Does occupational and environmental exposure to particulate air pollution contribute to chronic kidney disease?

Some studies report an association between ambient particulate matter (PM) air pollution and the risk of Chronic Kidney Disease (CKD), defined by estimated GFR (eGFR), which is however less specific than CKD diagnosed by nephrologists. There is also some support from animal studies.

Suggested mechanisms are similar as for PM and cardiovascular disease: inflammation, endothelial dysfunction and atherosclerosis.If this is a true causal association, CKD should be more common in occupations exposed to dust and fumes, where exposure levels can be much higher.

An association between quartz and glomerulonephritis is fairly established, but can only account for a minority of CKD cases.

Studies of occupational exposure to PM and CKD are scarce.We plan to examine associations between occupational and ambient PM exposure and CKD in:The large Swedish construction worker cohort. Occupational exposure to PM (inorganic dust, fumes, wood dust) has been assessed with a job-exposure matrix (JEM).

Over 300 000 participants and estimated 4-5000 CKD cases gives us a high statistical power to find an association between occupational exposure to PM and CKD.The Malmö Diet and Cancer Study (MDCS) cohort.

In another project we have assigned annual residential air pollution exposures (source-specific PM2.5, PM10, BC) for 30 000 participants 1991-2018, and have detailed individual covariate data.

Based on our recent study of CKD in relation to lead in 15% of the cohort, we estimate to have around 1500 CKD cases during the study period.The SCAPIS Gothenburg cohort.

We have assigned residential air pollution 1990-2018 for 6500 participants and will investigate associations with kidney function (eGFR, based on Cystatin C).For the construction worker and MDCS cohorts we will use survival analyses for associations between PM exposures and CKD cases from high-quality Swedish registries, adjusted for possible confounders.

For the SCAPIS cohort the analysis will be cross-sectional.