背景:慢性肾脏病(CKD)具有很高的公共卫生负担,但对金属加工液(MWF)气溶胶之间的关系知之甚少,职业性噪声和CKD。我们旨在探讨职业性MWF气溶胶之间的关系,职业性噪声和CKD。
方法:从无锡市的三家加工公司中抽取了2,738名机械师,中国,2022年。我们使用国家职业安全与健康研究所(NIOSH)方法5524收集MWF气溶胶暴露的单个样本,和中国国家标准(GBZ/T189.8-2007)方法对个人职业噪声暴露进行检测。CKD的诊断标准为尿白蛋白/肌酐比值(UACR)≥30mg/g和肾功能降低(eGFR<60mL。min-1.1.73m-2)持续时间超过3个月。通过平滑曲线拟合分析MWF气溶胶和职业性噪声与CKD的相关性。采用分段回归模型对阈值效应进行分析。
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=1.77,95CI:1.06-2.96)的工人CKD患病率高于未暴露工人。在增加的MWF气溶胶和职业噪声剂量与CKD风险之间发现了非线性和正相关。当MWF气溶胶的每日累积暴露剂量超过8.03mg/m3时,OR为1.24(95CI:1.03-1.58),当职业噪声超过87.22dB(A)时,OR为1.16(95CI:1.04-1.20)。在MWF气溶胶与职业噪声的交互分析中,暴露于MWF气溶胶(累积暴露量≥8.03mg/m3-天)和职业噪声(LEX,8h≥87.22dB(A))的CKD患病率增加(OR=2.71,95CI:1.48-4.96)。MWF气溶胶和职业噪声在CKD患病率中具有正相互作用。
结论:职业MWF气溶胶和噪声与CKD呈正相关和非线性相关,累积MWF气溶胶和噪声暴露与CKD呈正相互作用。这些发现强调了评估暴露于MWF气溶胶和职业噪声的工人的肾功能的重要性。前瞻性和纵向队列研究对于阐明这些关联的因果关系是必要的。
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. 1.73 m- 2) 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/m3, 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/m3-day) and occupational noise (LEX,8 h ≥ 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.