1
|
Shaban M, Amer FGM, Shaban MM. The impact of nursing sustainable prevention program on heat strain among agricultural elderly workers in the context of climate change. Geriatr Nurs 2024; 58:215-224. [PMID: 38838403 DOI: 10.1016/j.gerinurse.2024.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 05/13/2024] [Accepted: 05/22/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND This study assesses a geriatric nursing-led sustainable heat prevention program for elderly agricultural workers. It targets those aged 60 and above, addressing the heightened risk of heat strain in the era of climate change. METHODS A community-based quasi-experimental design involved 120 elderly agricultural workers, divided into intervention and control groups. The program, spanning three months, included education on hydration, rest, protective clothing, and recognition of heat-related illnesses. RESULTS The intervention led by geriatric nursing professionals showed significant improvements in heat strain metrics. The Heat Strain Score Index (HSSI) and the Observational-Perceptual Heat Strain Risk Assessment (OPHSRA) Index indicated increased safety levels and reduced risk categories among participants. CONCLUSIONS The study demonstrates the effectiveness of a geriatric nursing-led, tailored prevention program in reducing heat strain among elderly agricultural workers. It highlights the crucial role of nursing in adapting healthcare practices to the challenges posed by climate change. TRIAL REGISTRATION ClinicalTrials.gov, ID NCT06192069 retrospectively registered.
Collapse
|
2
|
Mizelle E, Modly LA, Smith DJ. Farmworker Acceptability of Backpack Hydration Systems. J Agromedicine 2024; 29:477-485. [PMID: 38704610 PMCID: PMC11160487 DOI: 10.1080/1059924x.2024.2349022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2024]
Abstract
OBJECTIVE To improve water access while working and contribute to fewer heat-related illnesses (HRI), backpack hydration systems were provided to over 200 farmworkers to use during the 2022 growing season. Acceptability of the water intake intervention was assessed among farmworkers in eastern North Carolina, USA. METHODS With a pre-established community-university partnership, the acceptability of the intervention was assessed using a cross-sectional survey. The backpack brand selected included a 3-liter water bladder and attached drinking hose. Data analysis included descriptive and correlation statistics. RESULTS Among 47 male, migrant farmworkers, most (90%) reported the hydration backpack to be acceptable or completely acceptable to workplace fluid intake. Most (53%) reported using the backpack some of the time, compared to 28% who used it often. The participants reported an average of 4.8 (SD 2.2) liters of water intake from the backpack on a typical workday. Most reported the backpack improved the quantity and frequency of their water consumption. CONCLUSION This study was an important first step in implementation of hydration backpack systems as an HRI-preventative intervention among farmworkers. Future interventional studies could assess the efficacy of the backpacks on health outcomes, including incidence of dehydration and symptoms of HRI.
Collapse
Affiliation(s)
| | - Lori A. Modly
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Daniel J. Smith
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, PA, USA
| |
Collapse
|
3
|
Abasilim C, Friedman LS, Martin MC, Madigan D, Perez J, Morera M, Tovar A, Roka F, Xiuhtecutli N, Forst L, Monaghan P. Risk factors associated with indicators of dehydration among migrant farmworkers. ENVIRONMENTAL RESEARCH 2024; 251:118633. [PMID: 38462085 DOI: 10.1016/j.envres.2024.118633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 02/05/2024] [Accepted: 03/04/2024] [Indexed: 03/12/2024]
Abstract
OBJECTIVE Farmworkers are at increased risk of adverse health outcomes related to occupational heat exposure and inadequate access to water, shade, or rest breaks. Presently, there is a dearth of studies examining the prevalence of dehydration and related factors in U.S. farmworkers. Our objectives were to characterize hydration status during typical workdays and to identify risk factors associated with increased dehydration in migrant farmworkers employed in Florida. METHODS Urine samples were collected and analyzed for urine specific gravity (USG) 2-3 times per person per day over five days in May 2021 and 2022. Data collection included demographic characteristics, wet-bulb-globe-temperature (WBGT), and information on working conditions (task type, duration, and crop units harvested), fluid intake, clothing worn, and heat safety behaviors. Multivariable mixed regression models were used to evaluate risk factors associated with change in USG levels (continuous) during a work shift. RESULTS A total of 111 farmworkers participated in this study providing 1020 cumulative USG measurements, of which 96.8% of end-of-shift USG samples were above 1.020 indicating potential dehydration. In multivariable models, dehydration assessed using change in USG levels significantly declined with age (β = -0.078; 95%CI: 0.150, -0.006) but showed significant increase with body mass index (β = 0.016; 95%CI: 0.003, 0.028), WGBT (β = 0.054; 95%CI:0.044, 0.064), mean shift duration, and state of primary residence. We did not find significant associations of dehydration with type of clothing worn, intake of employer-provided water, or crop units harvested during a shift in this sample of farmworkers. CONCLUSION Our findings underscore the need for additional research to evaluate adverse outcomes related to dehydration and to better understand recovery patterns from chronic dehydration across workweeks and harvest seasons in migrant farmworkers.
Collapse
Affiliation(s)
- Chibuzor Abasilim
- Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, IL, USA
| | - Lee S Friedman
- Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, IL, USA
| | - Miranda Carver Martin
- Department of Agricultural Education and Communication, University of Florida, Gainesville, FL, USA
| | - Dana Madigan
- Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, IL, USA.
| | - Jose Perez
- Department of Agricultural Education and Communication, University of Florida, Gainesville, FL, USA
| | - Maria Morera
- Department of Agricultural Education and Communication, University of Florida, Gainesville, FL, USA
| | | | - Fritz Roka
- Florida Gulf Coast University, Ft. Myers, FL, USA
| | | | - Linda Forst
- Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, IL, USA
| | - Paul Monaghan
- Department of Agricultural Education and Communication, University of Florida, Gainesville, FL, USA
| |
Collapse
|
4
|
Flunker JC, Spector JT, Blancas M, Briggs NL, Flores M, Whitaker CR, Schoonover T, Cardoso T. Farmworker-Relevant Heat Exposure in Different Crop and Shade Conditions. J Agromedicine 2024:1-14. [PMID: 38874305 DOI: 10.1080/1059924x.2024.2365647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
OBJECTIVES Agricultural workers are at risk of heat-related illness, which is preventable. Few field studies have compared farmworker-relevant heat exposure in different conditions. We examined heat exposure over time in different potential shade and work locations to inform future occupational heat prevention approaches. METHODS We assessed heat exposure in Eastern Washington State (WA) cherry and grape fields in August 2022. QUESTemp° monitors recorded Wet Bulb Globe Temperature (WBGT) and Black Globe Temperature (BGT) every 10 min from approximately 07:00-14:00 for three days in the center of crop rows (mid-row), under portable shade structures (shade), and in open field (open) locations. Linear mixed effects regression (LMER) models compared WBGT and BGT among field locations. Hourly time-weighted average WBGT and comparisons with occupational exposure limits (OELs) were computed for different hypothetical work-rest cycles during the hottest sampling hours, assuming different worker effort levels, rest locations (mid-row versus shade), and acclimatization statuses. RESULTS Across all crops and locations during the study period, the mean/SD air temperature was 31°C (88°F)/3.9°C (6.9°F), with a maximum temperature of 39°C (102°F) and a mean/SD relative humidity of 30%/9.6%. LMER models suggested no significant difference in mid-row versus open WBGT but significantly lower WBGT in shade versus open locations for both cherries (main effect -5.14: 95% confidence interval [CI] -6.97,-3.32) and grapes (-6.20: 95%CI -7.73,-4.67), though this difference diminished over the course of the day. BGT was significantly higher in the mid-row than the shade (cherries main effect 14.33: 95%CI 9.52,19.13 and grapes 17.10: 95%CI 13.44,20.75). During the hottest sampling hour, the exceedances of OELs were reduced with assumptions of increased shaded break lengths, reduced effort level, and acclimatization. CONCLUSIONS Shade canopies, but not the crops studied, provided significant reductions in heat exposure. We observed increased protection from heat assuming longer shaded breaks and reduced effort levels. Results highlight the need for additional field research on the effectiveness, feasibility, and acceptability of different shade types and work-rest cycles to guide employer optimization of best practices for worker protections, including acclimatization before high heat, sufficient shaded rest time, reduced effort levels as the day warms, and avoiding work in peak heat.
Collapse
Affiliation(s)
- John C Flunker
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - June T Spector
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
- Department of Labor and Industries, Safety & Health Assessment and Research for Prevention (SHARP) Program, Tumwater, WA, USA
| | - Maria Blancas
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Nicole L Briggs
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Miriam Flores
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Carolyn Reeb- Whitaker
- Department of Labor and Industries, Safety & Health Assessment and Research for Prevention (SHARP) Program, Tumwater, WA, USA
| | - Todd Schoonover
- Department of Labor and Industries, Safety & Health Assessment and Research for Prevention (SHARP) Program, Tumwater, WA, USA
| | - Tamre Cardoso
- Department of Statistics, University of Washington, Seattle, WA, USA
| |
Collapse
|
5
|
Almadani AK, Ahmed W, Al Obaidli AAK, Holt SG. Gender, age and nationality differences in chronic kidney disease prevalence in the emirate of Abu Dhabi, UAE. Nephrology (Carlton) 2024; 29:288-296. [PMID: 38450898 DOI: 10.1111/nep.14285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 02/19/2024] [Accepted: 02/21/2024] [Indexed: 03/08/2024]
Abstract
AIM We aimed to better understand the prevalence of chronic kidney disease in Abu Dhabi, UAE, where a very diverse ethnic population lives, each with their own risk profile. METHODS Data were analysed on all patients who were tested for serum creatinine in December 2019 for 4 years within our healthcare network. We analysed data for kidney disease by age, gender and nationality to study differences in prevalence and risk. RESULTS The entire cohort (EC) consisted 1 925 672 samples from 703 122 patients. 24% of patients had GFR < 90 mL/min/1.73 m2 (CKD2-5), 4% had more severe kidney dysfunction (CKD3-5) and 2% had UACR >3 mg/mmol and with GFR > 90 (CKD1). The long follow-up (LFU) group comprised 45.6% of patients who had eGFR on at least two occasions more than 90 days apart, and of these 19.5% had sustained eGFR <90, and 5.2% had CKD3-5. Males had lower eGFR than females in the EC (RR 1.68) and the LFU group (RR 1.76). Emirati Females had the lowest prevalence in the EC (2.9%) and expatriate females in the LFU (3.5%) groups. The relative risks of CKD in expatriate males were highest in the EC (2.14) and the LFU (2.39) groups. When we looked at the age distribution by nationality there were highly significant differences in some populations being highly represented at younger ages. CONCLUSION The prevalence of kidney disease in Abu Dhabi has a male predominance, with younger expatriates highly represented. A targeted strategy to identify those at high risk may identify early CKD to prevent progression to end-stage kidney disease.
Collapse
Affiliation(s)
- Ayman Kamal Almadani
- SEHA Kidney Care, Abu Dhabi, United Arab Emirates
- College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Wasim Ahmed
- SEHA Kidney Care, Abu Dhabi, United Arab Emirates
- College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Ali Abdul Kareem Al Obaidli
- SEHA Kidney Care, Abu Dhabi, United Arab Emirates
- College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Stephen G Holt
- SEHA Kidney Care, Abu Dhabi, United Arab Emirates
- College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| |
Collapse
|
6
|
Politis MD, Gutiérrez-Avila I, Just A, Pizano-Zárate ML, Tamayo-Ortiz M, Greenberg JH, Téllez-Rojo MM, Sanders AP, Rosa MJ. Recent ambient temperature and fine particulate matter (PM 2.5) exposure is associated with urinary kidney injury biomarkers in children. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 907:168119. [PMID: 37884142 PMCID: PMC10842020 DOI: 10.1016/j.scitotenv.2023.168119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 10/10/2023] [Accepted: 10/23/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND Limited research has examined associations between exposure to ambient temperature, air pollution, and kidney function or injury during the preadolescent period. We examined associations between exposure to ambient temperature and particulate matter with aerodynamic diameter ≤ 2.5 μm (PM2.5) with preadolescent estimated glomerular filtration rate (eGFR) and urinary kidney injury biomarkers. METHODS Participants included 437 children without cardiovascular or kidney disease enrolled in the Programming Research in Obesity, Growth, Environment and Social Stressors birth cohort study in Mexico City. eGFR and urinary kidney injury biomarkers were assessed at 8-12 years. Validated satellite-based spatio-temporal models were used to estimate mean daily temperature and PM2.5 levels at each participant's residence 7- and 30-days prior to the date of visit. Linear regression and distributed lag nonlinear models (DLNM) were used to examine associations between daily mean temperature and PM2.5 exposure and kidney outcomes, adjusted for covariates. RESULTS In single linear regressions, higher seven-day average PM2.5 was associated with higher urinary alpha-1-microglobulin and eGFR. In DLNM analyses, higher temperature exposure in the seven days prior to date of visit was associated with a decrease in urinary cystatin C of -0.56 ng/mL (95 % confidence interval (CI): -1.08, -0.04) and in osteopontin of -0.08 ng/mL (95 % CI: -0.15, -0.001). PM2.5 exposure over the seven days prior to date of visit was associated with an increase in eGFR of 1.77 mL/min/1.73m2 (95 % CI: 0.55, 2.99) and urinary cystatin C of 0.19 ng/mL (95 % CI: 0.03, 0.35). CONCLUSIONS Recent exposure to ambient temperature and PM2.5 were associated with increased and decreased urinary kidney injury biomarkers that may reflect subclinical glomerular or tubular injury in children. Further research is required to assess environmental exposures and worsening subclinical kidney injury across development.
Collapse
Affiliation(s)
- Maria D Politis
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Iván Gutiérrez-Avila
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Allan Just
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Department of Epidemiology and Department of Earth, Environmental, and Planetary Sciences, Brown University, Providence, RI, United States
| | - María Luisa Pizano-Zárate
- Nutrition and Bioprogramming Coordination, National Institute of Perinatology, Mexico City, Mexico; UMF 4, South Delegation of the Federal District, Mexican Social Security Institute (IMSS), Mexico City, Mexico
| | - Marcela Tamayo-Ortiz
- Occupational Health Research Unit, Mexican Social Security Institute, Mexico City, Mexico; Department of Environmental Health Sciences, Mailman School of Public Health at Columbia University, New York, NY, United States
| | - Jason H Greenberg
- Department of Pediatrics, Section of Nephrology, Yale University School of Medicine, New Haven, CT, United States
| | - Martha M Téllez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Alison P Sanders
- Department of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Maria José Rosa
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
| |
Collapse
|
7
|
N SVSC, Xu Z. Heat and health of occupational workers: a short summary of literature. J Occup Health 2024; 66:uiae018. [PMID: 38604180 PMCID: PMC11131018 DOI: 10.1093/joccuh/uiae018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/02/2024] [Accepted: 03/21/2024] [Indexed: 04/13/2024] Open
Abstract
Globally, occupational workers suffer various health impacts due to extreme heat. In this short review, we examine the literature discussing health impacts of heat on occupational workers, and then discuss certain individual and institutional measures needed to address the problem. Though the available literature in the recent decade discusses health impacts of heat on workers as various heat-related illnesses, we found very few studies examining how occupational workers suffer from issues concerning cardiovascular health, neurological health, respiratory health, and mental health. In this regard, we highlight the need for more studies to examine how occupational workers exposed to extreme heat conditions suffer from fatal health issues like cardiovascular attack, brain stroke, and other ailments impacting vital organs of the body. Occupational workers across the world should be made aware of measures to protect themselves from extreme heat. Further, countries should develop occupational heat safety guidelines with statutory effect.
Collapse
Affiliation(s)
- Sai Venkata Sarath Chandra N
- School of Medicine and Dentistry, Parklands Drive, Southport, Gold Coast Campus, Griffith University, QLD 4222, Australia
| | - Zhiwei Xu
- School of Medicine and Dentistry, Parklands Drive, Southport, Gold Coast Campus, Griffith University, QLD 4222, Australia
| |
Collapse
|
8
|
Albu I, Elon L, Xiuhtecutli N, McCauley L, Chicas R. Retention of Agricultural Workers Participating in a Renal Longitudinal Study. J Agromedicine 2024; 29:26-33. [PMID: 37574800 PMCID: PMC10841276 DOI: 10.1080/1059924x.2023.2246966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
OBJECTIVES The relationship between heat stress, chronic kidney diseases and acute kidney injury has been documented in cross-sectional studies with agricultural workers. However, only a few international studies have assessed renal function in agricultural workers longitudinally. Our research study, Occupational Heat Exposure and Renal Dysfunction (OHEaRD) is the first longitudinal study in the U.S. that monitored renal function in agricultural workers five times over the course of 32-months. The main objectives of this study were to evaluate the rate of retention and identify predictors associated with retention in a longitudinal study with agricultural workers. METHODS In January 2020, we enrolled 119 Florida agricultural workers to observe on 5 workdays over 32 months. Retention was defined by the number of follow-up visits that a participant attended, the consistency of visit attendance, and attendance at the last visit. Participants were provided hemoglobin A1C, lipid panel, creatinine measurement, glomerular filtration rate (eGFR), blood pressure, and body mass index results and an incentive gift card were handed out to participants at each visit. RESULTS Four enrollees did not participate on any workday, thus analysis concentrated on the remaining 115 participants. The majority of participants (64%) completed the 32-month study, 78% completed at least 4 visits, and 55% completed all 5 visits. The statistically significant predictors of higher retention among this study were being older in age (p=0.02), Mexican nationality (p=0.004), working in ferneries (p=0.009), more years working in agriculture (p=0.02), and higher total cholesterol (p=0.02). Appreciation for the health tests was associated with greater participation at the final visit (p=0.01). CONCLUSION Retention in longitudinal studies is crucial to better understand kidney disease among agricultural workers, an understudied population. Participants reported valuing the access to health results, indicating that implementing point-of-care health screenings and providing the health results to each participant is a good retention strategy. There was some evidence that a participant living with or being related to a fellow co-participant could impact retention as they either showed up or missed visits together, suggesting recruiting from the same household may reduce retention.
Collapse
Affiliation(s)
- Ioana Albu
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Lisa Elon
- Rollins School of Public Health, Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, USA
| | - Nezahualcoyotl Xiuhtecutli
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
- Farmworker Association of Florida, Apopka, FL, USA
| | - Linda McCauley
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Roxana Chicas
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| |
Collapse
|
9
|
Freidin N, Hayes E, Struthers SA. Implications of climate change on acute kidney injury. Curr Opin Nephrol Hypertens 2024; 33:83-88. [PMID: 37678384 DOI: 10.1097/mnh.0000000000000926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
PURPOSE OF REVIEW Climate change is an active and growing threat to human health. This review examines the evidence linking climate change to kidney diseases, with a focus on acute kidney injury (AKI). RECENT FINDINGS A growing body of evidence documents the adverse impact of various environmental and occupational exposures on kidney health. Extreme heat exposure increases the risk for AKI in vulnerable populations, particularly outdoor workers. These effects are being seen in both developed and developing nations, impacting equatorial as well as more northern climates. Climate change is also increasing the risk of water-borne and vector-borne infections, which are important causes of AKI in tropical regions. Due to overlapping environmental and social risk factors, populations in low-income and middle-income countries are likely to be disproportionately affected by climate-related health impacts, including heightened risk for kidney diseases. SUMMARY Climate change will adversely impact global kidney health over the course of the century through effects on temperature and risk of endemic infections. Alongside efforts to aggressively reduce carbon emissions, additional research is needed to guide public and environmental health policies aimed at mitigating the impact of climate change on human health.
Collapse
Affiliation(s)
- Natalie Freidin
- Medical University of South Carolina, Charleston, South Carolina
| | - Eily Hayes
- Medical University of South Carolina, Charleston, South Carolina
| | | |
Collapse
|
10
|
Habibi P, Heydari A, Dehghan H, Moradi A, Moradi G. Climate Change and Occupational Heat Strain Among Women Workers: A Systematic Review. Indian J Occup Environ Med 2024; 28:4-17. [PMID: 38783874 PMCID: PMC11111142 DOI: 10.4103/ijoem.ijoem_320_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 01/08/2022] [Accepted: 02/05/2022] [Indexed: 05/25/2024] Open
Abstract
Climate change increases heat stress exposure and occupational heat strain in tropical and subtropical regions with generally hot-humid climate conditions. The present systematic review was conducted to assess the effect of climate change on occupational heat strain among women workers. In this study, three main databases (PubMed, Scopus, and Web of Science) were searched to find relevant literature on climate change and its effects using subject headings and appropriate MeSh terms. This article has been written according to the PRISMA checklist. A total of 6,176 studies were identified for screening and 13 studies were eligible for data extraction. Scientific evidence reveals that there is an imprecise but positive relationship between climate change and occupational heat strain regarding women workers. Some complications associated with occupational heat strain among women workers include fatigue, discomfort, dehydration, reduced brain function, and loss of concentration. Climate change can lead to an increase in the occurrence of heat-related illnesses and the levels of injury risk. In addition, its adverse health effects on women workers are mentioned. This systematic study identifies key priorities for action to better characterize and understand how occupational heat strain among women workers may be associated with climate change events. Strong evidence indicates that climate change will continue to cause occupational heat strain among women workers. It is essential to implement preventive measures considering multidisciplinary strategies to reduce the adverse effects of climate change on women workers health in hot weather settings. This can limit the health risks and negative effects of climate change.
Collapse
Affiliation(s)
- Peymaneh Habibi
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahad Heydari
- Department of Health in Disaster and Emergencies, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Habibollah Dehghan
- Department of Occupational Health Engineering, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amirhossein Moradi
- Safety and Risk Engineering, Faculty of Engineering and Applied Science, Memorial University of Newfoundland, St. John’s, NL, Canada
| | - Gholamreza Moradi
- Department of Occupational Health Engineering, School of Public Health, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
11
|
Neyra JS, Davis RE. The association between climate and emergency department visits for renal and urinary disease in Charlottesville, Virginia. ENVIRONMENTAL RESEARCH 2024; 240:117525. [PMID: 37898224 DOI: 10.1016/j.envres.2023.117525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 10/19/2023] [Accepted: 10/25/2023] [Indexed: 10/30/2023]
Abstract
Diseases of the kidney and urinary tract impose a significant portion of the total disease burden, and linkages to high temperature exposure suggest that this burden may increase in the near future. We examined the association between climate and daily emergency department (ED) visits for kidney and urinary disease at the University of Virginia main hospital in Charlottesville, Virginia from 2005 to 2020. Generalized additive models and distributed lag nonlinear models were used to examine these associations over a 21-day lag period. After testing a variety of weather variables from observations taken at the Charlottesville, Albemarle County Airport weather station, 1 p.m. temperature was found to have the strongest association with ED visits for renal and urinary visits while controlling for seasonal and trend factors, air quality, day of the week, and wintry weather. The relative risk of ED visits exhibited a stronger association with high temperatures compared to low temperatures. The heat response was pronounced at short lags (0-1 days) with the relative risk (RR) increasing when 1 p.m. temperatures exceeded 20°C and peaking at 29°C (RR = 1.28). By comparison, low temperatures (≤0°C) exhibited a negative association (RR = 0.80 at -10°C) at short lags (0-1 day), with evidence of a weak RR increase at lags of 2-3 and 9-14 days. These results for ED visitation are consistent with other studies linking high temperatures to acute kidney injury, chronic kidney disease, the development of kidney stones, and other associated illnesses. A better understanding of the impact of temperature extremes in generating or exacerbating existing conditions could assist medical health professionals in the prevention and management of these diseases during extreme weather events.
Collapse
Affiliation(s)
- Jesus S Neyra
- Department of Environmental Sciences, University of Virginia, Charlottesville, VA, United States.
| | - Robert E Davis
- Department of Environmental Sciences, University of Virginia, Charlottesville, VA, United States.
| |
Collapse
|
12
|
Lan R, Qin Y, Chen X, Hu J, Luo W, Shen Y, Li X, Mao L, Ye H, Wang Z. Risky working conditions and chronic kidney disease. J Occup Med Toxicol 2023; 18:26. [PMID: 37964292 PMCID: PMC10644450 DOI: 10.1186/s12995-023-00393-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 11/06/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Individuals in the workplace are exposed to various environments, tasks, and schedules. Previous studies have indicated a link between occupational exposures and an increased risk of chronic kidney disease (CKD). However, the social conditions of the work environment may also be a crucial contributing factor to CKD. Furthermore, individuals may encounter multiple occupational-related risk factors simultaneously, underscoring the importance of investigating the joint risk of different working conditions on CKD. METHODS A prospective analysis of 65,069 UK Biobank participants aged 40 to 69 years without CKD at baseline (2006-2010) was performed. A self-administered questionnaire assessed working conditions and a working conditions risk score were developed. Participants who answered "sometimes" or "often" exposure to occupational heat or occupational secondhand cigarette smoke; involved in shift work or heavy workloads ("usually" or "always"), were grouped as high-risk working conditions. Each working condition was scored as 1 if grouped as high-risk, and 0 if not. The working conditions risk score was equal to the sum of these four working conditions. Cox proportional hazard regression models were used to estimate the associations between working conditions and CKD incidence. RESULTS The mean follow-up time was 6.7 years. After adjusting for demographic, lifestyle, and working time factors, the hazard ratios for the development of CKD for heavy workloads, shift work, occupational secondhand cigarette smoke exposure, and occupational heat exposure were 1.24 (95%CI = 1.03, 1.51), 1.33 (95%CI = 1.10, 1.62), 1.13 (95%CI = 1.01, 1.26), 1.11 (95%CI = 0.99, 1.24), respectively. The risk of CKD was found to be significantly associated with an increasing working conditions risk score. Individuals with a working conditions risk score of 4 had an 88.0% (95% CI = 1.05, 3.35) higher risk of developing CKD when compared to those with a working conditions risk score of 0. CONCLUSIONS Adverse working conditions, particularly when considered in combination, can significantly elevate the risk of chronic kidney disease (CKD). These results provide a reference for implementing measures to prevent CKD.
Collapse
Affiliation(s)
- Rui Lan
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Street, Yuzhong District, Chongqing, 400016, China
| | - Yao Qin
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Street, Yuzhong District, Chongqing, 400016, China
| | - Xiangjun Chen
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Street, Yuzhong District, Chongqing, 400016, China
| | - Jinbo Hu
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Street, Yuzhong District, Chongqing, 400016, China
| | - Wenjin Luo
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Street, Yuzhong District, Chongqing, 400016, China
| | - Yan Shen
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Street, Yuzhong District, Chongqing, 400016, China
| | - Xue Li
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Street, Yuzhong District, Chongqing, 400016, China
| | - Lina Mao
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Street, Yuzhong District, Chongqing, 400016, China
| | - Hanwen Ye
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Street, Yuzhong District, Chongqing, 400016, China
| | - Zhihong Wang
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Street, Yuzhong District, Chongqing, 400016, China.
| |
Collapse
|
13
|
Chicas RC, Wang Y, Jennifer Weil E, Elon L, Xiuhtecutli N, C Houser M, Jones DP, M Sands J, Hertzberg V, McCauley L, Liang D. The impact of heat exposures on biomarkers of AKI and plasma metabolome among agricultural and non-agricultural workers. ENVIRONMENT INTERNATIONAL 2023; 180:108206. [PMID: 37734144 PMCID: PMC10637212 DOI: 10.1016/j.envint.2023.108206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/22/2023] [Accepted: 09/11/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND Agricultural workers are consistently exposed to elevated heat exposures and vulnerable to acute kidney injury. The underlying pathophysiology and detailed molecular mechanisms of AKI among agricultural workers, and the disproportionate burden of HRI and heat stress exposure are not well understood, especially at the level of cellular metabolism. OBJECTIVE The aim of this study was to examine the impact of heat exposures on renal biomarkers and on the human metabolome via untargeted high-resolution metabolomics among agricultural and non-agricultural workers. METHODS Blood and urine samples were collected pre- and post-work shift from 63 agricultural workers and 27 non- agricultural workers. We evaluated pre- and post-work shift renal biomarkers and completed untargeted metabolomics using high-resolution mass spectrometry with liquid chromatography. Metabolome-wide association studies (MWAS) models identified the metabolic features differentially expressed between agricultural workers and non-agricultural workers. RESULTS Median values of pre-shift creatinine and osteopontin (p < 0.05) were higher for agricultural workers than non-agricultural workers. Metabolic pathway enrichment analyses revealed 27 diverse pathways differed between agricultural workers and non-agricultural workers (p < 0.05) including TCA cycle and urea cycle, carbohydrate metabolism, histidine metabolism and evidence for altered microbiome shikimate pathway. CONCLUSION This is the first investigation on the metabolic pathways that are affected among agricultural workers who are exposed to heat compared to non-heat exposed workers. This study shows extensive responses of central metabolic systems to heat exposures that impact human health.
Collapse
Affiliation(s)
- Roxana C Chicas
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA.
| | - Yilin Wang
- Rollins School of Public Health, Gangarosa Department of Environmental Health, Emory University, Atlanta, GA, USA.
| | - E Jennifer Weil
- Division of Renal Medicine, Department of Medicine, Emory University, Atlanta, GA, USA.
| | - Lisa Elon
- Rollins School of Public Health, Gangarosa Department of Environmental Health, Emory University, Atlanta, GA, USA.
| | - Nezahualcoyotl Xiuhtecutli
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA; Farmworker Association of Florida, Apopka, FL, USA.
| | - Madelyn C Houser
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA.
| | - Dean P Jones
- Department of Medicine, Emory University, Atlanta, GA, USA.
| | - Jeff M Sands
- Division of Renal Medicine, Department of Medicine, Emory University, Atlanta, GA, USA.
| | - Vicki Hertzberg
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA.
| | - Linda McCauley
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA.
| | - Donghai Liang
- Rollins School of Public Health, Gangarosa Department of Environmental Health, Emory University, Atlanta, GA, USA.
| |
Collapse
|
14
|
Suarez JJ, Elon L, Rangel-Rodriguez A, Xiuhtecutli N, Houser MC, Hertzberg V, McCauley L, Sands JM, Chicas RC. A Pilot Study Examining the Use of Ultrasound to Measure Intravascular Volume Status in Agricultural Workers in a Field-Based Research Setting. J Occup Environ Med 2023; 65:685-688. [PMID: 37167934 PMCID: PMC10524425 DOI: 10.1097/jom.0000000000002880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
OBJECTIVE The aim of this pilot study was to explore if internal jugular vein (IJV) ultrasound studies on agricultural workers in a field-based research setting could assess volume status during a hydration intervention. METHODS We performed pre- and post-work shift IJV ultrasound images on 30 agricultural workers. The IJV collapsibility index values were <39% (euvolemic) or ≥39% (hypovolemic). RESULTS Of the water group, 13% (2/15) had an IJV collapsibility index ≥39%, and this increased to 19% (3/16) by the end of the work shifts. The electrolyte group did not have any workers start the work shift with an IJV collapsibility index ≥39%; however, at the postshift assessment, 15% (2/13) were hypovolemic. CONCLUSION Internal jugular vein ultrasounds may have the potential to be a useful tool to determine volume status in field-based research settings. Further investigation is needed to confirm these findings.
Collapse
Affiliation(s)
- Jonathan J Suarez
- From the Division of Renal Medicine, Department of Medicine, Emory University, Atlanta, Georgia (J.J.S., J.M.S.); Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia (L.E.); Rollins School of Public Health, Emory University, Atlanta, Georgia (A.R.R.); Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia (N.X.); and Farmworker Association of Florida, Apopka, Florida (N.X., M.C.H., V.H., L.M.C., R.C.C.)
| | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Venugopal V, Lennqvist R, Latha PK, Shanmugam R, Krishnamoorthy M, Selvaraj N, Balakrishnan R, Omprashant R, Purty AJ, Bazroy J, Glaser J, Jakobsson K. Occupational Heat Stress and Kidney Health in Salt Pan Workers. Kidney Int Rep 2023; 8:1363-1372. [PMID: 37441492 PMCID: PMC10334398 DOI: 10.1016/j.ekir.2023.04.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 04/08/2023] [Accepted: 04/10/2023] [Indexed: 07/15/2023] Open
Abstract
Introduction Work in heat affects millions of workers. Although kidney function in agricultural workers is increasingly researched, nonagricultural studies are scarce. In coastal salt pans, the absence of occupational exposures to pesticides and other toxicants allows assessment of heat stress alone. Methods Seven Indian salt pans were surveyed from 2017 to 2020. Job-specific workload was assessed. Heat stress was characterized as exceeding the wet bulb globe temperature (WBGT)-threshold limit value (TLV) for high and moderate workloads. Preshift and postshift heart rates (HRs), tympanic temperatures, and urine specific gravity (USG) were measured for 352 workers, as were sweat rates (SwR), serum creatinine (SCr), serum uric acid, and urine dipstick. Estimated glomerular filtration rate (eGFR; ml/min per 1.73 m2) was computed. Heat-strain symptoms were assessed using questionnaires. Results The mean WBGT was 30.5 ± 1.3 °C (summer) and 27.8 ± 1.9 °C (winter). Water intake during the workday was low, median was one Litre, and most workers (87%) exceeded the TLV for heat stress. Dehydration-related symptoms were frequent in those with high-heat stress, as were cross-shift increases in temperature (≥1°C; 15%), a high USG (≥1.020; 28%), and a high SwR (≥1 l/h; 53%). An eGFR of 60 to 89 ml/min per 1.73 m2 was observed in 41% of all workers examined, and 7% had eGFR below 60 ml/min per 1.73 m2. The odds ratio for eGFR <90 ml/min per 1.73 m2 in workers exceeding the TLV, compared to workers below this limit, adjusted for age and gender was 2.9 (95% CI: 1.3-6.4). Conclusion Workplace interventions to prevent heat stress and dehydration in the salt pans and other at-risk industries are urgently required. The findings strengthen the notion that high-heat stress and limited hydration is a risk factor for kidney dysfunction.
Collapse
Affiliation(s)
- Vidhya Venugopal
- Department of Environmental Health Engineering, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Robin Lennqvist
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - PK Latha
- Department of Environmental Health Engineering, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Rekha Shanmugam
- Department of Environmental Health Engineering, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Manikandan Krishnamoorthy
- Department of Environmental Health Engineering, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Nandhini Selvaraj
- Department of Environmental Health Engineering, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Rajagurusamy Balakrishnan
- Department of Environmental Health Engineering, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - R. Omprashant
- Department of Environmental Health Engineering, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Anil Jacob Purty
- Department of Community Medicine, Pondicherry Institute of Medical Sciences, Puducherry, India
| | - Joy Bazroy
- Department of Community Medicine, Pondicherry Institute of Medical Sciences, Puducherry, India
| | | | - Kristina Jakobsson
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- La Isla Network, Washington, USA
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| |
Collapse
|
16
|
Langer CE, Armitage TL, Beckman S, Tancredi DJ, Mitchell DC, Schenker MB. How Does Environmental Temperature Affect Farmworkers' Work Rates in the California Heat Illness Prevention Study? J Occup Environ Med 2023; 65:e458-e464. [PMID: 37026741 PMCID: PMC10332655 DOI: 10.1097/jom.0000000000002853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Abstract
OBJECTIVE Estimate the association between environmental temperature (wet bulb globe temperature [WBGT]) and work rate over the course of a workday. METHODS Repeated-measures regression was used to identify characteristics impacting work rate in a cross-sectional study of Latino farmworkers. Minute-by-minute work rate (measured by accelerometer) and WBGT were averaged over 15-minute intervals. RESULTS Work rate decreased by 4.34 (95% confidence interval [CI], -7.09 to -1.59) counts per minute per degree Celsius WBGT in the previous 15-minute interval. Cumulative quarter hours worked (2.13; 95% CI, 0.82 to 3.45), age (-3.64; 95% CI, -4.50 to -2.79), and dehydration at the end of workday (51.37; 95% CI, 19.24 to 83.50) were associated with counts per minute as were gender, pay type (piece rate vs hourly) and body mass index ≥25 kg/m 2 . The effects of pay type and body mass index were modified by gender. CONCLUSION Increased temperature was associated with a decrease in work rate.
Collapse
|
17
|
Petropoulos ZE, Keogh SA, Jarquín E, López-Pilarte D, Amador Velázquez JJ, García-Trabanino R, Amador Sánchez MR, Guevara R, Gruener A, Allen DR, Leibler JH, Delgado IS, McClean MD, Friedman DJ, Brooks DR, Scammell MK. Heat stress and heat strain among outdoor workers in El Salvador and Nicaragua. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2023; 33:622-630. [PMID: 37041408 PMCID: PMC10403352 DOI: 10.1038/s41370-023-00537-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 03/02/2023] [Accepted: 03/13/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND There is growing attention on occupational heat stress in Central America, as workers in this region are affected by a unique form of chronic kidney disease. Previous studies have examined wet bulb globe temperatures and estimated metabolic rates to assess heat stress, but there are limited data characterizing heat strain among these workers. OBJECTIVE The aims were to characterize heat stress and heat strain and examine whether job task, break duration, hydration practices, and kidney function were associated with heat strain. METHODS We used data from the MesoAmerican Nephropathy Occupational Study, a cohort of 569 outdoor workers in El Salvador and Nicaragua who underwent workplace exposure monitoring, including continuous measurement of core body temperature (Tc), heart rate (HR), physical activity, and wet bulb globe temperature (WBGT), over the course of three days in January 2018 - May 2018. Participants represented five industries: sugarcane, corn, plantain, brickmaking, and construction. RESULTS Median WBGTs were relatively high (>27 °C) at most sites, particularly when work shifts spanned the afternoon hours (e.g., 29.2 °C among plantain workers). Sugarcane workers, especially cane cutters in both countries and Nicaraguan agrichemical applicators, had the highest estimated metabolic rates (medians: 299-318 kcal/hr). Most workers spent little time on break (<10% of the shift), as determined by physical activity data. Overall, sugarcane workers-particularly those in Nicaragua-experienced the highest Tc and HR values. However, a few workers in other industries reached high Tc (>39 °C) as well. Impaired kidney function (estimated glomerular filtration rate <90 mL/min/1.73 m2) was associated with higher Tc and HR values, even after adjustment. SIGNIFICANCE This is the largest study to-date examining heat stress and strain among outdoor workers in Central America. Workers at sugar companies regularly experienced Tc > 38°C (76.9% of monitored person-days at Nicaraguan companies; 46.5% at Salvadoran companies). Workers with impaired kidney function had higher measures of Tc and HR. IMPACT STATEMENT This study examined levels of occupational heat stress and heat strain experienced among outdoor workers in five industries in El Salvador and Nicaragua. We characterized heat stress using wet bulb globe temperatures and estimated metabolic rate and heat strain using core body temperature and heart rate. Sugarcane workers, particularly cane cutters and Nicaraguan agrichemical applicators, performed more strenuous work and experienced greater levels of heat strain. Impaired kidney function was associated with higher heart rates and core body temperatures.
Collapse
Affiliation(s)
- Zoe E Petropoulos
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA.
| | - Sinead A Keogh
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Emmanuel Jarquín
- Agencia para el Desarrollo y la Salud Agropecuaria (AGDYSA), San Salvador, El Salvador
| | - Damaris López-Pilarte
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | | | - Ramón García-Trabanino
- Agencia para el Desarrollo y la Salud Agropecuaria (AGDYSA), San Salvador, El Salvador
- Centro de Hemodiálisis, San Salvador, El Salvador
- Emergency Social Fund for Health, Tierra Blanca, El Salvador
| | | | - Raúl Guevara
- Agencia para el Desarrollo y la Salud Agropecuaria (AGDYSA), San Salvador, El Salvador
| | - Alexa Gruener
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Dustin R Allen
- Department of Health Sciences, Boston University College of Health and Rehabilitation Sciences, Boston, MA, USA
| | - Jessica H Leibler
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Iris S Delgado
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Michael D McClean
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - David J Friedman
- Division of Nephrology, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Daniel R Brooks
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Madeleine K Scammell
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| |
Collapse
|
18
|
Geladari E, Vallianou N, Geladari C, Aronis K, Vlachos K, Andreadis E, Theocharopoulos I, Dourakis S. "Failing kidneys in a failing planet; CKD of unknown origin". REVIEWS ON ENVIRONMENTAL HEALTH 2023; 38:125-135. [PMID: 34881546 DOI: 10.1515/reveh-2021-0109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 11/22/2021] [Indexed: 06/13/2023]
Abstract
The 'alarm clock' for human beings in the era of climate medicine has rung. Original diseases have appeared, that could not be explained and attributed to common causes, which are suggested to be linked to global warming and environmental factors. Such an indolent disease is the chronic kidney disease of unknown cause (CKDu), introduced also as Mesoamerican or Uddanam nephropathy. Scientists equate the climate impact on kidneys with the canary in the coal mine; coal miners used to carry caged canaries with them, so that if poisonous gases, such as methane or carbon monoxide leaked into the mine-shaft, the gases would kill the canary before killing the miners; similarly, kidneys are injured before devastating and lethal complications occur in humans. In some regions of Central America, the deaths due to chronic kidney disease increased by 177% with a death toll being as high as over 20,000. It was first documented in animals that periodic heat and dehydration have a major role in causing chronic kidney disease. Based on that observation, it is advocated that young male agricultural workers in Central America and South Asia, develop renal disease by getting exposed to extreme heat repeatedly. The clinico-pathological characteristics of this type of kidney injury, do not belong to an existing classification, even though a form of tubulo-interstitial renal disease has been proposed. In this review, we will discuss about CKDu, its epidemiology and pathophysiological mechanisms, clinical presentation and diagnostic biomarkers and examine potential therapeutic options.
Collapse
Affiliation(s)
- Eleni Geladari
- National and Kapodistrian University of Athens, Athens, Attica, Greece
| | | | | | | | | | | | | | - Spyros Dourakis
- National and Kapodistrian University of Athens, Athens, Attica, Greece
| |
Collapse
|
19
|
Lucas RAI, Skinner BD, Arias-Monge E, Jakobsson K, Wesseling C, Weiss I, Poveda S, Cerda-Granados FI, Glaser J, Hansson E, Wegman DH. Targeting workload to ameliorate risk of heat stress in industrial sugarcane workers. Scand J Work Environ Health 2023; 49:43-52. [PMID: 36209512 PMCID: PMC10549916 DOI: 10.5271/sjweh.4057] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE The aim of this study was to quantify the physiological workload of manual laborers in industrial sugarcane and assess the effect of receiving a rest, shade, and hydration intervention to reduce heat stress exposure risk. METHODS In an observational study, physiological workload was evaluated for burned cane cutters (BCC), seed cutters (SC) and drip irrigation repair workers (DIRW) using heart rate (HR) recorded continuously (Polar®) across a work shift. Workers' percentage of maximal HR (%HRmax), time spent in different HR zones, and estimated core temperature (ECTemp) were calculated. The effect of increasing rest across two harvests was evaluated for BCC and SC. RESULTS A total of 162 workers participated in this study [52 BCC (all male), 71 SC (13 female) and 39 DIRW (16 female)]. Average %HRmax across a work shift was similar between BCC and SC (BCC: 58%, SC: 59%), but lower in DIRW (51%). BCC and SC spent similar proportions of work shifts at hard/very hard intensities (BCC: 13%, SC: 15%), versus DIRW who worked mostly at light (46%) or light-moderate (39%) intensities. SC maximum ECTemp reached 38.2°C, BCC 38.1°C; while DIRW only reached 37.7°C. Females performed at a higher %HRmax than males across work shifts (SC 64% versus 58%; DIRW 55% versus 49%). An additional rest period was associated with a lower average %HRmax across a work shift in BCC. CONCLUSION In this setting, BCC and SC both undertake very physiologically demanding work. Females maintained a higher workload than male co-workers. Regulated rest periods each hour, with water and shade access, appears to reduce physiological workload/strain.
Collapse
Affiliation(s)
- Rebekah A I Lucas
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Siqueira VB, Carvalho FM. Presenteeism among fruit farm workers in Northeast Brazil: cross-sectional study. INDUSTRIAL HEALTH 2022; 60:525-534. [PMID: 34866096 PMCID: PMC9726604 DOI: 10.2486/indhealth.2021-0105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 11/21/2021] [Indexed: 06/13/2023]
Abstract
The scientific literature about presenteeism among farm workers is scarce. This study estimated the prevalence of and factors associated with presenteeism among paid fruit farm workers. A cross-sectional study investigated 340 paid employees of both sexes, aged 18 years or above, who worked during the 2019 irrigated fruit harvest in the municipality of Petrolina, Northeast Brazil. Information about sociodemographic characteristics, lifestyle, general health status, occupational characteristics, interpersonal work aspects, and the work environment's structural characteristics was collected in a structured questionnaire. Presenteeism was established when participants reported working one or more days during the previous season despite feeling ill or when injured. Cox regression was used to estimate prevalence ratios adjusted by sex, area of residence (urban or rural), employment contract (permanent or seasonal), satisfaction with management, participation in workplace decision-making, availability of on-site healthcare facilities, and on-site availability of sunscreen. The prevalence of presenteeism during the previous season was high: 58.2%. In the final multivariate model, the adjusted prevalence ratio was higher (≥1.20) among female workers (1.42), workers dissatisfied with management (1.28), and those for whom sunscreen was not available on site (1.61). The prevalence of presenteeism was high and associated with personal, work organizational, and workplace resources characteristics.
Collapse
Affiliation(s)
- Vitória B Siqueira
- Collegiate of Nursing, Federal University of Vale do São Francisco, Brazil
- State University of Feira de Santana, Brazil
| | - Fernando M Carvalho
- Department of Social and Preventive Medicine, Federal University of Bahia, Brazil
| |
Collapse
|
21
|
Aoun M, Chelala D. Where do you live and what do you do? Two questions that might impact your kidney health. FRONTIERS IN NEPHROLOGY 2022; 2:1011964. [PMID: 37675017 PMCID: PMC10479685 DOI: 10.3389/fneph.2022.1011964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 09/13/2022] [Indexed: 09/08/2023]
Abstract
In many cases the social determinants of health need to be assessed through their interaction with environmental factors. This review looks at the impact of physical location and occupation of individuals on their kidney health. It examines the effect of living at high altitude on kidney function and the relationship between extreme cold or hot temperatures and the incidence of kidney injury. It reviews as well the many occupations that have been linked to kidney disease in high-income and low-and-middle-income countries. As a conclusion, this overview proposes preventive recommendations that could be individualized based on weather, altitude, socio-economic level of the country and occupation of the individual.
Collapse
Affiliation(s)
- Mabel Aoun
- Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
| | | |
Collapse
|
22
|
Chicas RC, Elon L, Houser MC, Mutic A, Gallegos EI, Smith DJ, Modly L, Xiuhtecutli N, Hertzberg VS, Flocks J, Sands JM, McCauley L. The Health Status of Hispanic Agricultural Workers in Georgia and Florida. J Immigr Minor Health 2022; 24:1129-1136. [PMID: 34988908 PMCID: PMC10479758 DOI: 10.1007/s10903-021-01326-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2021] [Indexed: 12/28/2022]
Abstract
To examine the health status of Hispanic agricultural workers in Florida and Georgia. Health data from agricultural workers in the Farm Worker Family Health Program (June 2019) and research studies in Florida (May 2015 and May 2019) were examined. Data from 728 agricultural workers were collected through sociodemographic questionnaire and clinical data. In the Florida sample, 83% were overweight or obese, 70% elevated blood pressure, 60% met the definition of prediabetes. In Georgia, 64% were overweight or obese and 67% had elevated blood pressure. Weak correlations were observed between BMI and systolic blood pressure (unadjusted r = 0.20), diastolic blood pressure (unadjusted r = 0.19), and glucose (unadjusted r = 0.14). Adjusting for age and gender did not show statistically significant correlation between BMI and systolic and diastolic blood pressure or glucose. While BMI has been shown to be strongly associated with high blood pressure and impaired glucose, we found a weak correlation among agricultural workers. Given the common and high use of pesticides and elevated rates of hypertension, impaired glucose, and adiposity in agricultural workers, the public health impact of this relationship may require and lead to occupational reform that protects the health of agricultural workers. Future studies should assess occupational and environmental factors and lifestyle differences between agricultural workers and the general population to better understand these discrepancies in health status.
Collapse
Affiliation(s)
- Roxana C Chicas
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, Atlanta, GA, USA.
- Renal Division, Department of Medicine, School of Medicine, Emory University, Atlanta, GA, USA.
| | - Lisa Elon
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Madelyn C Houser
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, Atlanta, GA, USA
| | - Abby Mutic
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, Atlanta, GA, USA
| | | | - Daniel J Smith
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, Atlanta, GA, USA
| | - Lori Modly
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, Atlanta, GA, USA
| | | | - Vicki S Hertzberg
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, Atlanta, GA, USA
| | - Joan Flocks
- Levin College of Law, University of Florida, Gainesville, GL, USA
| | - Jeff M Sands
- Renal Division, Department of Medicine, School of Medicine, Emory University, Atlanta, GA, USA
| | - Linda McCauley
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, Atlanta, GA, USA
| |
Collapse
|
23
|
Flunker JC, Zuidema C, Jung J, Kasner E, Cohen M, Seto E, Austin E, Spector JT. Potential Impacts of Different Occupational Outdoor Heat Exposure Thresholds among Washington State Crop and Construction Workers and Implications for Other Jurisdictions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11583. [PMID: 36141863 PMCID: PMC9517246 DOI: 10.3390/ijerph191811583] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 09/05/2022] [Accepted: 09/08/2022] [Indexed: 06/10/2023]
Abstract
Occupational heat exposure is associated with substantial morbidity and mortality among outdoor workers. We sought to descriptively evaluate spatiotemporal variability in heat threshold exceedances and describe potential impacts of these exposures for crop and construction workers. We also present general considerations for approaching heat policy-relevant analyses. We analyzed county-level 2011-2020 monthly employment (Bureau of Labor Statistics Quarterly Census of Employment and Wages) and environmental exposure (Parameter-elevation Relationships on Independent Slopes Model (PRISM)) data for Washington State (WA), USA, crop (North American Industry Classification System (NAICS) 111 and 1151) and construction (NAICS 23) sectors. Days exceeding maximum daily temperature thresholds, averaged per county, were linked with employment estimates to generate employment days of exceedances. We found spatiotemporal variability in WA temperature threshold exceedances and crop and construction employment. Maximum temperature exceedances peaked in July and August and were most numerous in Central WA counties. Counties with high employment and/or high numbers of threshold exceedance days, led by Yakima and King Counties, experienced the greatest total employment days of exceedances. Crop employment contributed to the largest proportion of total state-wide employment days of exceedances with Central WA counties experiencing the greatest potential workforce burden of exposure. Considerations from this analysis can help inform decision-making regarding thresholds, timing of provisions for heat rules, and tailoring of best practices in different industries and areas.
Collapse
Affiliation(s)
- John C. Flunker
- Department of Environmental and Occupational Health Sciences, Hans Rosling Center for Population Health, University of Washington, Seattle, WA 98195, USA
| | - Christopher Zuidema
- Department of Environmental and Occupational Health Sciences, Hans Rosling Center for Population Health, University of Washington, Seattle, WA 98195, USA
| | - Jihoon Jung
- Department of Environmental and Occupational Health Sciences, Hans Rosling Center for Population Health, University of Washington, Seattle, WA 98195, USA
| | - Edward Kasner
- Department of Environmental and Occupational Health Sciences, Hans Rosling Center for Population Health, University of Washington, Seattle, WA 98195, USA
| | - Martin Cohen
- Department of Environmental and Occupational Health Sciences, Hans Rosling Center for Population Health, University of Washington, Seattle, WA 98195, USA
| | - Edmund Seto
- Department of Environmental and Occupational Health Sciences, Hans Rosling Center for Population Health, University of Washington, Seattle, WA 98195, USA
| | - Elena Austin
- Department of Environmental and Occupational Health Sciences, Hans Rosling Center for Population Health, University of Washington, Seattle, WA 98195, USA
| | - June T. Spector
- Department of Environmental and Occupational Health Sciences, Hans Rosling Center for Population Health, University of Washington, Seattle, WA 98195, USA
- Safety & Health Assessment and Research for Prevention (SHARP) Program, Washington State Department of Labor and Industries, Olympia, WA 98504, USA
| |
Collapse
|
24
|
Al-Bouwarthan M, AlMulla AA, Yaseen M. The impact of heat on kidney health: A PRISMA-compliant bibliometric analysis. Medicine (Baltimore) 2022; 101:e30328. [PMID: 36086778 PMCID: PMC10980493 DOI: 10.1097/md.0000000000030328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 07/19/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Exposure to excessive heat can impact kidney health. Climate change is projected to aggravate this impact. An analysis of articles published between 1958 and 2021 was conducted to explore the progress of the research on this issue. METHODS This study included a bibliometric analysis wherein Web of Science was used to generate a list of all published articles related to the impact of heat on kidney health. Basic information about the articles, such as titles, authors' names, keywords, and citations, were recorded and analyzed. RESULTS A total of 226 published articles related to the impact of heat on kidney health were identified as of November 20, 2021. Most of these articles (93%) were published within the last decade. The United States was the most prominent country in terms of research productivity and collaboration. Researchers from the United States were well represented among the top 20 contributors of published articles on the study issue. The productivity of the top 20 authors varied between 6 and 32 articles each. A total of 25 common words used by the authors were identified. The most frequently used keywords were chronic kidney disease, heat stress, acute kidney injury, Mesoamerican nephropathy, and climate change. Keyword analysis revealed 3 distinct major research clusters in the existing scientific research on the impact of heat on kidney health: chronic kidney disease of unknown etiology, heat stress and renal physiology, and the effect of climate change on kidney health. CONCLUSIONS Research on heat-related kidney injury has witnessed rapid development in recent decades, motivated by the emergence of chronic kidney disease of unknown etiology and climate change. Developing countries in hot regions must increase their productivity in this research area through international collaboration and partnerships.
Collapse
Affiliation(s)
- Mohammed Al-Bouwarthan
- Department of Environmental Health, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Abdulaziz A. AlMulla
- Department of Environmental Health, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Muhammad Yaseen
- Faculty of Sciences, Department of Mathematics and Statistics, University of Agriculture, Faisalabad, Pakistan
| |
Collapse
|
25
|
Mizelle E, Larson KL, Bolin LP, Kearney GD. Fluid Intake and Hydration Status Among North Carolina Farmworkers: A Mixed Methods Study. Workplace Health Saf 2022; 70:532-541. [PMID: 36002982 DOI: 10.1177/21650799221117273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Agricultural workers are disproportionately at risk for heat-related morbidity and mortality. The purpose of this study was to explore how sociocultural and occupational factors, and environmental heat stress influenced fluid intake and hydration status among Latino farmworkers working in eastern North Carolina. METHODS A community-informed, mixed methods research study was conducted in partnership with staff at a federally qualified health center. In summer 2020, we recruited Latino farmworkers at migrant camps. Twenty-eight male, migrant farmworkers participated in focus group discussions and 30 completed surveys and provided urine specimens. Wet bulb globe temperatures were measured in fields where workers labored. Content analysis and parametric analyses were performed. Data integration was completed using a meta-matrix. RESULTS Prior to work, 46.7% of farmworkers' urine specific gravity measurements indicated dehydration, which increased to 100% after work. The farmworkers spent between 2 and 7.5 hours of their day working in conditions above the recommended limits for workplace heat exposure. Farmworkers described exposure to extreme heat and inconsistent occupational policy compliance. Farmworkers expressed the opportunity to drink water but accessibility and poor water quality limited hydration. The integrated data supported congruent findings of extreme heat, few work breaks, and substandard housing. CONCLUSION/APPLICATION TO PRACTICE Farmworkers are dehydrated at work, placing them at higher risk for heat-related illness (HRI). By engaging with agricultural stakeholders, occupational health nurses can combine efforts and advocate for effective health and safety work policies to reduce HRIs and deaths among farmworkers. Legislation stipulating cooling and hydration practices would support safer work environments.
Collapse
|
26
|
The effect of interval and continuous work on markers of acute kidney injury in a hot environment. Eur J Appl Physiol 2022; 122:2437-2450. [PMID: 35999474 DOI: 10.1007/s00421-022-05030-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 07/15/2022] [Indexed: 12/26/2022]
Abstract
PURPOSE To examine the effect of high-intensity interval work (HIIW) and moderate-intensity continuous work (MICW) on markers of acute kidney injury (AKI) and kidney function in a hot environment. METHODS Nine males completed 2 h of work (2 × 60 min with 10 min passive rest) in a hot environment (40 °C and 15% relative humidity) as either HIIW [2 min at 80% peak oxygen consumption (VO2peak) and 3 min at 30% VO2peak] or MICW (matched for total work of HIIW). Blood and urine samples were collected immediately before (Pre), after (Post), 1 h (1 h Post), and 24 h after (24 h Post) the trials. Urine flow rate (UFR), creatinine clearance, insulin-like growth factor binding protein 7 (IGFBP7), urinary neutrophil gelatinase-associated lipocalin (uNGAL), and urinary kidney injury marker 1 (uKIM-1) were measured to assess kidney function and injury. RESULTS Log IGFBP7 (p < 0.01), log uNGAL (p < 0.01), and log uKIM-1 (p = 0.01) all displayed a main effect for time after both HIIW and MICW. IGFBP7 (p = 0.01) and uKIM-1 (p < 0.01), corrected for Uosm, were higher after HIIW compared to MICW at Post, while IGFBP7 was also higher 1 h Post after HIIW compared to MICW (p = 0.02). UFR significantly decreasing from Pre to Post (p < 0.01) and 1 h Post (p < 0.01), but no main effect for condition (p = 0.53). CONCLUSION Both HIIW and MICW in a hot environment caused an increase in biomarkers of kidney injury (IGFBP7, KIM-1, and NGAL), but HIIW may have a greater impact on biomarkers related to AKI.
Collapse
|
27
|
Mizelle E, Larson K, Doherty C. Understanding Farmworker Fluid Intake Using Intersectionality Theory. New Solut 2022; 32:19-29. [PMID: 35229666 DOI: 10.1177/10482911221078964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In the United States, Latino farmworkers are disproportionately at risk for death from heat-related illnesses. To elicit Latino farmworker perceptions on their fluid intake and heat stress, a qualitative descriptive, community-informed research study was conducted in eastern North Carolina. A total of 28 Mexican farmworkers participated in one of 4 focus groups. Using content analysis and guided by Intersectionality theory, themes and subthemes were identified. The first theme was Absence of Protection, represented by 2 subthemes: (1a) Intense Climate Considerations; and (1b) Workplace Exploitation. The second theme, Freedom to Drink, included 2 subthemes: (2a) Distance and Distaste; and (2b) Culture of Farm Work. Farmworkers perceived extreme outdoor temperatures as the greatest workplace barrier to staying hydrated and reported water accessibility and quality issues. Farmworker fluid intake was influenced by interlocking social categories and power systems. Policy recommendations that prevent farmworker heat-related illness and promote hydration are discussed.
Collapse
Affiliation(s)
- Elizabeth Mizelle
- Department of Baccalaureate Education, College of Nursing, 3627East Carolina University, Greenville, NC, USA
| | - Kim Larson
- Department of Nursing Science, College of Nursing, 3627East Carolina University, Greenville, NC, USA
| | | |
Collapse
|
28
|
Chicas R, Suarez J, Elon L, Xiuhtecutli N, House MC, Berra L, Sands JM, Hertzberg V, McCauley L. Hydration Interventions Among Agricultural Workers: A Pilot Study. J Occup Environ Med 2022; 64:e357-e359. [PMID: 35260538 PMCID: PMC10499402 DOI: 10.1097/jom.0000000000002531] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To estimate the impact of hydration interventions on postworkday hydration status and incidence of acute kidney injury (AKI). METHODS Thirty agricultural workers were first monitored on a workday without any interventions. On the intervention workday, the same workers were randomized to one of two groups: 169 ounces (oz) (5 L) of plain water (n = 16) or 169 oz (5L) of water with electrolytes (n = 14). RESULTS No participants in the electrolyte group had an estimate glomerular filtration rate (eGFR) at the end of the workday of less than 90 mL/min/1.73 m2 or met the criteria for AKI in comparison to the water group (eGFR < 90: 15%; AKI: 23%) or the control group (eGFR < 90: 28%; AKI: 18%). CONCLUSION The study showed that drinking water with electrolytes may lower the risk for development of AKI among agricultural workers.
Collapse
Affiliation(s)
- Roxana Chicas
- Nell Hodgson Woodruff School of Nursing (Dr Chicas, Dr Houser, Dr Hertzberg, Dr McCauley); Division of Renal Medicine, Department of Medicine (Dr Suarez, Dr Sands); Rollins School of Public Health (Ms Elon, Ms Berra), Emory University, Atlanta, Georgia; Anthropology Department, Tulane University, New Orleans, Louisiana (Mr Xiuhtecutli); and Farmworker Association of Florida, Apopka, Florida (Mr Xiuhtecutli)
| | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Zuidema C, Austin E, Cohen MA, Kasner E, Liu L, Busch Isaksen T, Lin KY, Spector J, Seto E. Potential impacts of Washington State's wildfire worker protection rule on construction workers. Ann Work Expo Health 2022; 66:419-432. [PMID: 34935028 PMCID: PMC9030230 DOI: 10.1093/annweh/wxab115] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 11/19/2021] [Accepted: 11/26/2021] [Indexed: 12/04/2022] Open
Abstract
Driven by climate change, wildfires are increasing in frequency, duration, and intensity across the Western United States. Outdoor workers are being exposed to increasing wildfire-related particulate matter and smoke. Recognizing this emerging risk, Washington adopted an emergency rule and is presently engaged in creating a permanent rule to protect outdoor workers from wildfire smoke exposure. While there are growing bodies of literature on the exposure to and health effects of wildfire smoke in the general public and wildland firefighters, there is a gap in knowledge about wildfire smoke exposure among outdoor workers generally and construction workers specifically-a large category of outdoor workers in Washington totaling 200,000 people. Several data sources were linked in this study-including state-collected employment data and national ambient air quality data-to gain insight into the risk of PM2.5 exposure among construction workers and evaluate the impacts of different air quality thresholds that would have triggered a new Washington emergency wildfire smoke rule aimed at protecting workers from high PM2.5 exposure. Results indicate the number of poor air quality days has increased in August and September in recent years. Over the last decade, these months with the greatest potential for particulate matter exposure coincided with an annual peak in construction employment that was typically 9.4-42.7% larger across Washington counties (one county was 75.8%). Lastly, the 'encouraged' threshold of the Washington emergency rule (20.5 μg m-3) would have resulted in 5.5 times more days subject to the wildfire rule on average across all Washington counties compared to its 'required' threshold (55.5 μg m-3), and in 2020, the rule could have created demand for 1.35 million N-95 filtering facepiece respirators among construction workers. These results have important implications for both employers and policy makers as rules are developed. The potential policy implications of wildfire smoke exposure, exposure control strategies, and data gaps that would improve understanding of construction worker exposure to wildfire smoke are also discussed.
Collapse
Affiliation(s)
- Christopher Zuidema
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Elena Austin
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Martin A Cohen
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Edward Kasner
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Lilian Liu
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Tania Busch Isaksen
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Ken-Yu Lin
- Department of Construction Management, University of Washington, Seattle, WA, USA
| | - June Spector
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Edmund Seto
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| |
Collapse
|
30
|
Crowe J, Rojas-Valverde D, Rojas-Garbanzo M, Gutiérrez-Vargas R, Ugalde-Ramírez JA, Ledezma-Rojas JP, Cabrera-Alpizar W, Salazar-Salazar M, Mauricio-La Torre R, Valera-Amador L, van Wendel de Joode B. Kidney Function in Rice Workers Exposed to Heat and Dehydration in Costa Rica. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19094962. [PMID: 35564355 PMCID: PMC9100597 DOI: 10.3390/ijerph19094962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 04/01/2022] [Accepted: 04/05/2022] [Indexed: 12/04/2022]
Abstract
The aim of this study was to evaluate heat exposure, dehydration, and kidney function in rice workers over the course of three months, in Guanacaste, Costa Rica. We collected biological and questionnaire data across a three-month-period in male field (n = 27) and other (n = 45) workers from a rice company where chronic kidney disease of unknown origin (CKDu) is endemic. We used stepwise forward regression to determine variables associated with estimated glomerular filtration rate eGFR at enrollment and/or change in eGFR, and Poisson regression to assess associations with incident kidney injury (IKI) over the course of three months. Participants were 20−62 years old (median = 40 in both groups). Dehydration was common (≥37%) in both groups, particularly among other workers at enrollment, but field workers were more exposed to heat and had higher workloads. Low eGFR (<60 mL/min/1.73 m2) was more prevalent in field workers at enrollment (19% vs. 4%) and follow-up (26% vs. 7%). Field workers experienced incident kidney injury (IKI) more frequently than other workers: 26% versus 2%, respectively. Age (β = −0.71, 95%CI: −1.1, −0.4), current position as a field worker (β = −2.75, 95%CI: −6.49, 0.99) and past work in construction (β = 3.8, 95%CI: −0.1, 7.6) were included in the multivariate regression model to explain eGFR at enrollment. The multivariate regression model for decreased in eGFR over three month included current field worker (β = −3.9, 95%CI: −8.2, 0.4), current smoking (β= −6.2, 95%CI: −13.7−1.3), dehydration (USG ≥ 1.025) at both visits (β= −3.19, 95%CI: −7.6, 1.2) and pain medication at follow-up (β= −3.2, 95%CI: −8.2, 1.95). Current fieldwork [IR (incidence rate) = 2.2, 95%CI 1.1, 5.8) and being diabetic (IR = 1.8, 95%CI 0.9, 3.6) were associated with IKI. Low eGFR was common in field workers from a rice company in Guanacaste, and being a field worker was a risk factor for IKI, consistent with the hypothesis that occupational heat exposure is a critical risk factor for CKDu in Mesoamerica.
Collapse
Affiliation(s)
- Jennifer Crowe
- Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia 40101, Costa Rica; (M.R.-G.); (B.v.W.d.J.)
- Correspondence:
| | - Daniel Rojas-Valverde
- Centro de Investigación y Diagnóstico en Salud y Deporte (CIDISAD), Escuela de Ciencias del Movimiento Humano y Calidad de Vida (CIEMHCAVI), Universidad Nacional, Heredia 40101, Costa Rica; (D.R.-V.); (R.G.-V.); (J.A.U.-R.); (W.C.-A.)
| | - Marianela Rojas-Garbanzo
- Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia 40101, Costa Rica; (M.R.-G.); (B.v.W.d.J.)
| | - Randall Gutiérrez-Vargas
- Centro de Investigación y Diagnóstico en Salud y Deporte (CIDISAD), Escuela de Ciencias del Movimiento Humano y Calidad de Vida (CIEMHCAVI), Universidad Nacional, Heredia 40101, Costa Rica; (D.R.-V.); (R.G.-V.); (J.A.U.-R.); (W.C.-A.)
| | - José Alexis Ugalde-Ramírez
- Centro de Investigación y Diagnóstico en Salud y Deporte (CIDISAD), Escuela de Ciencias del Movimiento Humano y Calidad de Vida (CIEMHCAVI), Universidad Nacional, Heredia 40101, Costa Rica; (D.R.-V.); (R.G.-V.); (J.A.U.-R.); (W.C.-A.)
| | - José Pablo Ledezma-Rojas
- Masters Program in Occupational Health, Universidad Nacional-Instituto Tecnológico de Costa Rica, Heredia 40101, Costa Rica;
| | - William Cabrera-Alpizar
- Centro de Investigación y Diagnóstico en Salud y Deporte (CIDISAD), Escuela de Ciencias del Movimiento Humano y Calidad de Vida (CIEMHCAVI), Universidad Nacional, Heredia 40101, Costa Rica; (D.R.-V.); (R.G.-V.); (J.A.U.-R.); (W.C.-A.)
| | | | | | | | - Berna van Wendel de Joode
- Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia 40101, Costa Rica; (M.R.-G.); (B.v.W.d.J.)
| |
Collapse
|
31
|
Lee J, Lee YH, Choi WJ, Ham S, Kang SK, Yoon JH, Yoon MJ, Kang MY, Lee W. Heat exposure and workers' health: a systematic review. REVIEWS ON ENVIRONMENTAL HEALTH 2022; 37:45-59. [PMID: 33752272 DOI: 10.1515/reveh-2020-0158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 03/08/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Several studies on the health effects of heat exposure on workers have been reported; however, only few studies have summarized the overall and systematic health effects of heat exposure on workers. This study aims to review the scientific reports on the health status of workers exposed to high temperatures in the workplace. METHODS We reviewed literature from databases such as PubMed and Google Scholar, using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines to identify studies that address health effects of heat exposure among workers. RESULTS In total, 459 articles were identified, and finally, 47 articles were selected. Various health effects of heat exposure on workers have been reported, such as heat-related diseases, deaths, accidents or injuries, effects on the urinary system, reproductive system, and on the psychological system. CONCLUSIONS Our review suggests that many workers are vulnerable to heat exposure, and this has a health effect on workers.
Collapse
Affiliation(s)
- Junhyeong Lee
- Department of Occupational and Environmental Medicine, Gil Medical Center, Incheon, Republic of Korea
| | - Yong Ho Lee
- Department of Occupational and Environmental Medicine, Gil Medical Center, Incheon, Republic of Korea
| | - Won-Jun Choi
- Department of Occupational and Environmental Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Seunghon Ham
- Department of Occupational and Environmental Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Seong-Kyu Kang
- Department of Occupational and Environmental Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Jin-Ha Yoon
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Min Joo Yoon
- Jungbu Area Epidemiologic Investigation Team, Occupational Safety and Health Research Institute, Korea Occupational Safety & Health Agency, Incheon, Republic of Korea
| | - Mo-Yeol Kang
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Wanhyung Lee
- Department of Occupational and Environmental Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| |
Collapse
|
32
|
Glaser J, Wegman DH, Arias-Monge E, Pacheco-Zenteno F, Prince H, Chavarria D, Martinez-Cuadra WJ, Jakobsson K, Hansson E, Lucas RAI, Weiss I, Wesseling C. Workplace Intervention for Heat Stress: Essential Elements of Design, Implementation, and Assessment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073779. [PMID: 35409463 PMCID: PMC8998134 DOI: 10.3390/ijerph19073779] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 02/24/2022] [Accepted: 03/14/2022] [Indexed: 11/16/2022]
Abstract
Heat stress is associated with numerous health effects that potentially harm workers, especially in a warming world. This investigation occurred in a setting where laborers are confronted with occupational heat stress from physically demanding work in high environmental temperatures. Collaboration with a major Nicaraguan sugarcane producer offered the opportunity to study interventions to prevent occupational heat-stress-related kidney disease. Two aims for this study of a rest-shade-water intervention program were: (1) describe the evolving intervention, summarize findings that motivated proposed improvements, assess impact of those improvements, and identify challenges to successful implementation and (2) extract primary lessons learned about intervention research that have both general relevance to investigations of work-related disease prevention and specific relevance to this setting. The learning curve for the various stakeholders as well as the barriers to success demonstrate that effectiveness of an intervention cannot be adequately assessed without considerations of implementation. Designing, effectively implementing, and assessing both health impacts and implementation quality is a resource-intensive endeavor requiring a transdisciplinary approach. Both general and specific lessons learned are presented for decisions on study design and study elements, implementation assessment, and management engagement in understanding how productivity and health can be successfully balanced and for building effective communication between investigators and all levels of management.
Collapse
Affiliation(s)
- Jason Glaser
- La Isla Network, 2219 California Ave NW, #52, Washington, DC 20008, USA; (E.A.-M.); (W.J.M.-C.); (K.J.); (E.H.); (R.A.I.L.); (I.W.); (C.W.)
- Correspondence: (J.G.); (D.H.W.); Tel.: +1-(347)-585-7465 (J.G.); +1-(617)-921-1506 (D.H.W.)
| | - David H. Wegman
- La Isla Network, 2219 California Ave NW, #52, Washington, DC 20008, USA; (E.A.-M.); (W.J.M.-C.); (K.J.); (E.H.); (R.A.I.L.); (I.W.); (C.W.)
- University of Massachusetts Lowell, Lowell, MA 01854, USA
- Correspondence: (J.G.); (D.H.W.); Tel.: +1-(347)-585-7465 (J.G.); +1-(617)-921-1506 (D.H.W.)
| | - Esteban Arias-Monge
- La Isla Network, 2219 California Ave NW, #52, Washington, DC 20008, USA; (E.A.-M.); (W.J.M.-C.); (K.J.); (E.H.); (R.A.I.L.); (I.W.); (C.W.)
- Unidad de Gestión Ambiental y Seguridad Laboral, Instituto Tecnológico de Costa Rica, 15th Street, 14th Avenue, Cartago 159-7050, Costa Rica
| | - Felipe Pacheco-Zenteno
- School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, 405 30 Göteborg, Sweden;
| | - Heath Prince
- Ray Marshall Center, LBJ School of Public Affairs, University of Texas at Austin, 3001 Lake Austin Blvd., Ste. 3.200, Austin, TX 78703, USA;
| | - Denis Chavarria
- Occupational Health, Ingenio San Antonio, Chinandega 26100, Nicaragua;
| | - William Jose Martinez-Cuadra
- La Isla Network, 2219 California Ave NW, #52, Washington, DC 20008, USA; (E.A.-M.); (W.J.M.-C.); (K.J.); (E.H.); (R.A.I.L.); (I.W.); (C.W.)
| | - Kristina Jakobsson
- La Isla Network, 2219 California Ave NW, #52, Washington, DC 20008, USA; (E.A.-M.); (W.J.M.-C.); (K.J.); (E.H.); (R.A.I.L.); (I.W.); (C.W.)
- School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, 405 30 Göteborg, Sweden;
- Occupational and Environmental Medicine, Sahlgrenska University Hospital, 405 30 Göteborg, Sweden
| | - Erik Hansson
- La Isla Network, 2219 California Ave NW, #52, Washington, DC 20008, USA; (E.A.-M.); (W.J.M.-C.); (K.J.); (E.H.); (R.A.I.L.); (I.W.); (C.W.)
- School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, 405 30 Göteborg, Sweden;
| | - Rebekah A. I. Lucas
- La Isla Network, 2219 California Ave NW, #52, Washington, DC 20008, USA; (E.A.-M.); (W.J.M.-C.); (K.J.); (E.H.); (R.A.I.L.); (I.W.); (C.W.)
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Ilana Weiss
- La Isla Network, 2219 California Ave NW, #52, Washington, DC 20008, USA; (E.A.-M.); (W.J.M.-C.); (K.J.); (E.H.); (R.A.I.L.); (I.W.); (C.W.)
| | - Catharina Wesseling
- La Isla Network, 2219 California Ave NW, #52, Washington, DC 20008, USA; (E.A.-M.); (W.J.M.-C.); (K.J.); (E.H.); (R.A.I.L.); (I.W.); (C.W.)
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Solnavägen 4, 113 65 Stockholm, Sweden
| |
Collapse
|
33
|
El Khayat M, Halwani DA, Hneiny L, Alameddine I, Haidar MA, Habib RR. Impacts of Climate Change and Heat Stress on Farmworkers' Health: A Scoping Review. Front Public Health 2022; 10:782811. [PMID: 35211437 PMCID: PMC8861180 DOI: 10.3389/fpubh.2022.782811] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 01/10/2022] [Indexed: 01/27/2023] Open
Abstract
Due to the continuous rise of global temperatures and heatwaves worldwide as a result of climate change, concerns for the health and safety of working populations have increased. Workers in the food production chain, particularly farmworkers, are especially vulnerable to heat stress due to the strenuous nature of their work, which is performed primarily outdoors under poor working conditions. At the cross-section of climate change and farmworkers' health, a scoping review was undertaken to summarize the existing knowledge regarding the health impacts associated with climate change and heat stress, guide future research toward better understanding current and future climate change risks, and inform policies to protect the health and safety of agricultural workers. A systematic search of 5 electronic databases and gray literature websites was conducted to identify relevant literature published up until December 2021. A total of 9045 records were retrieved from the searches, of which 92 articles were included in the final review. The majority of the reviewed articles focused on heat-related illnesses (n = 57) and kidney diseases (n = 28). The risk factors identified in the reviewed studies included gender, dehydration, heat strain, wearing inappropriate clothing, workload, piece-rate payment, job decision latitude, and hot environmental conditions. On the other hand, various protective and preventive factors were identified including drinking water, changing work hours and schedule of activities, wearing appropriate clothing, reducing soda consumption, taking breaks in shaded or air-conditioned areas, and increasing electrolyte consumption in addition to improving access to medical care. This review also identified various factors that are unique to vulnerable agricultural populations, including migrant and child farmworkers. Our findings call for an urgent need to expand future research on vulnerable agricultural communities including migrant workers so as to develop effective policies and interventions that can protect these communities from the effects of heat stress.
Collapse
Affiliation(s)
- Moussa El Khayat
- Department of Environmental Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Dana A. Halwani
- Department of Environmental Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Layal Hneiny
- Saab Medical Library, American University of Beirut, Beirut, Lebanon
| | - Ibrahim Alameddine
- Department of Civil and Environmental Engineering, Maroun Semaan Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon
| | - Mustapha A. Haidar
- Department of Agriculture, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Rima R. Habib
- Department of Environmental Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| |
Collapse
|
34
|
Urine proteomics as a non-invasive approach to monitor exertional rhabdomyolysis during military training. J Proteomics 2022; 258:104498. [DOI: 10.1016/j.jprot.2022.104498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 01/21/2022] [Indexed: 11/23/2022]
|
35
|
Liu J, Varghese BM, Hansen A, Borg MA, Zhang Y, Driscoll T, Morgan G, Dear K, Gourley M, Capon A, Bi P. Hot weather as a risk factor for kidney disease outcomes: A systematic review and meta-analysis of epidemiological evidence. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 801:149806. [PMID: 34467930 DOI: 10.1016/j.scitotenv.2021.149806] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/06/2021] [Accepted: 08/17/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The occurrence or exacerbation of kidney disease has been documented as a growing problem associated with hot weather. The implementation of effective prevention measures requires a better understanding of the risk factors that increase susceptibility. To fill gaps in knowledge, this study reviews the current literature on the effects of heat on kidney-disease outcomes (ICD-10 N00-N39), including morbidity and mortality. METHODS Databases were systematically searched for relevant literature published between 1990 and 2020 and the quality of evidence evaluated. We performed random effects meta-analysis to calculate the pooled relative risks (RRs) of the association between high temperatures (and heatwaves) and kidney disease outcomes. We further evaluated vulnerability concerning contextual population characteristics. RESULTS Of 2739 studies identified, 91 were reviewed and 82 of these studies met the criteria for inclusion in a meta-analysis. Findings showed that with a 1 °C increase in temperature, the risk of kidney-related morbidity increased by 1% (RR 1.010; 95% CI: 1.009-1.011), with the greatest risk for urolithiasis. Heatwaves were also associated with increased morbidity with a trend observed with heatwave intensity. During low-intensity heatwaves, there was an increase of 5.9% in morbidity, while during high-intensity heatwaves there was a 7.7% increase. There were greater RRs for males, people aged ≤64 years, and those living in temperate climate zones. Similarly, for every 1 °C temperature increase, there was a 3% (RR 1.031; 95% CI: 1.018-1.045) increase in the risk of kidney-related mortality, which also increased during heatwaves. CONCLUSIONS High temperatures (and heatwaves) are associated with an elevated risk of kidney disease outcomes, particularly urolithiasis. Preventive measures that may minimize risks in vulnerable individuals during hot spells are discussed.
Collapse
Affiliation(s)
- Jingwen Liu
- School of Public Health, The University of Adelaide, Australia
| | | | - Alana Hansen
- School of Public Health, The University of Adelaide, Australia
| | - Matthew A Borg
- School of Public Health, The University of Adelaide, Australia
| | - Ying Zhang
- Sydney School of Public Health, The University of Sydney, Australia
| | - Timothy Driscoll
- Sydney School of Public Health, The University of Sydney, Australia
| | - Geoffrey Morgan
- Sydney School of Public Health, The University of Sydney, Australia
| | - Keith Dear
- School of Public Health, The University of Adelaide, Australia
| | - Michelle Gourley
- Burden of Disease and Mortality Unit, Australian Institute of Health and Welfare, Australia
| | - Anthony Capon
- Monash Sustainable Development Institute, Monash University, Australia
| | - Peng Bi
- School of Public Health, The University of Adelaide, Australia.
| |
Collapse
|
36
|
Yoon J, Lee W, Yoon MJ, Lee W. Risk of Heat-Related Mortality, Disease, Accident, and Injury Among Korean Workers: A National Representative Study From 2002 to 2015. GEOHEALTH 2021; 5:e2021GH000516. [PMID: 34938932 PMCID: PMC8672090 DOI: 10.1029/2021gh000516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 11/23/2021] [Accepted: 11/30/2021] [Indexed: 06/14/2023]
Abstract
Many studies have shown that heat waves can cause both death and disease. Considering the adverse health effects of heat waves on vulnerable groups, this study highlights their impact on workers. The present study thus investigated the association between heat exposure and the likelihood of hospitalization and death, and further identified the risk of heat-related diseases or death according to types of heat and dose-response modeling with heat threshold. Workers were selected from the Korean National Health Insurance Service-National Sample Cohort 2002-2015, and regional data measured by the Korea Meteorological Administration were used for weather information. The relationship between hospitalization attributable to disease and weather variables was analyzed by applying a generalized additional model. Using the Akaike information criterion, we selected a model that presented the optimal threshold. Maximum daily temperature (MaxT) was associated with an increased risk of death and outdoor mortality. The association between death outdoors and MaxT had a threshold of 31.2°C with a day zero lag effect. History of medical facility visits due to the health effects of heat waves was evident in certain infectious and parasitic diseases (A and B), cardio and cerebrovascular diseases (I20-25 and I60-69), injury, poisoning, and other consequences of external causes (S, T). The study demonstrated that heat exposure is a risk factor for death and infectious, cardio-cerebrovascular, and genitourinary diseases, as well as injuries or accidents among workers. The finding that heat exposure affects workers' health has future implications for decision makers and researchers.
Collapse
Affiliation(s)
- Jin‐Ha Yoon
- Department of Preventive MedicineYonsei University College of MedicineSeoulSouth Korea
- The Institute for Occupational HealthYonsei University College of MedicineSeoulSouth Korea
| | - Won‐Tae Lee
- The Institute for Occupational HealthYonsei University College of MedicineSeoulSouth Korea
- Department of Occupational and Environmental MedicineSeverance HospitalYonsei University College of MedicineSeoulSouth Korea
| | - Min Joo Yoon
- Jungbu Area Epidemiologic Investigation TeamOccupational Safety and Health Research InstituteKorea Occupational Safety & Health AgencyIncheonSouth Korea
| | - Wanhyung Lee
- Department of Occupational and Environmental MedicineGil Medical CenterGachon University College of MedicineIncheonSouth Korea
| |
Collapse
|
37
|
Simpson C, Hosking JS, Mitchell D, Betts RA, Shuckburgh E. Regional disparities and seasonal differences in climate risk to rice labour. ENVIRONMENTAL RESEARCH LETTERS : ERL [WEB SITE] 2021; 16:124004. [PMID: 34795795 PMCID: PMC8592055 DOI: 10.1088/1748-9326/ac3288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 10/18/2021] [Accepted: 10/22/2021] [Indexed: 06/13/2023]
Abstract
The 880 million agricultural workers of the world are especially vulnerable to increasing heat stress due to climate change, affecting the health of individuals and reducing labour productivity. In this study, we focus on rice harvests across Asia and estimate the future impact on labour productivity by considering changes in climate at the time of the annual harvest. During these specific times of the year, heat stress is often high compared to the rest of the year. Examining climate simulations of the Coupled Model Intercomparison Project 6 (CMIP6), we identified that labour productivity metrics for the rice harvest, based on local wet-bulb globe temperature, are strongly correlated with global mean near-surface air temperature in the long term (p ≪ 0.01, R 2 > 0.98 in all models). Limiting global warming to 1.5 °C rather than 2.0 °C prevents a clear reduction in labour capacity of 1% across all Asia and 2% across Southeast Asia, affecting the livelihoods of around 100 million people. Due to differences in mechanization between and within countries, we find that rice labour is especially vulnerable in Indonesia, the Philippines, Bangladesh, and the Indian states of West Bengal and Kerala. Our results highlight the regional disparities and importance in considering seasonal differences in the estimation of the effect of climate change on labour productivity and occupational heat-stress.
Collapse
Affiliation(s)
- Charles Simpson
- British Antarctic Survey, High Cross, Cambridge CB3 0ET, United Kingdom
- Institute for Environmental Design and Engineering, University College London, Central House, 14 Upper Woburn Place, London WC1H 0NN, United Kingdom
| | - J Scott Hosking
- British Antarctic Survey, High Cross, Cambridge CB3 0ET, United Kingdom
- The Alan Turing Institute, 96 Euston Rd, Somers Town, London NW1 2DB, United Kingdom
| | - Dann Mitchell
- University of Bristol, University Road, Clifton, Bristol BS8 1SS, United Kingdom
| | - Richard A Betts
- Met Office Hadley Centre, FitzRoy Road, Exeter EX1 3PB, United Kingdom
- University of Exeter Global Systems Institute, Laver Building, North Park Road, Exeter EX4 4QE, United Kingdom
| | - Emily Shuckburgh
- Department of Computer Science and Technology, University of Cambridge, JJ Thomson Ave, Cambridge CB3 0FD, United Kingdom
| |
Collapse
|
38
|
Alemu Gelaye K, Debalke G, Awoke Ayele T, Fekadu Wolde H, Sisay MM, Teshome DF, Akalu TY, Daba Wami S. Occupational Health Problems among Seasonal and Migrant Farmworkers in Ethiopia: A Cross-Sectional Study. Risk Manag Healthc Policy 2021; 14:4447-4456. [PMID: 34744466 PMCID: PMC8566000 DOI: 10.2147/rmhp.s323503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 10/19/2021] [Indexed: 11/23/2022] Open
Abstract
Background Migrant and seasonal farmworkers are at increased risk for occupational fatalities and injuries. Although such employment-related geographical mobility is receiving increasing attention, there is limited evidence about occupational health problems among seasonal farmworkers. Therefore, this study aims to investigate occupational health problems among seasonal and migrant farmworkers in Ethiopia. Methods A cross-sectional study design was employed from October to December 2019 among seasonal and migrant farmworkers. The study was carried out in two sites of Amhara regional state, northwest Ethiopia. A cluster sampling technique was used to recruit 990 study participants. Bivariable and multivariable binary logistic regression analyses were performed using SPSS version 20 to identify factors associated with injuries. The significance level was obtained at 95% CI and p-value ≤0.05. Results In this study, the period prevalence of work-related injury among seasonal and migrant farmworkers was 32.5% (95% CI: 29.7, 35.9). Being unemployed before migration (AOR = 2.22, 95% CI: 1.26, 3.91), working for >8 h/day (AOR = 1.62, 95% CI: 1.16, 2.27), stress (AOR = 1.38, 95% CI: 1.02, 1.88) and thermal discomfort (AOR = 1.48, 95% CI: 1.09, 1.98) were the significant risk factors for work-related injury. In addition, nearly two-third (60.9%) of the study participants have shown three or more heat-related illness symptoms. Moreover, the prevalence of work-related stress among seasonal and migrant farmworkers was 67.6% (95% CI: 64.6, 70.7). Conclusion Occupational health problems among seasonal and migrant farmworkers in northwest Ethiopia remain a major public health problem. Hence, implementing tailored preventive measures like training on health and safety, and hazard control measures would be supremely important to minimize the risk.
Collapse
Affiliation(s)
- Kasahun Alemu Gelaye
- Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Getu Debalke
- Department of Health Education and Behavioral Science, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Tadesse Awoke Ayele
- Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Haileab Fekadu Wolde
- Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Malede Mequanent Sisay
- Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Destaw Fetene Teshome
- Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Temesgen Yihunie Akalu
- Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Sintayehu Daba Wami
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
39
|
Pan Q, Sumner DA, Mitchell DC, Schenker M. Compensation incentives and heat exposure affect farm worker effort. PLoS One 2021; 16:e0259459. [PMID: 34727122 PMCID: PMC8562852 DOI: 10.1371/journal.pone.0259459] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 10/19/2021] [Indexed: 11/19/2022] Open
Abstract
Farm workers are exposed to high risk of heat-related illness, especially when their jobs require working outside at a fast pace during hot days. Climate change has increased the number of days with high temperatures, and thereby the amount of time that farm workers are likely exposed to extreme heat. To better understand how high heat exposure affects farm workers, this study investigates how crop workers respond to heat exposure and estimates the effects of different pay and work arrangements on workers' responses to heat exposure. We explore, specifically, whether piece-rate arrangements increase workers' effort during periods with high heat exposure compared to workers paid by hourly wages. We use observational data from detailed measurements of localized heat exposure and individual workers' effort in the field. First, these results show workers adjust their effort in response to heat exposure when the heat exposure level changes. Second, piece-rate arrangements increase workers' effort during work shifts. Third, piece-rate arrangements allow workers to modify their effort more easily during different heat exposure levels. When facing low levels of heat exposure, workers who were paid by piece-rate arrangements exert a higher effort than workers paid by hourly wages, up until WBGT is 26.6˚C. When facing high levels of heat exposure (with WBGT exceeding 29.6˚C), workers paid by piece-rate arrangements lower their effort compared to workers paid by hourly wage arrangements.
Collapse
Affiliation(s)
- Qianyao Pan
- Agricultural and Resource Economics, University of California, Davis, California, United States of America
| | - Daniel A. Sumner
- Agricultural and Resource Economics, University of California, Davis, California, United States of America
- Member of Giannini Foundation of Agricultural Economics, Davis, California, United States of America
| | - Diane C. Mitchell
- Department of Public Health Sciences, University of California, Davis, California, United States of America
| | - Marc Schenker
- Department of Public Health Sciences, University of California, Davis, California, United States of America
| |
Collapse
|
40
|
López-Gálvez N, Wagoner R, Canales RA, Ernst K, Burgess JL, de Zapien J, Rosales C, Beamer P. Longitudinal assessment of kidney function in migrant farm workers. ENVIRONMENTAL RESEARCH 2021; 202:111686. [PMID: 34273367 PMCID: PMC8578352 DOI: 10.1016/j.envres.2021.111686] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 07/09/2021] [Accepted: 07/09/2021] [Indexed: 05/30/2023]
Abstract
Chronic kidney disease of unknown etiology (CKDu) is an epidemic that affects young agricultural workers in several warm regions of the world. However, there is a lack of monitoring of kidney issues in regions with extremely warm environments such as the Northwest of Mexico, a semi-arid region with a growing agricultural industry, where migrant and seasonal farm workers (MSFWs) travel to work in the fields. The objective of this study was to longitudinally assess kidney functioning of MSFWs in relation to pesticide exposure, heat stress and dehydration in a large-scale farm in Mexico. We enrolled 101 MSFWs, of whom 50 were randomly selected to work in an organic certified area and 51 were randomly selected to work in a conventional area. We also enrolled 50 office workers within the same region as a reference group. We collected urine and blood samples from all workers in addition to demographic, behavioral, and occupational characteristics. The physiological strain index (PSI) was used to estimate workers' heat strain. Sampling was conducted at pre-harvest (March) and late in the harvest (July). Linear mixed models were built with the estimated glomerular filtration rate (eGFR) as the dependent variable. We found a significant decrease in kidney function in MSFWs compared to office workers. By the late harvest, one MSFW developed kidney disease, two MSFWs suffered a kidney injury, and 14 MSFWs were at risk of a kidney injury. We found that the eGFR in MSFWs decreased significantly from pre-harvest (125 ± 13.0 mL/min/1.73 m2) to late harvest (109 ± 13.6 mL/min/1.73 m2) (p < 0.001), while no significant change was observed in office workers. The eGFR was significantly lower in MSFWs who worked in the conventional field (101.2 ± 19.4 mL/min/1.73 m2) vs the organic field (110.9 ± 13.6 mL/min/1.73 m2) (p = 0.002). In our final model, we found that dehydration was associated with the decrease of eGFR. We also found an interaction between heat strain and job category, as a significant decline in eGFR by job category (conventional/organic MSFWs and office workers) was related to an increase in heat strain. This suggests that pesticide exposure needs to be considered in combination with heat stress and dehydration. This study provides valuable information on kidney function in MSFWs, and it shows the importance of early long-term monitoring in farm workers in other regions where CKDu has not been evaluated yet.
Collapse
Affiliation(s)
- Nicolás López-Gálvez
- San Diego State University Research Foundation, San Diego State University, 5250 Campanile Dr, San Diego, CA, 92182, USA; Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave, PO 245210, Tucson, AZ, 85724, USA.
| | - Rietta Wagoner
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave, PO 245210, Tucson, AZ, 85724, USA
| | - Robert A Canales
- Interdisciplinary Program in Applied Mathematics, University of Arizona, 617 N. Santa Rita Ave, PO Box 210089, Tucson, AZ, 85721, USA
| | - Kacey Ernst
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave, PO 245210, Tucson, AZ, 85724, USA
| | - Jefferey L Burgess
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave, PO 245210, Tucson, AZ, 85724, USA
| | - Jill de Zapien
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave, PO 245210, Tucson, AZ, 85724, USA
| | - Cecilia Rosales
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave, PO 245210, Tucson, AZ, 85724, USA
| | - Paloma Beamer
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave, PO 245210, Tucson, AZ, 85724, USA
| |
Collapse
|
41
|
Electrolyte Beverage Intake to Promote Hydration and Maintain Kidney Function in Guatemalan Sugarcane Workers Laboring in Hot Conditions. J Occup Environ Med 2021; 62:e696-e703. [PMID: 33003044 PMCID: PMC7720870 DOI: 10.1097/jom.0000000000002033] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVES To evaluate impact of electrolyte supplementation on hydration status and health outcomes in Guatemalan agricultural workers performing heavy work under hot climatic conditions. METHODS A 3-week pragmatic trial was conducted with a group of 50 workers during the 2017 to 2018 sugarcane harvest. Workers received an electrolyte hydration intervention during 2 of the 3 weeks. Blood and urine samples were collected each week. RESULTS Increased electrolyte intake resulted in less muscle injury. Kidney function was maintained across the intervention period. Workers were adequately hydrated and average electrolyte levels remained in normal ranges. Mild indications of hyponatremia occurred at higher levels of fluid intake. CONCLUSIONS This trial demonstrates the feasibility of maintaining workers' electrolyte levels under extremely hot and humid conditions while mitigating muscle injury. Electrolyte supplementation should be added to standard workplace water, rest, and shade interventions to protect workers.
Collapse
|
42
|
Chapman CL, Hess HW, Lucas RAI, Glaser J, Saran R, Bragg-Gresham J, Wegman DH, Hansson E, Minson CT, Schlader ZJ. Occupational heat exposure and the risk of chronic kidney disease of nontraditional origin in the United States. Am J Physiol Regul Integr Comp Physiol 2021; 321:R141-R151. [PMID: 34161738 DOI: 10.1152/ajpregu.00103.2021] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Occupational heat exposure is linked to the development of kidney injury and disease in individuals who frequently perform physically demanding work in the heat. For instance, in Central America, an epidemic of chronic kidney disease of nontraditional origin (CKDnt) is occurring among manual laborers, whereas potentially related epidemics have emerged in India and Sri Lanka. There is growing concern that workers in the United States suffer with CKDnt, but reports are limited. One of the leading hypotheses is that repetitive kidney injury caused by physical work in the heat can progress to CKDnt. Whether heat stress is the primary causal agent or accelerates existing underlying pathology remains contested. However, the current evidence supports that heat stress induces tubular kidney injury, which is worsened by higher core temperatures, dehydration, longer work durations, muscle damaging exercise, and consumption of beverages containing high levels of fructose. The purpose of this narrative review is to identify occupations that may place US workers at greater risk of kidney injury and CKDnt. Specifically, we reviewed the scientific literature to characterize the demographics, environmental conditions, physiological strain (i.e., core temperature increase, dehydration, heart rate), and work durations in sectors typically experiencing occupational heat exposure, including farming, wildland firefighting, landscaping, and utilities. Overall, the surprisingly limited available evidence characterizing occupational heat exposure in US workers supports the need for future investigations to understand this risk of CKDnt.
Collapse
Affiliation(s)
| | - Hayden W Hess
- Department of Kinesiology, School of Public Health, Indiana University, Bloomington, Indiana
| | - Rebekah A I Lucas
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Jason Glaser
- La Isla Network, Washington, D.C.,Responsible Business Center at Birkbeck, University of London, London, United Kingdom
| | - Rajiv Saran
- Division of Nephrology and the Kidney Epidemiology and Cost Center, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan.,Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Jennifer Bragg-Gresham
- Division of Nephrology and the Kidney Epidemiology and Cost Center, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan
| | - David H Wegman
- Department of Epidemiology, University of Massachusetts Lowell, Lowell, Massachusetts
| | - Erik Hansson
- La Isla Network, Washington, D.C.,School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Zachary J Schlader
- Department of Kinesiology, School of Public Health, Indiana University, Bloomington, Indiana
| |
Collapse
|
43
|
Krenz J, Santos EC, Torres E, Palmández P, Carmona J, Blancas M, Marquez D, Sampson P, Spector JT. The multi-level heat education and awareness tools [HEAT] intervention study for farmworkers: Rationale and methods. Contemp Clin Trials Commun 2021; 22:100795. [PMID: 34169175 PMCID: PMC8209069 DOI: 10.1016/j.conctc.2021.100795] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 05/24/2021] [Accepted: 06/03/2021] [Indexed: 11/29/2022] Open
Abstract
Background The burden of adverse health effects from heat exposure is substantial, and outdoor workers who perform heavy physical work are at high risk. Though heat prevention interventions have been developed, studies have not yet systematically evaluated the effectiveness of approaches that address risk factors at multiple levels. Objective We sought to test the effectiveness of a multi-level heat prevention approach (heat education and awareness tools [HEAT]), which includes participatory training for outdoor agricultural workers that addresses individual and community factors and a heat awareness mobile application for agricultural supervisors that supports decisions about workplace heat prevention, in the Northwest United States. Design We designed the HEAT study as a parallel, comparison, randomized group intervention study that recruited workers and supervisors from agricultural workplaces. In intervention arm crews, workers received HEAT training, and supervisors received the HEAT awareness application. In comparison arm crews, workers were offered non-HEAT training. Primary outcomes were worker physiological heat strain and heat-related illness (HRI) symptoms. In both worker groups, we assessed HRI symptoms approximately weekly, and heat strain physiological monitoring was conducted at worksites approximately monthly, from June through August. Discussion To our knowledge, this is the first study to evaluate the effectiveness of a multi-level heat prevention intervention on physiological heat strain and HRI symptoms for outdoor agricultural workers. Trial registration ClinicalTrials.gov Registration Number: NCT04234802;
Collapse
Affiliation(s)
- Jennifer Krenz
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | | | - Elizabeth Torres
- Northwest Communities Education Center/Radio KDNA, Granger, WA, USA
| | - Pablo Palmández
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Jose Carmona
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Maria Blancas
- College of the Environment, University of Washington, Seattle, WA, USA
| | - Diana Marquez
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Paul Sampson
- Department of Statistics, University of Washington, Seattle, WA, USA
| | - June T Spector
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA.,Department of Medicine, University of Washington, Seattle, WA, USA
| |
Collapse
|
44
|
Langer CE, Mitchell DC, Armitage TL, Moyce SC, Tancredi DJ, Castro J, Vega-Arroyo AJ, Bennett DH, Schenker MB. Are Cal/OSHA Regulations Protecting Farmworkers in California From Heat-Related Illness? J Occup Environ Med 2021; 63:532-539. [PMID: 33741829 PMCID: PMC8893044 DOI: 10.1097/jom.0000000000002189] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Determine compliance with and effectiveness of California regulations in reducing farmworkers' heat-related illness (HRI) risk and identify main factors contributing to HRI. METHODS In a cross-sectional study of Latino farmworkers, core body temperature (CBT), work rate, and environmental temperature (WBGT) were monitored over a work shift by individual ingestible thermistors, accelerometers, and weather stations, respectively. Multiple logistic modeling was used to identify risk factors for elevated CBT. RESULTS Although farms complied with Cal/OSHA regulations, worker training of HRI prevention and hydration replacement rates were insufficient. In modeling (AOR [95% CI]) male sex (3.74 [1.22 - 11.54]), WBGT (1.22 [1.08 - 1.38]), work rate (1.004 [1.002 - 1.006]), and increased BMI (1.11 [1.10 - 1.29]) were all independently associated with elevated CBT. CONCLUSION Risk of HRI was exacerbated by work rate and environmental temperature despite farms following Cal/OSHA regulations.
Collapse
Affiliation(s)
- Chelsea Eastman Langer
- Center for Health and the Environment, University of California, Davis, Davis, California, USA (Dr Langer, Castro); Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis, California, USA (Dr Mitchell, Armitage, Dr Vega-Arroyo, Dr Bennett, Dr Schenker); Betty Irene Moore School of Nursing, University of California, Davis, Davis, California, USA (Dr Moyce); College of Nursing, Montana State University, Bozeman, Montana, USA (Dr Moyce); Department of Pediatrics , Center for Healthcare Policy and Research, School of Medicine, University of California, Davis, Sacramento, California, USA (Dr Tancredi)
| | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Aguilar-Ramirez D, Raña-Custodio A, Villa A, Rubilar X, Olvera N, Escobar A, Johnson RJ, Sanchez-Lozada L, Obrador GT, Madero M. Decreased kidney function and agricultural work: a cross-sectional study in middle-aged adults from Tierra Blanca, Mexico. Nephrol Dial Transplant 2021; 36:1030-1038. [PMID: 32443156 DOI: 10.1093/ndt/gfaa041] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 01/30/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND We aimed to determine the prevalence of decreased kidney function in a potential chronic kidney disease (KD) of unknown aetiology hotspot in Mexico, assess its distribution across occupations and examine the associated risk factors. METHODS A cross-sectional study collected sociodemographic, occupational, medical and biometric data from 616 men and women aged 20-60 years who were residents of three communities within the Tierra Blanca region in Mexico. Kidney function was assessed by standardized serum creatinine and estimated glomerular filtration rate (eGFR) and semi-quantitative albumin-to-creatinine ratio (ACR). To examine the distribution of decreased kidney function within the population, age- and sex-adjusted prevalence of low eGFR (≤60 mL/min/1.73 m2) was estimated for all participants and across occupations. Multivariable logistic regression was used to assess the association of occupation with having low eGFR. RESULTS Of the 579 participants analysed (37 excluded due to missing data), the age- and sex-adjusted prevalence of low eGFR was 3.5%. Agriculture was the occupation associated with the highest adjusted prevalence of low eGFR (8.8%), with 1 in every 11 agricultural workers having low eGFR. Working in agriculture was independently associated with more than a 5-fold risk of having low eGFR [odds ratio 5.2 (95% confidence interval 1.1-24.3), P = 0.032], after adjustment for age, sex, diabetes, hypertension, body mass index, ACR and family history of KD. Additionally, a quarter of the population (25%) had either low eGFR or an ACR >30 mg/g, mostly due to albuminuria. CONCLUSIONS Our work suggests that there is a high prevalence of decreased kidney function in Tierra Blanca, particularly amongst agricultural workers.
Collapse
Affiliation(s)
- Diego Aguilar-Ramirez
- Department of Epidemiology and Biostatistics, Universidad Panamericana, Mexico City, Mexico.,Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Antonio Villa
- Department of Epidemiology and Biostatistics, Universidad Panamericana, Mexico City, Mexico
| | - Ximena Rubilar
- School of Nursing, Universidad Panamericana, Mexico City, Mexico
| | - Nadia Olvera
- Department of Epidemiology and Biostatistics, Universidad Panamericana, Mexico City, Mexico
| | | | - Richard J Johnson
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Laura Sanchez-Lozada
- Department of Cardio-renal Physiopathology, National Heart Institute 'Ignacio Chávez', Mexico City, Mexico
| | - Gregorio T Obrador
- Department of Epidemiology and Biostatistics, Universidad Panamericana, Mexico City, Mexico
| | - Magdalena Madero
- Division of Nephrology, National Heart Institute 'Ignacio Chávez', Mexico City, Mexico
| |
Collapse
|
46
|
Petropoulos ZE, Ramirez-Rubio O, Scammell MK, Laws RL, Lopez-Pilarte D, Amador JJ, Ballester J, O’Callaghan-Gordo C, Brooks DR. Climate Trends at a Hotspot of Chronic Kidney Disease of Unknown Causes in Nicaragua, 1973-2014. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5418. [PMID: 34069421 PMCID: PMC8159092 DOI: 10.3390/ijerph18105418] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 11/17/2022]
Abstract
An ongoing epidemic of chronic kidney disease of uncertain etiology (CKDu) afflicts large parts of Central America and is hypothesized to be linked to heat stress at work. Mortality rates from CKDu appear to have increased dramatically since the 1970s. To explore this relationship, we assessed trends in maximum and minimum temperatures during harvest months between 1973 and 2014 as well as in the number of days during the harvest season for which the maximum temperature surpassed 35 °C. Data were collected at a weather station at a Nicaraguan sugar company where large numbers of workers have been affected by CKDu. Monthly averages of the daily maximum temperatures between 1996 and 2014 were also compared to concurrent weather data from eight Automated Surface Observing System Network weather stations across Nicaragua. Our objectives were to assess changes in temperature across harvest seasons, estimate the number of days that workers were at risk of heat-related illness and compare daily maximum temperatures across various sites in Nicaragua. The monthly average daily maximum temperature during the harvest season increased by 0.7 °C per decade between 1973 and 1990. The number of days per harvest season with a maximum temperature over 35 °C increased by approximately five days per year between 1974 and 1990, from 32 days to 114 days. Between 1991 and 2013, the number of harvest days with a maximum temperature over 35 °C decreased by two days per year, and the monthly average daily maximum temperature decreased by 0.3 °C per decade. Comparisons with weather stations across Nicaragua demonstrate that this company is located in one of the consistently hottest regions of the country.
Collapse
Affiliation(s)
- Zoe E. Petropoulos
- Department of Environmental Health, Boston University School of Public Health, Boston, MA 02118, USA; (M.K.S.); (R.L.L.)
| | - Oriana Ramirez-Rubio
- ISGlobal, 08003 Barcelona, Spain; (O.R.-R.); (J.B.); (C.O.-G.)
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA; (D.L.-P.); (J.J.A.); (D.R.B.)
| | - Madeleine K. Scammell
- Department of Environmental Health, Boston University School of Public Health, Boston, MA 02118, USA; (M.K.S.); (R.L.L.)
| | - Rebecca L. Laws
- Department of Environmental Health, Boston University School of Public Health, Boston, MA 02118, USA; (M.K.S.); (R.L.L.)
| | - Damaris Lopez-Pilarte
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA; (D.L.-P.); (J.J.A.); (D.R.B.)
| | - Juan José Amador
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA; (D.L.-P.); (J.J.A.); (D.R.B.)
| | - Joan Ballester
- ISGlobal, 08003 Barcelona, Spain; (O.R.-R.); (J.B.); (C.O.-G.)
| | - Cristina O’Callaghan-Gordo
- ISGlobal, 08003 Barcelona, Spain; (O.R.-R.); (J.B.); (C.O.-G.)
- Universitat Pompeu Fabra (UPF), 08002 Barcelona, Spain
- Faculty of Health Sciences, Universitat Oberta de Catalunya, 08018 Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Daniel R. Brooks
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA; (D.L.-P.); (J.J.A.); (D.R.B.)
| |
Collapse
|
47
|
Mac V, Elon L, Mix J, Tovar-Aguilar A, Flocks J, Economos E, Hertzberg V, McCauley L. Risk Factors for Reaching Core Body Temperature Thresholds in Florida Agricultural Workers. J Occup Environ Med 2021; 63:395-402. [PMID: 33560064 DOI: 10.1097/jom.0000000000002150] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND There is a compelling need to identify agricultural workers at risk for heat related illness (HRI). METHODS Data from Florida agricultural workers (N = 221) were collected over 3 summer workdays (2015 to 2017) to examine risk factors for exceeding NIOSH-recommended core temperature (Tc) thresholds (38 °C [Tc38] and 38.5 °C [Tc38.5]) using generalized linear mixed models. RESULTS On an average workday, 49% of participants exceeded Tc38 and 10% exceeded Tc38.5. On average, participants first exceeded both thresholds early in the day; the Tc38 threshold mid-morning (10:38 AM), and Tc38.5 about a half hour later (11:10 AM). Risk factors associated with exceeding Tc38 included years working in US agriculture, body mass index, time performing moderate-to-vigorous physical activity, increasing heat index, and field crop work. CONCLUSIONS The high prevalence of core temperatures exceeding recommended limits emphasizes the serious need for mandated HRI prevention programs for outdoor workers.
Collapse
Affiliation(s)
- Valerie Mac
- Nell Hodgson Woodruff School of Nursing (Dr Mac, Dr Mix, Dr Hertzberg, Dr McCauley); Rollins School of Public Health (Ms Elon), Emory University, Atlanta, Georgia; Farmworkers Association of Florida, Apopka (Dr Tovar-Aguilar, Ms Economos); and Levine College of Law, University of Florida, Gainesville (Mrs Flocks), Florida
| | | | | | | | | | | | | | | |
Collapse
|
48
|
Mac VV, Elon L, Smith DJ, Tovar‐Aguilar A, Economos E, Flocks J, Hertzberg V, McCauley L. A modified physiological strain index for workplace-based assessment of heat strain experienced by agricultural workers. Am J Ind Med 2021; 64:258-265. [PMID: 33543496 DOI: 10.1002/ajim.23230] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 01/08/2021] [Accepted: 01/10/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND As global temperatures rise, increasing numbers of individuals will work in hot environments. Interventions to protect their health are critical, as are reliable methods to measure the physiological strain experienced from heat exposure. The physiological strain index (PSI) is a measure of heat strain that relies on heart rate and core temperature but is challenging to calculate in a real-world occupational setting. METHODS We modified the PSI for use in field settings where resting temperature and heart rate are not available and used the modified physiological strain index (mPSI) to describe risk factors for high heat strain (mPSI ≥ 7) experienced by agricultural workers in Florida during the summers of 2015 through 2017. mPSI was calculated for 221 workers, yielding 465 days of data. RESULTS A higher heat index (β = 0.185; 95% CI: 0.064, 0.307) and higher levels of physical activity at work (0.033; 95% CI: 0.017, 0.050) were associated with a higher maximum mPSI. More years worked in US agriculture (-0.041; 95% CI: -0.061, -0.020) were protective against a higher maximum mPSI. Out of 23 workdays that a participant experienced a maximum mPSI ≥ 7, 22 were also classified as strained by at least one other measure of high heat strain (core temperature [Tc] >38.5°C, sustained heart rate >(180 - age), and mean heart rate > 115 bpm). CONCLUSIONS This study provides critical information on risk factors for elevated heat strain for agricultural workers and suggests a practical approach for using PSI in field-based settings.
Collapse
Affiliation(s)
- Valerie V. Mac
- Nell Hodgson Woodruff School of Nursing Emory University Atlanta Georgia USA
| | - Lisa Elon
- Rollins School of Public Health Emory University Atlanta Georgia USA
| | - Daniel J. Smith
- Nell Hodgson Woodruff School of Nursing Emory University Atlanta Georgia USA
| | | | | | - Joan Flocks
- Center for Governmental Responsibility University of Florida Gainesville Florida USA
| | - Vicki Hertzberg
- Nell Hodgson Woodruff School of Nursing Emory University Atlanta Georgia USA
| | - Linda McCauley
- Nell Hodgson Woodruff School of Nursing Emory University Atlanta Georgia USA
| |
Collapse
|
49
|
Castillo F, Mora AM, Kayser GL, Vanos J, Hyland C, Yang AR, Eskenazi B. Environmental Health Threats to Latino Migrant Farmworkers. Annu Rev Public Health 2021; 42:257-276. [PMID: 33395542 PMCID: PMC8168948 DOI: 10.1146/annurev-publhealth-012420-105014] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Approximately 75% of farmworkers in the United States are Latino migrants, and about 50% of hired farmworkers do not have authorization to work in the United States. Farmworkers face numerous chemical, physical, and biological threats to their health. The adverse effects of these hazards may be amplified among Latino migrant farmworkers, who are concurrently exposed to various psychosocial stressors. Factors such as documentation status, potential lack of authorization to work in the United States, and language and cultural barriers may also prevent Latino migrants from accessing federal aid, legal assistance, and health programs. These environmental, occupational, and social hazards may further exacerbate existing health disparities among US Latinos. This population is also likely to be disproportionately impacted by emerging threats, including climate change and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Latino migrant farmworkers are essential to agriculture in the United States, and actions are needed to protect this vulnerable population.
Collapse
Affiliation(s)
- Federico Castillo
- Department of Environmental Science, Policy and Management, University of California, Berkeley, California 94720, USA;
| | - Ana M Mora
- Center for Environmental Research and Children's Health, School of Public Health, University of California, Berkeley, California 94720, USA; , ,
- Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia 86-3000, Costa Rica
| | - Georgia L Kayser
- Health Sciences, University of California, San Diego, California 92093, USA; ,
| | - Jennifer Vanos
- School of Sustainability, Arizona State University, Tempe, Arizona 85287, USA;
| | - Carly Hyland
- Center for Environmental Research and Children's Health, School of Public Health, University of California, Berkeley, California 94720, USA; , ,
| | - Audrey R Yang
- Health Sciences, University of California, San Diego, California 92093, USA; ,
| | - Brenda Eskenazi
- Center for Environmental Research and Children's Health, School of Public Health, University of California, Berkeley, California 94720, USA; , ,
| |
Collapse
|
50
|
Smith DJ, Pius LM, Plantinga LC, Thompson LM, Mac V, Hertzberg VS. Heat Stress and Kidney Function in Farmworkers in the US: A Scoping Review. J Agromedicine 2021; 27:183-192. [PMID: 33691597 DOI: 10.1080/1059924x.2021.1893883] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Chronic kidney disease of unknown etiology (CKDu) has been well described in farmworkers in Latin America. Agricultural workers in the United States (US) are exposed to similar hot and humid working conditions, but CKDu in the US is under-described. This review aims to better understand the current literature describing the connection between heat stress and kidney function in farmworkers in the United States. Utilizing a scoping review methodology, we searched CINAHL, Embase, PubMed, and Web of Science databases to better understand the current state of the heat stress and kidney function research in farmworkers within the United States. In this review, 229 pieces of literature were screened. Ultimately, 4 articles were chosen to be included in the scoping review. Common themes within the articles were variations in study protocol lengths and type of heat stress measurement. Additionally, the majority of the work completed was quantitative to date, with only one study providing a critical social lens for analysis of CKDu in the United States. We found evidence that more work is needed within the US to understand the relationship between working in the heat and kidney function in agricultural and other workers who experience high heat conditions at work and are susceptible to the deleterious effects of working in said conditions.
Collapse
Affiliation(s)
- Daniel J Smith
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Lisa M Pius
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Laura C Plantinga
- Division of Geriatrics and Gerontology, School of Medicine, Emory University, Atlanta, GA, USA
| | - Lisa M Thompson
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Valerie Mac
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Vicki S Hertzberg
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| |
Collapse
|