A Retrospective Occupational Cohort Study of End-Stage Renal Disease in Aircraft Workers Exposed to Trichloroethylene and Other Hydrocarbons

OBJECTIVE: Case-control studies suggest hydrocarbons increase end-stage renal disease (ESRD) risk. No cohort studies have been conducted. METHODS: An occupational database was matched to the U.S. Renal Data System, and the outcome of all-cause ESRD was examined using multivariable Cox regression. Sixteen individual hydrocarbons were studied, although exposures were not mutually exclusive. RESULTS: For the 1973-2000 period, there was an approximate twofold increased risk of ESRD among workers exposed to trichloroethylene, 1,1,1-trichloroethane, and JP4 gasoline compared with unexposed subjects (all P < 0.05). Relative risk was greater than unity (P > 0.05) for several other hydrocarbons. Associations attenuated (all P > 0.05) when 2001-2002 data were included in the analyses. CONCLUSIONS: Certain hydrocarbons may increase all-cause ESRD risk. Uncertainty regarding the mechanism for increased risk and the observed attenuation in risk in 2001-2002, as well as the overlap of exposures, complicates interpretation. Additional research is needed.