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Original research
End-stage renal disease and metalworking fluid exposure


Objective Despite increasing prevalence of end-stage renal disease (ESRD), little attention has been directed to how occupational exposures may contribute to risk. Our objective was to investigate the relationship between metalworking fluids (MWF) and ESRD in a cohort of 36 703 male autoworkers.

Methods We accounted for competing risk of death, using the subdistribution hazard approach to estimate subhazard ratios (sHRs) and 95% CIs in models with cubic splines for cumulative exposure to MWF (straight, soluble or synthetic).

Results Based on 501 ESRD cases and 13 434 deaths, we did not observe an association between MWF and ESRD overall. We observed modest associations between MWF and ESRD classification of glomerulonephritis and diabetic nephropathy. For glomerulonephritis, the 60th percentile of straight MWF was associated with an 18% increased subhazard (sHR=1.18, 95% CI: 0.99 to 1.41). For diabetic nephropathy, the subhazard increased 28% at the 60th percentile of soluble MWF (sHR=1.28, 95% CI: 1.00 to 1.64). Differences by race suggest that black males may have higher disease rates following MWF exposure.

Conclusions Exposure to straight and soluble MWF may be related to ESRD classification, though this relationship should be further examined.

  • cutting fluids
  • kidney diseases

Data availability statement

Data are available upon reasonable request. The data that can be made available upon reasonable request are deidentified participant data accompanied by a data dictionary. Data can be requested from Liza Lutzker, Data Manager, UC Berkeley, ORCID: 0000-0003-0611-0158. Conditions of reuse would include submission of researcher’s IRB approval to the UC Berkeley IRB and pending permission from the National Death Index and US Renal Data System.

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