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pmid28409224
      Int+Arch+Occup+Environ+Health 2017 ; 90 (7 ): 555-574
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  • Occupational exposure to respirable crystalline silica and chronic non-malignant renal disease: systematic review and meta-analysis #MMPMID28409224
  • Möhner M ; Pohrt A ; Gellissen J
  • Int Arch Occup Environ Health 2017[Oct]; 90 (7 ): 555-574 PMID28409224 show ga
  • BACKGROUND: While occupational exposure to respirable silica is known to lead to lung disease, most notably silicosis, its association with chronic kidney disease is unclear. OBJECTIVES: This review explores the association between occupational exposure to respirable silica and chronic non-malignant renal disease such as glomerulonephritis. The evidence has been collected and compiled. Possible sources of bias are thoroughly discussed. METHODS: Cohort studies with silica exposure and case-control studies of renal disease were searched in PubMed until January 2015. Two authors independently abstracted data; any disagreement was resolved by consulting a third reviewer. A meta-analysis was performed to evaluate the association to silica exposure. RESULTS: A total of 23 cohort and four case-control studies were included in the analysis. The meta-analysis of cohort studies yielded elevated overall SMRs for renal disease. Some studies, however, included dose-response analyses, most of which did not show a positive trend. The approaches and results of the case-control studies were very heterogeneous. CONCLUSIONS: While the studies of cohorts exposed to silica found elevated SMRs for renal disease, no clear evidence of a dose-response relationship emerged. The elevated risk may be attributed to diagnostic and methodological issues. In order to permit a reliable estimation of a possible causal link, exposed cohorts should be monitored for renal disease, as the information from mortality studies is hardly reliable in this field.
  • |Case-Control Studies [MESH]
  • |Cohort Studies [MESH]
  • |Dose-Response Relationship, Drug [MESH]
  • |Glomerulonephritis/epidemiology [MESH]
  • |Humans [MESH]
  • |Inhalation Exposure/*statistics & numerical data [MESH]
  • |Occupational Diseases/*epidemiology [MESH]
  • |Occupational Exposure/*statistics & numerical data [MESH]
  • |Renal Insufficiency, Chronic/*epidemiology [MESH]
  • |Risk Assessment [MESH]


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