The report of the U.S. Public Health Service does give more detail on page 14 regarding the 1987 Rosenman et al. article. It states in the section on renal effects:
"Occupational exposure to silver metal dust has been associated with increased excretion of a particular renal enzyme (N-acetyl-beta-D-glucosaminidase,) and with decreased creatinine clearance (Rosenman et al. 1987.) Both of these effects are diagnostic of marginally impaired renal function. However, the workers in this study were also exposed to cadmium, known to be nephrotoxic; differentiation of the effects of the two metals in the kidney is not possible with the data presented. Therefore, no conclusion can be drawn regarding renal effects of silver based on this study. No studies in animals were located which support the observation of renal effects in the Rosenman et al (1987) study..." Matthew
