore Work Safety Work Practice (BP 2012)
  5. NFPA 1582, Chapter 6 Medical Evaluations of Candidates - 2012
  6. Australasian Fire Authorities Council (AFAC) Medical Guidelines for Firefighters, 2006
  7. HSE UK, The medical examination and assessment of divers (MA1) 2011, http://www.hse.gov.uk/Diving/ma1.pdf
  8. Doctors’ Guide to Medical Examinations for Workers engaged in Hazardous Occupations in Industrial Undertakings - Occupational Safety and Health – 2004, Hong Kong.
  9. OSHA, Screening and Surveillance: A Guide to OSHA Standards, 2009 https://www.osha.gov/Publications/osha3162.pdf
  10. At a glance Guide to the current Medical Standards of Fitness to Drive'. Drivers Medical Group, DVLA, UK, May 2014

 

Parent Category: Fitness for Work