Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Se Yuan Road, No. 9, Nantong, Jiangsu, 226001, China.
Wuxi Eighth People's Hospital, Wuxi, Jiangsu, China.
BMC Public Health. 2024 Jun 4;24(1):1495. doi: 10.1186/s12889-024-19006-7.
BACKGROUND: Chronic kidney disease (CKD) carries a high public health burden yet little is known about the relationship between metalworking fluid (MWF) aerosols, occupational noise and CKD. We aimed to explore the relationship between occupational MWF aerosols, occupational noise and CKD. METHODS: A total of 2,738 machinists were sampled from three machining companies in Wuxi, China, in 2022. We used the National Institute for Occupational Safety and Health (NIOSH) method 5524 to collect individual samples for MWF aerosols exposure, and the Chinese national standard (GBZ/T 189.8-2007) method to test individual occupational noise exposure. The diagnostic criteria for CKD were urinary albumin/creatinine ratio (UACR) of ≥ 30 mg/g and reduced renal function (eGFR < 60 mL.min. 1.73 m) lasting longer than 3 months. Smooth curve fitting was conducted to analyze the associations of MWF aerosols and occupational noise with CKD. A segmented regression model was used to analyze the threshold effects. RESULTS: Workers exposed to MWF aerosols (odds ratio [OR] = 2.03, 95% confidence interval [CI]: 1.21-3.41) and occupational noise (OR = 1.77, 95%CI: 1.06-2.96) had higher prevalence of CKD than nonexposed workers. A nonlinear and positive association was found between increasing MWF aerosols and occupational noise dose and the risk of CKD. When daily cumulative exposure dose of MWF aerosols exceeded 8.03 mg/m, the OR was 1.24 (95%CI: 1.03-1.58), and when occupational noise exceeded 87.22 dB(A), the OR was 1.16 (95%CI: 1.04-1.20). In the interactive analysis between MWF aerosols and occupational noise, the workers exposed to both MWF aerosols (cumulative exposure ≥ 8.03 mg/m-day) and occupational noise (L ≥ 87.22 dB(A)) had an increased prevalence of CKD (OR = 2.71, 95%CI: 1.48-4.96). MWF aerosols and occupational noise had a positive interaction in prevalence of CKD. CONCLUSIONS: Occupational MWF aerosols and noise were positively and nonlinearly associated with CKD, and cumulative MWF aerosols and noise exposure showed a positive interaction with CKD. These findings emphasize the importance of assessing kidney function of workers exposed to MWF aerosols and occupational noise. Prospective and longitudinal cohort studies are necessary to elucidate the causality of these associations.
背景：慢性肾脏病（CKD）给公共卫生带来了沉重负担，但人们对金属加工液（MWF）气溶胶、职业噪声与 CKD 之间的关系知之甚少。本研究旨在探讨职业性 MWF 气溶胶、职业噪声与 CKD 之间的关系。
方法：2022 年，我们从中国无锡的三家机械加工企业中抽取了 2738 名机械师作为样本。我们使用美国国家职业安全与健康研究所（NIOSH）方法 5524 采集个体 MWF 气溶胶暴露的个体样本，并使用中国国家标准（GBZ/T 189.8-2007）方法检测个体职业噪声暴露。CKD 的诊断标准为尿白蛋白/肌酐比值（UACR）≥30mg/g 和持续时间超过 3 个月的肾功能降低（eGFR<60mL.min.1.73m）。采用平滑曲线拟合分析 MWF 气溶胶和职业噪声与 CKD 的关系。采用分段回归模型分析阈值效应。
结果：暴露于 MWF 气溶胶（比值比 [OR] = 2.03，95%置信区间 [CI]：1.21-3.41）和职业噪声（OR = 1.77，95%CI：1.06-2.96）的工人患 CKD 的比例高于非暴露工人。MWF 气溶胶和职业噪声的累积剂量与 CKD 风险之间呈非线性正相关关系。当 MWF 气溶胶的每日累积暴露剂量超过 8.03mg/m 时，OR 为 1.24（95%CI：1.03-1.58），当职业噪声超过 87.22dB（A）时，OR 为 1.16（95%CI：1.04-1.20）。在 MWF 气溶胶和职业噪声之间的交互分析中，暴露于 MWF 气溶胶（累积暴露量≥8.03mg/m 天）和职业噪声（L≥87.22dB（A）的工人 CKD 患病率升高（OR = 2.71，95%CI：1.48-4.96）。MWF 气溶胶和职业噪声在 CKD 患病率方面呈正交互作用。
结论：职业性 MWF 气溶胶和噪声与 CKD 呈正相关且非线性，MWF 气溶胶和噪声的累积暴露呈正交互作用与 CKD。这些发现强调了评估接触 MWF 气溶胶和职业噪声的工人肾功能的重要性。需要前瞻性和纵向队列研究来阐明这些关联的因果关系。
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