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Occupational and other exposures associated with male end-stage renal disease: a case/control study

N K Steenland1, M J Thun, C W Ferguson

  • 1National Institute for Occupational Safety and Health, Cincinnati, OH 45226-1998.

American Journal of Public Health
|February 1, 1990
PubMed

Insights

Certain medications like phenacetin and acetaminophen, moonshine consumption, and occupational exposures to solvents and silica are linked to increased end-stage renal disease (ESRD) risk in men. Family history also significantly elevates risk.

Area of Science:

  • Nephrology
  • Environmental Health
  • Epidemiology

Background:

  • End-stage renal disease (ESRD) poses a significant public health challenge.
  • Identifying modifiable risk factors for ESRD is crucial for prevention strategies.

Purpose of the Study:

  • To investigate potential risk factors for end-stage renal disease (ESRD) in adult men.
  • To examine the association between lifestyle, family history, and occupational exposures and ESRD risk.

Main Methods:

  • A case-control study involving 325 men aged 30-69 diagnosed with ESRD between 1976-1984.
  • Cases were selected from the Michigan Kidney Registry, excluding specific nephropathies. Controls were pair-matched by age, race, and residence.
  • Data collected via telephone interviews with eligible cases (69%) and controls (79%).

Main Results:

  • Significant associations found between ESRD risk and phenacetin/acetaminophen use (OR=2.66), moonshine consumption (OR=2.43), and family history of renal disease (OR=9.30).
  • Occupational exposures to solvents (OR=1.51) and silica (OR=1.67) were also linked to increased risk.
  • Specific high-risk exposures included solvents as cleaning agents (OR=2.50), silica in foundries/brick factories (OR=1.92), and sandblasting (OR=3.83).

Conclusions:

  • Phenacetin, acetaminophen, moonshine, family history, and occupational solvent/silica exposures are significant risk factors for ESRD in men.
  • The duration of occupational exposure showed a trend for increased risk primarily with silica in sandblasting.
  • Limitations include potential case representativeness issues, self-report biases, and exposure misclassification.

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