The Center for Health Research/Southeast, Kaiser Permanente Georgia, Atlanta, GA 30305, USA.
Ren Fail. 2012;34(1):40-6. doi: 10.3109/0886022X.2011.623496. Epub 2011 Oct 27.
Occupational exposure to silica may be associated with chronic kidney disease (CKD). Most studies have been conducted in occupational cohorts with high levels of exposure but small numbers of cases. We analyzed data from a population-based case-control study of occupational silica exposure and CKD.
Cases were hospital patients with newly diagnosed CKD, and community controls were selected using random digit dialing and frequency matched by age, gender, race, and proximity to the hospital. Silica exposure estimates were assigned by industrial hygiene review of lifetime job history data and weighted for certainty and intensity. Conditional logistic regression was used to estimate the odds ratios (ORs) for CKD conditioned on demographic, lifestyle, and clinical variables.
The mean age of participants was 63 years (range 30-83 years); 59% were male and 55% were white. Any silica exposure (compared with none) was associated with a 40% increased risk of CKD [OR = 1.40, 95% confidence interval (CI): 1.04, 1.89] in a multivariable adjusted model. The mean cumulative duration of silica exposure was significantly higher in exposed cases than in exposed controls (33.4 vs. 24.8 years, respectively). Overall, compared with nonexposed participants, the ORs (95% CI) for those below and above the median duration of silica exposure were 1.20 (0.77, 1.86) and 1.76 (1.14, 2.71), respectively.
We found a positive relationship between occupational silica exposure and CKD. A dose-response trend of increasing CKD risk with increasing duration of silica exposure was observed and was particularly strong among nonwhites.
职业性接触二氧化硅可能与慢性肾脏病（CKD）有关。大多数研究都是在暴露水平较高但病例较少的职业队列中进行的。我们分析了一项基于人群的职业性二氧化硅暴露与 CKD 病例对照研究的数据。
病例是新诊断为 CKD 的住院患者，社区对照是通过随机数字拨号选择的，并按年龄、性别、种族和与医院的距离进行频数匹配。通过对终生工作史数据进行工业卫生审查来评估二氧化硅暴露量，并根据确定性和强度进行加权。条件逻辑回归用于估计在考虑人口统计学、生活方式和临床变量的情况下，CKD 的比值比（OR）。
参与者的平均年龄为 63 岁（范围 30-83 岁）；59%为男性，55%为白人。与无暴露相比，任何二氧化硅暴露（与无暴露相比）均与 CKD 风险增加 40%相关[比值比（OR）=1.40，95%置信区间（CI）：1.04，1.89]，在多变量调整模型中。暴露病例的平均累积二氧化硅暴露时间明显长于暴露对照（分别为 33.4 年和 24.8 年）。总体而言，与无暴露参与者相比，暴露时间低于和高于中位数的 OR（95%CI）分别为 1.20（0.77，1.86）和 1.76（1.14，2.71）。
我们发现职业性二氧化硅暴露与 CKD 之间存在正相关关系。观察到随着二氧化硅暴露时间的增加，CKD 风险呈增加趋势，且在非白人中尤为明显。
