POS-507 OCCUPATIONAL HEAT EXPOSURE AS A RISK FACTOR FOR END-STAGE KIDNEY DISEASE

Abstract

Globally, diabetes is the leading cause of end-stage kidney disease. However, a high percentage of patients are reaching hemodialysis because of kidney disease of undetermined etiology. The mesoamerican nephropathy is an example of environmental factors leading to dialysis in male sugar cane workers but studies are lacking in other parts of the world. This study aimed to explore occupational risk factors associated with hemodialysis. This is a matched case-control study that included as cases all hemodialysis patients of three Lebanese dialysis units and as controls patients with normal kidney function that were admitted to the affiliated hospitals during September and October 2020. Cases and controls were matched based on age category, sex and diabetes. Patients less than 18 years old and those who refused to give their consents to participate were excluded. Data collection included socio-demographic and job-related variables. Conditional logistic regression analysis was performed. A total of 476 patients were included, 238 hemodialysis patients and 238 controls. The mean age of hemodialysis patients was 66.5±13.8 years and of controls 67.2±14.3 years. Both groups had 61% of males and 42% of diabetics. Smoking, alcohol and educational level were not significantly different between the two groups. Patients with a history of gout had a higher risk for hemodialysis (OR=2.7; 95% CI: 1.31 to 5.58). Table 1 depicts risk factors associated with hemodialysis: heat exposure during work (OR=1.93; 95% CI: 1.24 to 3.00), working as a cook (OR=12; 95% CI: 1.56 to 92.29), working as a construction worker (OR=10; 95% CI: 1.28 to 78.12) and living in the urban setting (OR=1.95; 95% CI: 1.32 to 2.88). These results were more significant in males and those with kidney disease of unknown etiology. In this study, heat exposure during work and living in urban areas were found as risk factors for end stage kidney disease. Professions that expose to heat like cooks and construction workers were more associated with hemodialysis. Identifying modifiable occupational risk factors can help establish strategies and behavioral interventions to prevent kidney disease in high-risk professions.