THE IMPACT OF ENVIRONMENTAL FACTORS ON THE DEVELOPMENT OF CHRONIC LIVER DISEASES

Abstract

Chronic liver diseases (CLD) represent a complex group of conditions that account for a significant portion of the global health burden, encompassing a clinical spectrum ranging from hepatic fibrosis to cirrhosis and hepatocellular carcinoma. Recent large-scale population-based and epidemiological analyses indicate that CLD ranks among the major causes of mortality worldwide. Globally, liver diseases are responsible for approximately 1.5–2 million deaths annually, constituting nearly 4% of all deaths. These statistics demonstrate that CLD is not only a clinical condition but also a critical public health and environmental health challenge.
Traditional etiological frameworks attribute CLD primarily to viral hepatitis (HBV, HCV), alcohol-associated liver disease, and metabolic factors—particularly metabolic dysfunction–associated steatotic liver disease (NAFLD/MASLD). However, scientific literature from the past decade increasingly highlights the direct and indirect influence of living conditions and environmental exposures—including air pollution, drinking-water quality, agrochemical contamination (pesticides and heavy metals), industrial emissions, and urbanization processes—on hepatic biology. These environmental determinants may exacerbate oxidative stress within hepatocytes, activate inflammatory signaling pathways, disrupt metabolic activity, and impair detoxification enzymes, thereby contributing to chronic liver injury and disease progression