Hypertension: Do not forget the occupational etiology

Abstract

:The etiological diagnosis of arterial hypertension remains rare. The purpose of the study was to analyse the occupational hypertension characteristics in workers exposed to lead excluding other causes of hypertension. We included 13 workers of average age of 37 years (with extremes of 28 to 48 years). They were welders (6 cases), mechanics (3 cases), workers in electrical cable manufacturing industries (2 cases) and workers in dental amalgam plants (2 cases). The average duration of work and exposure was 8 hours/day for an average period of 5 to 7 years. The signs leading to consultation were various: urinary, digestive, neurosensory or general signs. The physical examination confirmed the presence of hypertension in both arms in standing and supine position. The complementary examinations were normal. The search for toxics was performed. Blood lead levels with leaduria and cadminemia with admiuria were high in 9 and 2 cases, respectively. Renal biopsy was performed in 7 cases. It showed tubulointerstitial and glomerular lesions with presence of gold salts in the cells of the proximal convoluted tubule. Hospitalization was necessary in all cases. Management with a distance from the professional environment was started. The role of the occupational physician is absolutely fundamental in the diagnosis and prevention of arterial hypertension of toxic origin.