ArticleJournal of exposure science & environmental epidemiology2026
Effects of high ambient temperatures on liver function in an occupational population: Examining the mediation role of inflammatory cells and moderation role of age factors.
Article in Journal of exposure science & environmental epidemiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundOccupational exposure to high ambient temperature may affect liver function, but pathways remain unclear.
objectiveTo examine associations between high ambient temperature and liver enzymes among steelworkers, and to evaluate mediation by inflammatory cells and moderation by age.
methodsIn this cross-sectional study of 1111 steelworkers, high ambient temperature exposure was classified at the workshop level using wet-bulb globe temperature (WBGT) per Chinese standards (GBZ 2.2-2007): time-weighted average WBGT ≥ 25 °C (high-temperature) vs. <25 °C (control). Alanine aminotransferase (ALT), aspartate aminotransferase (AST), and inflammatory cell counts were measured from venous blood. Multivariable generalized linear models estimated associations; mediation (via lymphocytes) used bootstrap confidence intervals; age moderation was tested.
resultsCompared with controls, the high ambient temperature exposure group exhibited elevated levels of ALT and AST, as well as higher counts of white blood cells, lymphocytes, monocytes, and eosinophils (P < 0.05). High ambient temperature exposure emerged as independently associated with ALT (β = 0.384, 95%CI: 0.222, 0.546) and AST (β = 0.238, 95%CI:0.065, 0.410) levels. Lymphocyte counts statistically mediated the relationship between high ambient temperature exposure and elevated serum ALT (β = 0.062, 95%CI: 0.026, 0.104) and AST (β = 0.046, 95%CI:0.009, 0.092) levels. Additionally, age only moderated the path between high ambient temperature exposure and lymphocyte count (β = -0.192, 95%CI: -0.316, -0.067). SIGNIFICANCE: Occupational heat was associated with higher ALT/AST; lymphocyte-related indirect association was observed and attenuated with age. Longitudinal and mechanistic studies are needed to assess causality. IMPACT: Findings support WBGT-based heat monitoring, routine ALT and AST screening in hot posts, and targeted acclimatization hydration and work- rest protocols, especially for younger workers, while future studies test whether enhanced heat controls improve liver outcomes.
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