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Organic Solvent Exposure May Increase the Risk of Glomerular Nephropathies with Chronic Renal Failure
* INSERM U 170, 16 avenue Paul Vailant-Coutorier 94807 Villejurf, France
** INRS, Avenue de Bourgogne BP 27, 54501 Vandoeuvre-les-Nancy, France
Laboratoire d'Immunologie et d'Histocompatibilité, Hospital Saint-Louis 75475 Paris, France
Centre Hospitalier Intercommunal 40 Avenue de Verdun, 94010 Créteil, France
Background. Several studies have suggested that exposure to organic solvents is associated with glomerular nephropathies (GN), but this realationship remains controversial.
Methods. A case-control study of 298 biopsy-proven cases and 298 hospital controls, matched for year of birth, sex, origin, and place of residence, was conducted between 1989 and 1991 in five hospitals in the Paris area: 82 cases of membranous glomerulopathy were included: 100, nephrotic syndrome with either minimal change nephropathy or focal and segmental hyalinosis (MCN/FSH): and 116, IgA nephropathy (IgA N). Subjects were interviewed about their lifelong occupational and non-occupational activities. A ‘blind’ assessment of type, level, and duration of solvant exposure was carried out by two industrial hygienists. Human leucocyte antigen (HLA) phenotypes were determined.
Results. Among males, a clear association, which was not explained by social class, was observed between chronic renal failure and high exposure to solvents for both MCN/FSH (OR = 7.7, 95% Cl : 1.4–41.6) and lgA N (OR = 3.5, 95% Cl : 1.0–11.8). The odds ratios increased with duration of exposure. No relationship was observed between such exposure and GN cases with normal renal function. No evidence was found that the HLA phenotype plays a role in the association between solvent exposure and the disease.
Conclusions. These results support the hypothesis of a causal relationship between high solvent exposure, which concemed 15% of the males in this study, and the development of GN with chronic renal failure.
Received 1 October 1994
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