GLOMERULAR NEPHROPATHIES AND ORGANIC-SOLV ENT EXPOSURE

Several studies have suggested that exposure to organic solvents is as sociated with glomerular nephropathies (GN), but this relationship rem ains controversial. A case-control study of 298 biopsy-proven cases an d 298 hospital controls, matched for year of birth, sex, origin, and p lace of residence, was conducted between 1989 and 1991 in five hospita ls in the Paris area : 82 cases of membranous glomerulopathy were incl uded; 100, nephrotic syndrome with either minimal change nephropathy o r focal and segmental hyalinosis (MCN/FSH); and 116, IgA nephropathy ( IgA N). Subjects were interviewed about their lifelong occupational an d non-occupational activities. Type, level, and duration of solvent ex posure were assessed blind with respect to case-control status by two industrial hygienists. HLA phenotypes were determined. Among males, a clear association, which was not explained by social class, was observ ed between chronic renal failure and high exposure to solvents for bot h MCN/FSH (OR = 7.7, 95 %CI 1.4-41.6) and IgA N (OR = 3.5, 95 %CI 1.0- 11.8). The odds-ratios increased with duration of exposure. No relatio nship was observed between such exposure and GN cases with normal rena l function. No evidence was found that the HLA phenotype plays a role in the solvent exposure-disease association. These results support the hypothesis of a causal relationship between high solvent exposure, wh ich concerned 15% of the males in this study, and the development of G N with chronic renal failure.