Recent train derailments in East Palestine, Ohio, have made many people wonder about the safety of their environment – which was only exacerbated when the Kansas Department of Health and Environment announced that it had identified doubled rates of liver cancer in a historically Black neighborhood that faced a similar spill two decades ago. While lifestyle choices usually receive the bulk of attention around liver disease, the environment that we live in can also play an important role. Since liver health is public health, it is important to consider how our surroundings affect our livers.

Toxins: natural products found in the environment that can be harmful to humans
Toxicants: man-made, artificial products introduced to the environment by human activity that can be harmful to humans

In fact, liver damage is the most common organ damage as a result of occupational and environmental chemical exposures. A third of the most common workplace chemicals are associated with hepatotoxicity. The liver is the largest solid organ in the human body and is necessary for filtering out waste, among many critical functions. The presence of toxicants like vinyl chloride in the liver promote the presence of fat, inflammation, and scarring. These effects are similar to those of alcohol-associated liver disease and nonalcoholic fatty liver disease (NAFLD). This form of liver disease, caused by exposure to occupational or environmental toxicants, is referred to as toxicant-associated fatty liver disease (TAFLD).

Toxicant associated steatohepatitis (TASH) is the more serious form of TAFLD. Both TASH and TAFLD were only recently discovered, named, and found to have similar patterns to alcohol-associated liver disease and NAFLD and can lead to the same end-stage liver disease such as cirrhosis and liver cancer. 

Beyond an accidental spill, vinyl chloride can be found in pipes, packaging, and even wires. Industrial workers, people on military bases, or people impacted by an accident like the recent train derailment are exposed to high enough levels of vinyl chloride to be concerned. It is still unknown how low-level exposure may affect those with or without preexisting liver disease.

It is important to educate the community and encourage legislators and public health officials to better regulate toxins and toxicants like vinyl chloride and similar chemicals.

There are still steps you can take to protect yourself and others: 

• If you notice a chemical smell, itchiness, or become disoriented make sure to seek medical attention immediately. 
• Ask about the contents of the air you breathe and the water you drink.
• If you work in an industry with regular chemical exposure, be sure to follow safety guidelines and properly use protective equipment.

If you have any questions or concerns about your environmental exposures, be sure to consult local poison control or public health officials. TASH, along with many other liver diseases, is preventable, and sharing this information can save lives.