The Use of Carbohydrate-Deficient Transferrin in Occupational Setting: A Systematic Review

Background: Alcohol consumption is prohibited in some categories of workers due to its temporary and longterm effects. The purpose of this study is to review and evaluate the use of carbohydrate-deficient transferrin (CDT) as a biomarker to screen alcohol consumption in workers. Methods: A systematic review was performed, searching three databases, PubMed, Scopus and Isi Web of Knowledge, up to December 2021, screening for studies that used CDT as a biomarker in workers. A quality assessment was performed on the included studies. Results: Seven studies met the inclusion criteria, accounting for more than 3200 workers from five different countries; in the samples observed, a positive percentage of CDT was found in the single studies between 7 and 24%. The large interval could be due to the differences in populations in the included studies; furthermore, not all workers are prohibited from drinking on the job. Four out of the seven studies also included questionnaires on alcohol consumption assessment. Finally, included articles were stratified by occupational hazards and by industrial sector. Interestingly, different methods of analysis and different cut-offs were used by the different authors. Conclusions: The use of CDT as a biomarker of alcohol consumption has high specificity. However, further studies are needed to be able to strongly validate the use of CDT for screening purposes in the working population to detect alcohol abuse.