Occupational exposures and chronic kidney disease: Possible associations with endotoxin and ultrafine particles

Abstract

Background Chronic kidney disease (CKD) carries a high public health burden yet there is limited research on occupational factors, which are examined in this retrospective case-control study. Methods Newly diagnosed cases of CKD (n=547) and controls (n=508) from North Carolina provided detailed work histories in telephone interviews. Unconditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results There was heterogeneity in the association of CKD and agricultural work, with crop production associated with increased risk and work with livestock associated with decreased risk. Work with cutting/cooling/lubricating oils was associated with a reduced risk. CKD risk was increased for working in dusty conditions. Conclusions CKD risk was reduced in subjects with occupational exposures previously reported to involve endotoxin exposure. Further, exposure to dusty conditions was consistently associated with increased risk of glomerulonephritis across industry, suggesting that research on CKD and ultrafine particulates is needed.

The systemic nature of CKD

“…For example, ultrafine particles can not only cause lung disease, but also cardiovascular 198 and renal diseases 199 .…”

A Pilot Study to Assess Inhalation Exposures among Sugarcane Workers in Guatemala: Implications for Chronic Kidney Disease of Unknown Origin

“…There is a need to identify and characterize potentially preventable nephrotoxic exposures that may put workers at risk for the development of CKDu [ 1 ]. Recent research suggests that occupational exposure to respirable silica increases the risk for traditional CKD [ 32 , 33 , 34 , 35 ] and targets proximal tubular cells [ 36 ]. Silica is an abundant mineral that may exist in different forms in soil and can accumulate in sugarcane plants [ 37 ].…”

Risk factors for chronic kidney disease of non-traditional causes: a systematic review

“…The studies included in the qualitative and quantitative synthesis involved nearly 100 000 participants. A dose-response relationship also was found in participants of both sexes who work closer to sea level (compared to highlands) in Central America, with risks for both men and women (44, 57), as well as those who had worked in agriculture for more than 5 years in a non-endemic region (75). Work in agriculture is a wide context exposure that could also include multiple other exposures such as agrochemicals, heavy metals, and/or heat stress-dehydration.…”

“…Two systematic reviews (4, 5) and 25 primary studies (27 articles; 20, 26, 27, 30 – 34, 38, 40 – 42, 44, 45, 48, 50, 51, 57 – 59, 63, 66, 67, 75, 77) contributed data on exposure to agrochemicals and/or working in agriculture (see the Supplementary Materials for more details). The majority of studies were conducted in Central America ( n = 14) or South Asia ( n = 7).…”