A Pilot Study to Explore the Application of Silicone Wristband-Based Chemical Exposure Assessment to Kidney Disease Epidemiology in Agricultural Workers.

Exposure assessment in kidney disease epidemiology remains challenging because kidney function impairment may alter urinary chemical excretion, limiting the utility of urinary biomonitoring and highlighting the need for alternative tools. We combined targeted and nontargeted analyses of silicone wristbands worn by 43 male agricultural workers to characterize their personal chemical exposome and evaluate preliminary associations of these exposures, urinary biomarkers, and kidney health. Kidney function was assessed via estimated glomerular filtration rate (eGFR, mL/min/1.73m2). Pesticides were quantified in wristbands (worn 8-11 days) and spot urine samples using targeted analysis. A custom GC-HRMS nontargeted workflow was applied to examine potential chemical exposure differences from wristband measurements. Associations between pesticide exposure and kidney function were evaluated using minimally adjusted linear regression for continuous eGFR (β) and log-binomial regression for binary eGFR < 90 (prevalence ratio [PR]). Overall, our findings suggest that higher wristband pesticide concentrations may be associated with lower kidney function among participants. In adjusted models, a 10-fold increase in wristband chlorpyrifos concentration yielded a higher prevalence of eGFR < 90 (PR = 1.53; 95% CI: 0.99, 2.36). Oxyfluorfen detection was similarly associated with a higher prevalence of eGFR < 90 (PR = 2.38; 95% CI: 1.01, 5.61). Conversely, most urinary biomarkers showed no association, though specific gravity-corrected AMPA concentrations were inversely associated with eGFR < 90 (PR = 0.31; 95% CI: 0.11, 0.87). Exploratory nontargeted analysis identified 193 tentative features that were higher on wristbands from participants with eGFR < 90 and only one feature that was higher on wristbands from participants with eGFR ≥ 90. Silicone wristbands show promise for enhancing characterization of the personal chemical exposome and warrant further investigation as a complementary tool to urinary biomonitoring for reducing exposure misclassification in kidney disease epidemiology. These exploratory findings, based on a small sample, are hypothesis-generating and require validation through larger, longitudinal studies.