Elevated alanine aminotransferase (ALT) levels disqualify from employment
Jan 03, 2023
Source: Cainiu Health
Dr. Yang Shuwen
Introduction
Generally, the normal range for alanine aminotransferase (ALT) in pre-employment physical examinations is 0–40. Values above this range indicate possible liver inflammation or damage, and a recheck is required to determine the cause. If transaminase levels exceed twice the upper limit of normal, liver function should be rechecked multiple times. Levels not exceeding 80 are generally considered acceptable; however, final determination depends on the specific requirements of the examining hospital and the employing organization.
Generally, the normal range for alanine aminotransferase (ALT) in pre-employment physical examinations is 0–40 U/L. Values above this range indicate possible liver inflammation or damage and require retesting to determine the underlying cause. If ALT levels exceed twice the upper limit of normal, liver function should be repeatedly tested. Levels not exceeding 80 U/L are generally considered acceptable, although final decisions depend on specific requirements from the examining hospital and the employing institution.
ALT is a sensitive indicator of hepatocellular injury and its severity. It is present in various cells, most abundantly in hepatocytes, primarily located in the cytoplasm of liver cells, and to a lesser extent in skeletal muscle, kidneys, lungs, brain, myocardium, and other tissues. Elevated ALT levels often suggest liver damage and possible necrosis of liver cells.
Individuals found to have elevated ALT during physical exams can usually still qualify for employment if they experience no discomfort and respond well to timely treatment. For mild elevations, following medical advice to take liver-protective and enzyme-lowering medications, along with regular follow-up liver function tests, typically allows for eventual clearance and successful employment. If elevated ALT results from smoking, alcohol consumption, eating spicy or irritating foods, taking large amounts of hepatotoxic drugs, or excessive fatigue, adjusting lifestyle habits, ensuring adequate rest, and eliminating these factors usually restore ALT levels to normal within one to two weeks.
In summary, various diseases affecting the liver can lead to elevated transaminases. Predominant elevation of ALT usually indicates a hepatic origin. A definitive diagnosis and differential diagnosis should be made by combining clinical symptoms and laboratory findings, followed by targeted treatment accordingly.
