Occupational and environmental renal disease.

Occupational renal diseases provide models for understanding environmental renal diseases. Kidney damage in a few workers induced by heavy exposure to identifiable toxins indicates what to expect among the large population exposed to low levels of toxins dispersed in the larger environment. Occupational and environmental renal diseases present a unique opportunity for primary prevention as well as the diagnostic challenge of long latency and multifactorial etiology. The occupational and environmental toxins that cause chronic renal disease include the heavy metals (Pb, Cd, Hg, As, Cr, U), organic compounds sometimes referred to as solvents, silica, and beryllium. Toxins encountered as medicinal agents such as germanium, gold, and aluminum will not be considered. This review will update major contributions to the subject which have appeared over the past half decade.