Chronic low level trimethyltin exposure and the risk of developing nephrolithiasis

• Published in: Occupational and environmental medicine (London, England) Vol. 70; no. 8; pp. 561 - 567
• Main Authors: Tang, Xiaojiang, Li, Nanchun, Kang, Lisha, Dubois, Amber M, Gong, Zhihong, Wu, Banghua, Lai, Guanchao, Yang, Aichu, Ruan, Xiaoling, Gao, Hongbin, Zhu, Guanghua, Ge, Yichen, Zhang, Jinxin, Lin, Zhongning, Olson, James R, Ren, Xuefeng
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01.08.2013; BMJ Publishing Group; BMJ Publishing Group LTD
• Subjects: Adult; Air; Air sampling; Biological and medical sciences; Blood; Case-Control Studies; Chemical hazards; Chemical Industry; Cross-Sectional Studies; Drinking water; Employment; Epidemics; Factories; Female; Humans; Hypokalemia; Kidney - drug effects; Kidney - pathology; Kidney diseases; Kidney stones; Kidneys; Length of employment; Logistic Models; Male; Manufacturing; Medical sciences; Nephrolithiasis; Nephrolithiasis - blood; Nephrolithiasis - epidemiology; Nephrolithiasis - etiology; Nephrolithiasis - urine; Nephrology. Urinary tract diseases; Occupational Diseases - blood; Occupational Diseases - epidemiology; Occupational Diseases - etiology; Occupational Diseases - urine; Occupational exposure; Occupational Exposure - adverse effects; Occupational medicine; Occupations; Plastics; Poisoning; Poisons; Polyvinyl chloride; Predisposing factors; Prevalence; Public health. Hygiene-occupational medicine; Questionnaires; Regression analysis; Risk Factors; Socioeconomic factors; Surveys and Questionnaires; Toxicity; Trimethyltin Compounds - adverse effects; Trimethyltin Compounds - blood; Trimethyltin Compounds - urine; Urinary lithiasis; Urine; Vinyl polymers; Workers; Workplace; Workplaces; Young Adult; Asia; China; United States > US; Guangdong China; Kidney disease; Human; Urinary system disease; Toxicity; Low dose; Occupational exposure; Epidemiology; Urinary stone; Chronic; Renal lithiasis; Risk factor; Occupational medicine; Organic stannane
• ISSN: 1351-0711; 1470-7926
• DOI: 10.1136/oemed-2012-101261

Objectives Nephrolithiasis (kidney stones) is a common disease with the prevalence that is increasing globally. We previously found that trimethyltin (TMT), a by-product of plastic stabilisers, can inhibit the H+/K+ ATPase activity in renal intercalated cells and alter urinary pH, which is a known risk factor for nephrolithiasis. In this study, we conducted a cross-sectional analysis to evaluate the impact of chronic low level occupational TMT exposure on nephrolithiasis. Methods This study included 216 healthy workers with TMT exposure and 119 workers as controls with no TMT exposure. All study participants were administered a questionnaire and underwent a routine clinical examination including an ultrasonographic screening for kidney stones. Exposures were assessed by measuring TMT concentrations in personal air samples, blood and urine. Logistic regression analysis was used to estimate the ORs and 95% CIs for the risk of kidney stones. Results TMT exposed workers had a higher prevalence of kidney stones (18.06%) in comparison with control workers (5.88%). High TMT concentrations in personal air samples, blood and urines were positively associated with increased prevalence of kidney stones in workers exposed to TMT compared with controls workers (p-trend values=0.005, 0.008 and 0.002, respectively). The length of employment in plants with elevated TMT levels (duration of the exposure) was significantly associated with the increased prevalence of kidney stones (p trend=0.001). The ORs were 2.66 for <3 years, 3.73 for 3–<10 years and 7.89 for 10+ years of employment compared with control workers. Conclusions To our knowledge, this is the first report to demonstrate that occupational exposure to TMT is a potential risk factor for nephrolithiasis.