Occupational heat exposure, nighttime warming, and eGFR loss in petrochemical workers: a retrospective cohort study with metabolomic evidence.

Occupational heat exposure in 2,148 petrochemical workers in southeastern China is linked to higher eGFR loss risk (HR 1.44, 95% CI 1.16–1.79; P=0.001) over 11,412 person-years.

• Why it matters: It is unclear whether warming at night changes heat-related kidney risk in industrial workers, despite rising nighttime temperatures under climate change.
• What they did: WBGT from workplace monitoring quantified occupational heat exposure, while nighttime temperature (20:00–07:00) came from ERA5-Land; Cox models tested interactions, and serum metabolomics explored pathways.
• The result: The heat–eGFR association was stronger with higher nighttime warming rates (P for interaction <0.001) and higher nighttime temperatures (P for interaction = 0.012), alongside metabolomic shifts in amino acid, energy, and tryptophan-related pathways.

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