The work-relatedness of renal disease.
Landrigan-PJ; Goyer-RA; Clarkson-TW; Sandler-DP; Smith-JH; Thun-MJ; Wedeen-RP
Arch Environ Health 1984 May; 39(3):225-230
Possible relationships between chronic renal failure and occupational exposures are discussed. The incidence and annual cost of end stage renal disease in the United States are outlined. The lack of etiologic information in the great majority of end stage renal disease cases is considered, with reference to the long period between exposure and diagnosis, the similarities among tissue specimens from all renal disease patients, and the lack of information gathering mechanisms. Potential exposure of American workers to known or suspected nephrotoxins is estimated. Noninvasive tests of renal dysfunction are described, involving urine analysis for high and low molecular weight proteins and enzymes; methods for estimating urine flow rates with marker substances are noted. Epidemiological studies of chronic renal disease are reviewed along with their shortcomings. Areas are suggested in which clinical studies of workers exposed to nephrotoxins may be useful. The lack of experimental animal models of chronic renal disease is discussed. The authors suggest expanded record keeping on end stage renal disease patients by the Social Security Administration and federal support for the development of predictive renal function tests and for relevant epidemiological studies.
NIOSH-Author; Kidney-damage; Occupational-diseases; Occupational-exposure; Industrial-medicine; Pathology; Disease-incidence; Epidemiology; Clinical-symptoms; Diagnostic-techniques; Nephrotoxins; Urinalysis
Archives of Environmental Health