title: A retrospective occupational cohort study of end-stage renal disease in aircraft workers exposed to trichloroethylene and other hydrocarbons.
abstract: OBJECTIVE
  Case-control studies suggest hydrocarbons increase end-stage renal disease (ESRD) risk. No cohort studies have been conducted.
  
  
  METHODS
  An occupational database was matched to the U.S. Renal Data System, and the outcome of all-cause ESRD was examined using multivariable Cox regression. Sixteen individual hydrocarbons were studied, although exposures were not mutually exclusive.
  
  
  RESULTS
  For the 1973-2000 period, there was an approximate twofold increased risk of ESRD among workers exposed to trichloroethylene, 1,1,1-trichloroethane, and JP4 gasoline compared with unexposed subjects (all P < 0.05). Relative risk was greater than unity (P > 0.05) for several other hydrocarbons. Associations attenuated (all P > 0.05) when 2001-2002 data were included in the analyses.
  
  
  CONCLUSIONS
  Certain hydrocarbons may increase all-cause ESRD risk. Uncertainty regarding the mechanism for increased risk and the observed attenuation in risk in 2001-2002, as well as the overlap of exposures, complicates interpretation. Additional research is needed.
authors.affiliation: Worldwide Outcomes Research, Merck & Co., Inc., Whitehouse Station, NJ 08889, USA. larry_radican@merck.com
authors.forename: Larry
authors.initials: L
authors.lastname: Radican
authors.forename: Daniel
authors.initials: D
authors.lastname: Wartenberg
authors.forename: George G
authors.initials: GG
authors.lastname: Rhoads
authors.forename: Dona
authors.initials: D
authors.lastname: Schneider
authors.forename: Richard
authors.initials: R
authors.lastname: Wedeen
authors.forename: Patricia
authors.initials: P
authors.lastname: Stewart
authors.forename: Aaron
authors.initials: A
authors.lastname: Blair
mesh_terms: D000401:Aircraft; D000704:Analysis of Variance; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006838:Hydrocarbons / Q000009:adverse effects*; D007676:Kidney Failure, Chronic / Q000139:chemically induced / Q000453:epidemiology*; D008297:Male; D016273:Occupational Exposure / Q000009:adverse effects*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012306:Risk; D017678:Sex Distribution; D014241:Trichloroethylene / Q000009:adverse effects*; D014589:Utah / Q000453:epidemiology
chemical_list: D006838:Hydrocarbons; D014241:Trichloroethylene