Construction Trade Work Is Associated With Accelerated Decline in Kidney Function.

BACKGROUND

Construction workers are exposed to airborne particulates, organic solvents, and metals-agents linked to elevated risk of chronic kidney disease (CKD). Few studies have evaluated whether construction trade work is associated with longitudinal changes in estimated glomerular filtration rate (eGFR), a key indicator of kidney function. This study examined the relationship between construction-related exposures and eGFR decline.

METHODS

The cohort included 9192 participants in the Building Trades National Medical Screening Program (BTMed). An index of exposure to vapors, gases, dusts, and fumes (VGDF) was developed (measure = standard deviation increases in the log index). Mixed models estimated annual eGFR decline (mL/min/1.73 m2 per year) while adjusting for established CKD risk factors. Sensitivity analyses used inverse propensity score weighted (IPSW) regression to balance covariates between construction trade workers and an internal comparison group. Secondary analyses assessed CKD incidence using Cox proportional hazards models.

RESULTS

Construction work was significantly associated with faster annual eGFR decline (-0.22, 95% CI = -0.33 to -0.11). VGDF exposure was also associated with greater decline (-0.07, 95% CI = -0.09 to -0.05). CKD incidence was associated with construction work (Hazard Ratio [HR] = 1.46, 95% CI = 1.05-2.03) and VGDF exposure (HR = 1.07, 95% CI = 1.00-1.16). IPSW analyses supported these findings.

CONCLUSIONS

Construction trade work and VGDF exposure were associated with accelerated eGFR decline and increased CKD incidence, indicating broad renal impacts of mixed construction-related exposures. Primary and secondary prevention efforts to reduce VGDF exposures and to identify workers with rapid eGFR decline may help reduce the risk of progression to end-stage renal disease.