TY - JOUR T1 - Occupational kidney disease among Chinese herbalists exposed to herbs containing aristolochic acids JF - Occupational and Environmental Medicine JO - Occup Environ Med SP - 286 LP - 290 DO - 10.1136/oem.2010.058594 VL - 68 IS - 4 AU - Hsiao-Yu Yang AU - Jung-Der Wang AU - Tsai-Chang Lo AU - Pau-Chung Chen Y1 - 2011/04/01 UR - http://oem.bmj.com/content/68/4/286.abstract N2 - Objective Many Chinese herbs contain aristolochic acids (ALAs) which are nephrotoxic and carcinogenic. The objective of this study was to identify whether exposure to herbs containing ALAs increased the risk of kidney disease among Chinese herbalists.Methods A nested case–control study was carried out on 6538 Chinese herbalists registered between 1985 and 1998. All incident cases of chronic renal failure reported to the Database of Catastrophic Illness of the National Health Insurance Bureau between 1995 and 2000 were defined as the case group. Up to four controls without renal failure were randomly matched to each case by sex and year of birth. A structured questionnaire survey was administered between November and December 2002. The Mantel–Haenszel method and conditional logistic regression were used to estimate the risks.Results 40 cases and 98 matched controls were included in the final analysis. After adjusting for age, frequent analgesic use, and habitual consumption of alcohol, fermented or smoked food, we found manufacturing and selling Chinese herbal medicine (OR 3.43, 95% CI 1.16 to 10.19), processing, selling or dispensing herbal medicines containing Fangji (OR 4.17, 95% CI 1.36 to 12.81), living in the workplace (OR 3.14, 95% CI 1.11 to 8.84) and a history of taking of herbal medicines containing Fangji (frequently or occasionally) (OR 5.42, 95% CI 1.18 to 24.96) were significantly associated with renal failure.Conclusion Occupational exposure to and consumption of herbs containing ALAs increases the risk of renal failure in Chinese herbalists. ER -