Hot occupation and nephrolithiasis.
We investigated the prevalence of stone disease and urinary stone risk factors in machinists chronically exposed to a hot environment and massive sweating, without interference of nephrotoxic metals or other lithogenic compounds. The study was performed at a glass plant and exposure to heat stress was estimated by the Wet Bulb Globe Temperature climatic index. The prevalence of nephrolithiasis on the entire population of the machinists was 8.5% (20 of 236), while the prevalence on the controls working in normal temperature was 2.4% (4 of 165) (p = 0.03). A high incidence (38.8%) of uric acid stones was present in the workers exposed to heat stress. Among the urinary stone risk indexes determined for 3 days during the 8-hour work shift on a randomly selected sample of 21 workers exposed and 21 workers not exposed to heat stress without any evidence of stone disease significant differences were found in uric acid concentration (722 +/- 195 versus 482 +/- 184 mg./l., p < 0.001), specific gravity (1,026 +/- 4 versus 1,021 +/- 6, p < 0.005) and pH (5.31 +/- 0.28 versus 5.64 +/- 0.54, p < 0.02), respectively. Thus, high uric acid relative supersaturation was present during occupation in hot temperatures (8.67 +/- 3.49) compared to occupation in normal temperatures (4.15 +/- 2.7) (p < 0.001). This study confirms that chronic dehydration represents a real lithogenic risk factor, mainly for uric acid stones, and adequate fluid intake is recommended during hot occupations.
Borghi
L
L
Institute of Semeiotica Medica, University of Parma and Medicina Preventiva e Igiene del Lavoro, Parma, Italy.
Meschi
T
T
Amato
F
F
Novarini
A
A
Romanelli
A
A
Cigala
F
F
D000328:Adult; D003681:Dehydration / Q000209:etiology*; D006358:Hot Temperature / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D007669:Kidney Calculi / Q000737:chemistry / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology; D016273:Occupational Exposure; D009790:Occupations; D015995:Prevalence; D012307:Risk Factors; D013312:Stress, Physiological / Q000209:etiology; D014527:Uric Acid / Q000032:analysis
D014527:Uric Acid