Annals of Occupational and Environmental Medicine

Research Article

Association between exposure to ambient air pollution and renal function in Korean adults: Hyun-Jin Kim, Jin-young Min, Yong-Seok Seo, Kyoung-bok Min; Ann Occup Environ Med 2018;30:14. Published online February 28, 2018; DOI: https://doi.org/10.1186/s40557-018-0226-z

Background

Ambient air pollution has a negative effect on many diseases, such as cardiovascular and respiratory diseases. Recent studies have reported a relationship between air pollution and renal function, but the results were limited to exposure to particulate matter (PM). This study was to identify associations between various air pollutants and renal function among Korean adults.

Methods

Nationwide survey data for a total of 24,407 adults were analyzed. We calculated the estimated glomerular filtration rate (eGFR) for each individual to assess their renal function and used this to categorize those with chronic kidney disease (CKD). To evaluate exposure to ambient air pollution, we used the annual mean concentrations of four ambient air pollutants: PM with an aerodynamic diameter ≤ 10 μm (PM₁₀), nitrogen dioxide (NO₂), sulfur dioxide (SO₂), and carbon monoxide (CO).

Results

We identified significant inverse relationships between the air pollutants PM₁₀ and NO₂ and eGFR in all statistical adjustment models (all p < 0.05). In the full covariate model, interquartile range increases in the annual mean concentrations of PM₁₀ and NO₂ were associated with decreases in eGFR levels of 0.46 (95% CI = − 0.87, − 0.04) and 0.85 (95% CI = − 1.40, − 0.30), respectively. Three of the ambient air pollutants were significantly related to an increased risk of CKD in the unadjusted model (p < 0.0001), but all significant associations disappeared after adjusting for covariates (all p > 0.05).

Conclusions

Exposures to PM₁₀ and NO₂ were significantly associated with decreases in eGFR levels, but not CKD, in Korean adults.

Citations

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Original Articles

Associations of ALAD Genotype with Renal Function Indices in Lead Workers: Sung Soo Lee, Jin Ho Kim, Nam Soo Kim, Hwa Sung Kim, Kyu Dong Ahn, Byung Kook Lee; Korean Journal of Occupational and Environmental Medicine 2004;16(2):200-209. Published online June 30, 2004; DOI: https://doi.org/10.35371/kjoem.2004.16.2.200

Abstract PDF

OBJECTIVES
delta-Aminolevulinic acid dehydratase (ALAD) is a polymorphic enzyme that has two alleles, ALAD1 (ALAD1-1 as genotype) and ALAD2 (ALAD1-2 or ALAD2-2 as genotype). ALAD genotype has been reported to modify the pharmacokinetics and toxicity of lead. The authors investigated the influence of ALAD genotype polymorphism on renal function in lead workers METHODS: We studied 935 male lead workers and 87 male non-lead workers in the same industries. For cross-sectional renal indices, blood urea nitrogen (BUN), serum creatinine, serum uric acid and urine total protein were selected. Blood lead level was also measured an index of lead exposure. Information on weight, age, job duration, and smoking and drinking habits was collected.
RESULTS
Whereas the mean blood lead level of lead workers was 25.4+/-10.9 microgram/dL, that of non-lead workers in the same premise was 10.1+/-2.8 microgram/dL, and the difference between the two groups was statistically significant. Whereas the prevalence of the variant allele, ALAD2 in 935 lead workers was 10.6%, that in 87 non-lead workers was 4.6%. However there was no difference of prevalence between the two groups. The mean blood lead level of subjects with ALAD1 was 23.9+/-11.4 microgram/dL, which was slightly lower than that of subjects with ALAD2 (25.8+/-10.7 microgram/dL). However, this difference was not statistically significant. After adjustment for the covariates, the subjects with ALAD2 allele were 12.8% less likely to have a median value or more of BUN than subject with ALAD1. The adjusted odds ratio was 0.59 (95% confidence interval; 0.38-0.91). After adjustment for the covariates, the subjects with ALAD2 allele were 9.3% less likely to have a median value or more of serum creatinine than subject with ALAD1. The adjusted odds ratio was 0.64 (95% confidence interval; 0.41-0.98).
CONCLUSIONS
From the above results, it was found that the variant allele, ALAD2 appeared to modify the association of lead and renal function, and that ALAD2 genotype may be supportive for the protective effect of lead.

Citations

Citations to this article as recorded by

Effects of Factors Associated with Urine Hippuric Acid Correction Values in Urinary Creatinine by HPLC and Jaffe Method and Specific Gravity HPLC Jaffe Method
Key-Young Kim, Jong-Gyu Kim, Ki-Nam Yoon, Wha-Me Park, Hun-Hee Park
Journal of Korean Society of Occupational and Environmental Hygiene.2015; 25(4): 493. CrossRef
Environmental Exposure to Lead (Pb) and Variations in Its Susceptibility
Jina Kim, Youngeun Lee, Mihi Yang
Journal of Environmental Science and Health, Part C.2014; 32(2): 159. CrossRef

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Some Renal Function Indices in Workers Occupationally Exposed to Lead: Je Sung Nam, Yong Bae Kim, Hyun Cheol Ahn, Hwa Sung Kim, Gap Soo Lee, Kyu Yoon Hwang, Sung Soo Lee, Kyu Dong Ahn, Byung Kook Lee; Korean Journal of Occupational and Environmental Medicine 1998;10(2):139-148. Published online May 31, 1998; DOI: https://doi.org/10.35371/kjoem.1998.10.2.139

Abstract PDF

The influence of lead exposure on renal function was studied. Three hundred forty two male lead exposed workers who worked in 3 storage battery factories, 5 secondary smelting factories and 3 litharge making factories, and 60 male control workers who were not exposed to lead occupationally were chosen for this study. Blood lead (PbB), zinc protoporphyrin in whole blood (ZPP) and delta-aminolevulinic acid in urine (DALA) were selected as indicators of lead exposure. As indicators of renal function blood urea nitrogen(BUN) , serum creatinine(S-Cr), serum uric acid (S-UA), N-acetyl-beta-D-glucosaminidase in urine (NAG) and urine protein (U-TP) were selected. While the mean values of lead exposure indicators of lead workers were significantly different from non-exposed ones, the mean values of renal function indicators of exposed except S-UA were significantly different from non-exposed. The frequency of workers whose value of renal function indicators were over the nor mal criteria (BUN>20 mg/dl ; S-Cr>1.2 mg/dl ; S-UA>7.0 mg/dl ; NAG>8.0 U/liter; U-TP>8.0 mg/dl) by the level of lead absorption in terms of PbB, ZPP and DALA were calculated. Age adjusted odds ratio of over the normal value of BUN and NAG were statistically significant by the level of ZPP and that of BUN only showed the dose-dependant relationship. But the frequency of over the normal criteria of renal function indicators were not increased by the level of PbB and DALA. On stepwise multiple regression using renal function indicators as a dependent variable and each lead exposure indicator and age as independent variables, only BUN, NAG and U-TP were contributed by the lead exposure indicators. It was found that only NAG of renal function indices was most reliable indicator who showed dose-response relationship with lead exposure and the measurement of NAG for lead workers whose relatively high exposure is highly recommended.

Citations

Citations to this article as recorded by

Effect of Pork Consumption on Renal and Hematochemical Indices in Workers Occupationally Exposed to Unclean Environments
Chan-Kyu Han, Jeong-Hae Rho, Bog-Hieu Lee
Korean Journal for Food Science of Animal Resources.2008; 28(1): 91. CrossRef

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Comparison of Renal Function Indices Between Occupationally lead Exposed Females and Healthy Non-exposed Females: Du Shin Jeong, Joo Hee Park, Kyu Dong Ahn, Byung Kook Lee, Joung Soon Kim; Korean Journal of Occupational and Environmental Medicine 1994;6(2):153-165. Published online September 30, 1994; DOI: https://doi.org/10.35371/kjoem.1994.6.2.153

Abstract PDF

This study was to investigate the effect of lead on the selected clinical renal function in female lead workers. The 123 female lead workers from 9 lead industry and 177 females who were not occupationally exposed were examined. Females who had history of renal disease or oral medication were excluded. Blood lead, zinc protoporhphyrin in blood, delta-aminolevulinic acid and haemoglobin were examined as of lead exposure indices and blood urea nitrogen, serum creatinine, serum uric acid and urine protein were examined as of renal function indices. Mean concentration of lead were 40.7(+/-13.02)ug/dl for lead workers and 10.7(+/-3.56)ug/dl for non-lead workers. Differences between lead workers and non-lead workers in blood lead, zinc protoporhphyrin in blood and delta-aminoleuvulinic acid were statistically significant. There were significant differences between lead workers and non-lead workers in blood urea nitrogen, serum creatinine, serum uric acid except urine protein but their mean concentrations were all within normal limits. Serum creatinine and urine protein were not increasing according to the increasing blood lead. When cut off points of 20mg/dl in blood urea nitrogen, 1.2mg/dl in serum creatine, 7.0mg/dl in serum uric acid, 8.0mg/dl in urine protein and 40ug/dl in blood lead, 100ug/dl in zinc-protoporhphyrin in blood, 7.0mg/l in delta-aminoleuvulinic acid were accepted, comparison between frequencies of blood urea nitrogen, serum creatine, serum uric acid, urin protein by the level of blood lead, zinc-protoporhphyrin in blood and delta-aminoleuvulinic acid respectively was not statistically different. There were no dose-repsonse relationships in risk ratios by the level of blood lead and zinc-protoporphyrin in blood respectively. In summary, there were no significant effect of lead on the selected clinical renal function among the female lead workers at level of blood lead 40ug/dl that is the permissible level of lead poisoning in Korea.

Citations

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Pollutant levels in ambient air and blood in Korea
Chan-Seok Moon, Masayuki Ikeda
Environmental Health and Preventive Medicine.1996; 1(1): 33. CrossRef

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