ASSESSMENT OF A SCREENING PROTOCOL FOR OCCUPATIONAL RENAL-DISEASE

Using 10 guidelines for medical screening programs, this review assess es a screening protocol that seeks to identify presymptomatic occupati onal renal disease among workers with nephrotoxin exposure. The protoc ol uses urinary markers of early renal dysfunction for the screening t est. The review reveals that arguments for screening are the clinical significance of renal disease, worker acceptance of urine collection, the availability of exposure reduction as an intervention, and the ava ilability of diagnostic and treatment facilities. Obstacles to screeni ng are the lack of an effective intervention, the lack of strong evide nce to indicate that an elevation in the urinary markers represents a preclinical stage of occupational renal disease, and the absence of fi rm numbers to demarcate normal from elevated concentrations of urinary markers. Given these obstacles, screening for occupational renal dise ase is not recommended.