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 ALT levels exceed twice the upper limit of normal, liver function should be rechecked multiple times. Levels below 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) during pre-employment physical examinations is 0–40. Values above this range indicate possible liver inflammation or damage and require retesting to confirm the underlying cause. If ALT levels exceed twice the upper limit of normal, liver function should be repeatedly tested. However, if the level does not exceed 80, it is usually considered acceptable, although specific criteria may vary depending on the requirements of the examining hospital or employing organization.
As a sensitive indicator of liver cell damage and its severity, ALT is present in various cells throughout the body, with the highest concentrations found in hepatocytes. It primarily resides in the cytoplasm of liver cells, followed by lower levels in skeletal muscle, kidneys, lungs, brain, heart muscle, and other tissues. Elevated ALT levels often suggest liver injury and possible necrosis of liver cells.
Individuals found to have elevated ALT during physical exams can generally still qualify for employment if they experience no noticeable symptoms and respond well to appropriate treatment. If the elevation is mild, taking liver-protective and enzyme-lowering medications as prescribed by a doctor, followed by normalization of liver function upon follow-up testing, typically allows for successful employment clearance. In cases where elevated ALT results from smoking, alcohol consumption, eating spicy or irritating foods, taking large amounts of hepatotoxic drugs, or excessive fatigue, simply adjusting lifestyle habits, getting adequate rest, and eliminating these contributing factors usually leads to ALT normalization within about one to two weeks.
In summary, various diseases affecting the liver can lead to increased transaminase levels. A predominant rise in ALT particularly suggests a hepatic origin. Further diagnosis and differential diagnosis should be made in conjunction with other clinical findings and laboratory tests, followed by targeted treatment accordingly.
