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      Heat and PAHs Emissions in Indoor Kitchen Air and Its Impact on Kidney Dysfunctions among Kitchen Workers in Lucknow, North India

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          Abstract

          Indoor air quality and heat exposure have become an important occupational health and safety concern in several workplaces including kitchens of hotels. This study investigated the heat, particulate matter (PM), total volatile organic compounds (TVOCs) and polycyclic aromatic hydrocarbons (PAHs) emissions in indoor air of commercial kitchen and its association with kidney dysfunctions among kitchen workers. A cross sectional study was conducted on 94 kitchen workers employed at commercial kitchen in Lucknow city, North India. A questionnaire-based survey was conducted to collect the personal and occupational history of the kitchen workers. The urine analysis for specific gravity and microalbuminuria was conducted among the study subjects. Indoor air temperature, humidity, wet/ dry bulb temperature and humidex heat stress was monitored during cooking activities at the kitchen. Particulate matter (PM) for 1 and 2.5 microns were monitored in kitchen during working hours using Hazdust. PAHS in indoor air was analysed using UHPLC. Urinary hydroxy-PAHs in kitchen workers were measured using GC/MS-MS. Higher indoor air temperature, relative humidity, PM1 and PM2.5 (p<0.001) was observed in the kitchen due to cooking process. Indoor air PAHs identified are Napthalene, fluorine, acenaphthene, phenanthrene, pyrene, chrysene and indeno [1,2,3-cd) pyrene. Concentrations of all PAHs identified in kitchen were above the permissible OSHA norms for indoor air. Specific gravity of urine was significantly higher among the kitchen workers (p<0.001) as compared to the control group. Also, the prevalence of microalbuminuria was higher (p<0.001) among kitchen workers. Urinary PAH metabolites detected among kitchen workers were 1-NAP, 9-HF, 3-HF, 9-PHN and 1-OHP. Continuous heat exposure in kitchens due to cooking can alter kidney functions viz., high specific gravity of urine in kitchen workers. Exposure to PM, VOCs and PAHs in indoor air and presence of urinary PAHs metabolites may lead to inflammation, which can cause microalbuminuria in kitchen workers, as observed in the present study.

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          Most cited references38

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          Urinary indices during dehydration, exercise, and rehydration.

          This investigation evaluated the validity and sensitivity of urine color (Ucol), specific gravity (Usg), and osmolality (Uosm) as indices of hydration status, by comparing them to changes in body water. Nine highly trained males underwent a 42-hr protocol involving dehydration to 3.7% of body mass (Day 1, -2.64 kg), cycling to exhaustion (Day 2, -5.2% of body mass, -3.68 kg), and oral rehydration for 21 hr. The ranges of mean (across time) blood and urine values were Ucol, 1-7; Usg, 1.004-1.029; Uosm, 117-1,081 mOsm x kg-1; and plasma osmolality (Posm), 280-298 mOsm x kg-1. Urine color tracked changes in body water as effectively as (or better than) Uosm, Usg, urine volume, Posm, plasma sodium, and plasma total protein. We concluded that (a) Ucol, Uosm, and Usg are valid indices of hydration status, and (b) marked dehydration, exercise, and rehydration had little effect on the validity and sensitivity of these indices.
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            Combining GFR and albuminuria to classify CKD improves prediction of ESRD.

            Despite the high prevalence of chronic kidney disease (CKD), relatively few individuals with CKD progress to ESRD. A better understanding of the risk factors for progression could improve the classification system of CKD and strategies for screening. We analyzed data from 65,589 adults who participated in the Nord-Trøndelag Health (HUNT 2) Study (1995 to 1997) and found 124 patients who progressed to ESRD after 10.3 yr of follow-up. In multivariable survival analysis, estimated GFR (eGFR) and albuminuria were independently and strongly associated with progression to ESRD: Hazard ratios for eGFR 45 to 59, 30 to 44, and 15 to 29 ml/min per 1.73 m(2) were 6.7, 18.8, and 65.7, respectively (P < 0.001 for all), and for micro- and macroalbuminuria were 13.0 and 47.2 (P < 0.001 for both). Hypertension, diabetes, male gender, smoking, depression, obesity, cardiovascular disease, dyslipidemia, physical activity and education did not add predictive information. Time-dependent receiver operating characteristic analyses showed that considering both the urinary albumin/creatinine ratio and eGFR substantially improved diagnostic accuracy. Referral based on current stages 3 to 4 CKD (eGFR 15 to 59 ml/min per 1.73 m(2)) would include 4.7% of the general population and identify 69.4% of all individuals progressing to ESRD. Referral based on our classification system would include 1.4% of the general population without losing predictive power (i.e., it would detect 65.6% of all individuals progressing to ESRD). In conclusion, all levels of reduced eGFR should be complemented by quantification of urinary albumin to predict optimally progression to ESRD.
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              The effect of heat waves on hospital admissions for renal disease in a temperate city of Australia.

              A rarely investigated consequence of heat exposure is renal dysfunction resulting from dehydration and hyperthermia. Our study aims to quantify the relationship between exposure to extreme high temperatures and renal morbidity in South Australia. Poisson regression accounting for over dispersion, seasonality and long-term trend was used to estimate the effect of heat waves on hospital admissions for renal disease, acute renal failure and renal dialysis over a 12-year period. Selected comorbidities were investigated as possible contributing risk factors. Admissions for renal disease and acute renal failure were increased during heat waves compared with non-heat wave periods with an incidence rate ratio of 1.100 [95% confidence intervals (CI) 1.003-1.206] and 1.255 (95% CI 1.037-1.519), respectively. Hospitalizations for dialysis showed no corresponding increase. Comorbid diabetes did not increase the risk of renal admission, however 'effects of heat and light' and 'exposure to excessive natural heat' (collectively termed effects of heat) were identified as risk factors. Our findings suggest that as heat waves become more frequent, the burden of renal morbidity may increase in susceptible individuals as an indirect consequence of global warming.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                12 February 2016
                2016
                : 11
                : 2
                : e0148641
                Affiliations
                [1 ]Epidemiology Division, CSIR-Indian Institute of Toxicology Research, PB No 80, MG Marg, Lucknow, 226001, U.P, India
                [2 ]Environment Monitoring Division, CSIR-Indian Institute of Toxicology Research, PB No 80, MG Marg, Lucknow, 226001, U.P, India
                [3 ]Analytical Chemistry Division, CSIR-Indian Institute of Toxicology Research, PB No 80, MG Marg, Lucknow, 226001, U.P, India
                [4 ]Department of Biochemistry, Babu Banarasi Das University, BBD City, Faizabad Road, Lucknow, Uttar Pradesh - 226 028, U.P, India
                University of Utah School of Medicine, UNITED STATES
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Conceived and designed the experiments: CNK MKRM. Performed the experiments: CNK AS RK VB NS AHK AS MKRM MKG GNVS. Analyzed the data: CNK AS MKRM MKG GNVS VB NS AHK. Contributed reagents/materials/analysis tools: CNK AS MKRM MKG GNVS VB NS AHK. Wrote the paper: CNK AS MKRM MKG GNVS VB NS AHK.

                Article
                PONE-D-15-26298
                10.1371/journal.pone.0148641
                4752274
                26871707
                bfefb8b4-7255-4404-bde8-f357cabb8f79
                © 2016 Singh et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 3 July 2015
                : 20 January 2016
                Page count
                Figures: 2, Tables: 5, Pages: 16
                Funding
                This study was funded by the Council of Scientific and Industrial Research, New Delhi – Network program (Code: INDEPTH-BSC-0111), Government of India.
                Categories
                Research Article
                Biology and Life Sciences
                Anatomy
                Body Fluids
                Urine
                Medicine and Health Sciences
                Anatomy
                Body Fluids
                Urine
                Biology and Life Sciences
                Physiology
                Body Fluids
                Urine
                Medicine and Health Sciences
                Physiology
                Body Fluids
                Urine
                Biology and Life Sciences
                Biochemistry
                Metabolism
                Metabolites
                Biology and Life Sciences
                Anatomy
                Renal System
                Kidneys
                Medicine and Health Sciences
                Anatomy
                Renal System
                Kidneys
                Medicine and Health Sciences
                Nephrology
                Microalbuminuria
                Physical Sciences
                Chemistry
                Chemical Properties
                Specific Gravity
                Physical Sciences
                Chemistry
                Physical Chemistry
                Chemical Properties
                Specific Gravity
                Earth Sciences
                Atmospheric Science
                Meteorology
                Humidity
                Earth Sciences
                Atmospheric Science
                Atmospheric Chemistry
                Air Quality
                Physical Sciences
                Chemistry
                Environmental Chemistry
                Atmospheric Chemistry
                Air Quality
                Ecology and Environmental Sciences
                Environmental Chemistry
                Atmospheric Chemistry
                Air Quality
                Physical Sciences
                Physics
                Classical Mechanics
                Mechanical Stress
                Thermal Stresses
                Custom metadata
                Due to ethical restrictions related to protecting patient confidentiality, data within the paper are available only with the consent of the Institutional Human Ethics Committee, CSIR-Indian Institute of Toxicology Research, Lucknow, India. Interested researchers can send their request for data to Dr V Bihari, Member Secretary, Institutional Human Ethics Committee, CSIR-Indian Institute of Toxicology Research, PB No 80, MG Marg, Lucknow 226001, UP, India. email: ( vipin@ 123456iitr.res.in ).

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