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Dally M, Newman LS. Productivity as an efficacy measure in rest-shade-hydration interventions: the need for a more complete dissemination and implementation science approach. Ann Work Expo Health 2024; 68:665-667. [PMID: 38776124 DOI: 10.1093/annweh/wxae044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 04/25/2024] [Indexed: 07/09/2024] Open
Affiliation(s)
- Miranda Dally
- Center for Health, Work & Environment, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, 80045, USA
- Department of Environmental & Occupational Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, 80045, USA
| | - Lee S Newman
- Center for Health, Work & Environment, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, 80045, USA
- Department of Environmental & Occupational Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, 80045, USA
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, 80045, USA
- Pulmonary Division, School of Medicine, University of Colorado Anschutz Medical Campus, 80045, USA
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Hansson E, Jakobsson K, Glaser JR, Wesseling C, Chavarria D, Lucas RAI, Prince H, Wegman DH. Response to: Letter to the Editor-Productivity as an efficacy measure in rest-shade-hydration interventions: the need for a more complete dissemination and implementation science approach by Dally M and Newman LS. Ann Work Expo Health 2024; 68:668-671. [PMID: 38829828 DOI: 10.1093/annweh/wxae046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Indexed: 06/05/2024] Open
Affiliation(s)
- Erik Hansson
- La Isla Network, 2219 California NW Unit 52, 20008 Washington, District of Columbia, United States
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Box 414, 40530 Gothenburg, Sweden
| | - Kristina Jakobsson
- La Isla Network, 2219 California NW Unit 52, 20008 Washington, District of Columbia, United States
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Box 414, 40530 Gothenburg, Sweden
- Occupational and Environmental Medicine, Sahlgrenska University Hospital, Box 414, 40530 Gothenburg, Sweden
| | - Jason R Glaser
- La Isla Network, 2219 California NW Unit 52, 20008 Washington, District of Columbia, United States
| | - Catharina Wesseling
- La Isla Network, 2219 California NW Unit 52, 20008 Washington, District of Columbia, United States
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institute, Box 210, 171 77 Stockholm, Sweden
| | - Denis Chavarria
- Occupational Health Management, Ingenio San Antonio/Nicaragua Sugar Estates Limited, Km. 119 Carretera León-Chinandega, Chichigalpa, Nicaragua
| | - Rebekah A I Lucas
- La Isla Network, 2219 California NW Unit 52, 20008 Washington, District of Columbia, United States
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, United Kingdom
| | - Heath Prince
- La Isla Network, 2219 California NW Unit 52, 20008 Washington, District of Columbia, United States
- LBJ School of Public Affairs, University of Texas at Austin, 2315 Red River St, Austin, TX 78712, United States
| | - David H Wegman
- La Isla Network, 2219 California NW Unit 52, 20008 Washington, District of Columbia, United States
- University of Massachusetts Lowell, 1 University Avenue, Lowell, MA 01854, United States
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Hansson E, Jakobsson K, Glaser JR, Wesseling C, Chavarría D, Lucas RAI, Wegman DH. Association Between Acute Kidney Injury Hospital Visits and Environmental Heat Stress at a Nicaraguan Sugarcane Plantation. Workplace Health Saf 2024; 72:131-142. [PMID: 38591368 PMCID: PMC11055406 DOI: 10.1177/21650799241235410] [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: 04/10/2024]
Abstract
BACKGROUND Mesoamerican sugarcane cutters are at a high risk of chronic kidney disease of non-traditional origin, a disease likely linked to heat-related acute kidney injury (AKI). Studies in general populations have described a positive association between high environmental temperatures and clinically assessed kidney outcomes, but there are no studies in occupational settings. METHOD We accessed routine records of clinically diagnosed AKI (AKI-CD) and wet bulb globe temperatures (WBGT) at a large Nicaraguan sugarcane plantation and modeled the relationship between these using negative binomial regression. A rest-shade-hydration intervention was gradually enhanced during the study period, and efforts were made to increase the referral of workers with suspected AKI to healthcare. RESULTS Each 1°C WBGT was associated with an 18% (95% confidence interval [CI]: [4, 33%]) higher AKI-CD rate on the same day and a 14% (95% CI [-5, 37%]) higher rate over a week. AKI-CD rates and severity, and time between symptoms onset and diagnosis decreased during the study period, that is, with increasing rest-shade-hydration intervention. Symptoms and biochemical signs of systemic inflammation were common among AKI-CD cases. DISCUSSION Occupational heat stress, resulting from heavy work in environmental heat, was associated with a higher rate of clinically diagnosed AKI in a population at risk of CKDnt. Promoting rest-shade-hydration may have contributed to reducing AKI rates during the study period. Occupational health and safety personnel have key roles to play in enforcing rest, shade, and hydration practices, referring workers with suspected AKI to healthcare as well as collecting and analyzing the data needed to support workplace heat stress interventions.
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Affiliation(s)
- Erik Hansson
- La Isla Network, Washington, District of Columbia, USA
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kristina Jakobsson
- La Isla Network, Washington, District of Columbia, USA
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | - Catharina Wesseling
- La Isla Network, Washington, District of Columbia, USA
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Denis Chavarría
- Occupational Health Management, Ingenio San Antonio/Nicaragua Sugar Estates Limited, Chichigalpa, Nicaragua
| | - Rebekah A. I. Lucas
- La Isla Network, Washington, District of Columbia, USA
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - David H. Wegman
- La Isla Network, Washington, District of Columbia, USA
- University of Massachusetts Lowell, Lowell, Massachusetts, USA
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Elinder CG. Heat stroke - the tip of an iceberg. J Intern Med 2023. [PMID: 37126147 DOI: 10.1111/joim.13645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Affiliation(s)
- Carl-Gustaf Elinder
- Department of Clinical Science, Technology and Intervention, Division of Renal Medicine and Baxter Novum, Karolinska Institutet, Stockholm, Sweden
- Karolinska University Hospital Huddinge, Karolinska Institutet, Stockholm, Sweden
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Smyth B, Glaser J, Butler-Dawson J, Nanayakkara N, Wegman DH, Anand S, Levin A, Correa Rotter R, Eckardt KU, Fire A, Friedman D, Herath C, Jha V, Wijewickrama E, Yang CW, Bajpai D, Pippias M, Ulasi I, Nangaku M. Challenges and opportunities in interventions for chronic kidney disease of unknown origin (CKDu): report from the International Society of Nephrology Consortium of Collaborators on CKDu. Kidney Int 2023; 103:6-12. [PMID: 36603985 DOI: 10.1016/j.kint.2022.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/22/2022] [Accepted: 10/18/2022] [Indexed: 01/04/2023]
Affiliation(s)
- Brendan Smyth
- National Health and Medical Research Council (NHMRC) Clinical Trials Centre, University of Sydney, Camperdown, New South Wales, Australia; Department of Renal Medicine, St George Hospital, Kogarah, New South Wales, Australia
| | - Jason Glaser
- La Isla Network, Washington, District of Columbia, USA
| | - Jaime Butler-Dawson
- Center for Health, Work, and Environment, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA; Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | | | - David H Wegman
- La Isla Network, Washington, District of Columbia, USA; Department of Work Environment, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Shuchi Anand
- Division of Nephrology, Department of Medicine, Stanford University, Palo Alto, California, USA.
| | - Adeera Levin
- Division of Nephrology, University of British Columbia, Vancouver, British Columbia, Canada
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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.
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Affiliation(s)
- Rebekah A I Lucas
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom.
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Kidney Function in Factory Workers Exposed to Heat Stress: A 2-Year Follow-up Study. J Occup Environ Med 2022; 64:e685-e689. [PMID: 35959898 DOI: 10.1097/jom.0000000000002666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES The aims of the study are to re-evaluate kidney function in workers exposed and not exposed to heat stress after 2 years and to compare kidney function cross-shift using creatinine and cystatin C. METHODS Participants were workers from a metallurgical industry. The clinical and biochemical markers of hydration and kidney function were evaluated before and after a single shift in work. RESULTS We included 14 workers (6 in the heat group and 8 in the control group). The serum creatinine levels did not change during the follow-up period. Cross-shift, creatinine-based eGFR (estimated glomerular filtration rate) decreased, and cystatin C-based eGFR was maintained in the heat and control groups. CONCLUSIONS Workers exposed to heat stress maintained their kidney function after a 2-year follow-up. Cystatin C is a better kidney function marker than creatinine for cross-shift assessments in this setting.
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Jabakhanji SB, Arnold SR, Aunan K, Chersich MF, Jakobsson K, McGushin A, Kelly I, Roche N, Stauffer A, Stanistreet D. Public Health Measures to Address the Impact of Climate Change on Population Health-Proceedings from a Stakeholder Workshop. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13665. [PMID: 36294243 PMCID: PMC9603356 DOI: 10.3390/ijerph192013665] [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: 09/10/2022] [Revised: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The World Health Organization identified climate change as the 21st century's biggest health threat. This study aimed to identify the current knowledge base, evidence gaps, and implications for climate action and health policymaking to address the health impact of climate change, including in the most underserved groups. METHODS The Horizon-funded project ENBEL ('Enhancing Belmont Research Action to support EU policy making on climate change and health') organised a workshop at the 2021-European Public Health conference. Following presentations of mitigation and adaptation strategies, seven international researchers and public health experts participated in a panel discussion linking climate change and health. Two researchers transcribed and thematically analysed the panel discussion recording. RESULTS Four themes were identified: (1) 'Evidence is key' in leading the climate debate, (2) the need for 'messaging about health for policymaking and behaviour change' including health co-benefits of climate action, (3) existing 'inequalities between and within countries', and (4) 'insufficient resources and funding' to implement national health adaptation plans and facilitate evidence generation and climate action, particularly in vulnerable populations. CONCLUSION More capacity is needed to monitor health effects and inequities, evaluate adaptation and mitigation interventions, address current under-representations of low- or middle-income countries, and translate research into effective policymaking.
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Affiliation(s)
- Samira Barbara Jabakhanji
- Department of Public Health and Epidemiology, School of Population Health, RCSI University of Medicine and Health Sciences, 123 St Stephen’s Green, D02 YN77 Dublin, Ireland
| | | | - Kristin Aunan
- CICERO Center for International Climate Research, 0318 Oslo, Norway
| | | | - Kristina Jakobsson
- School of Public Health and Community Medicine, University of Gothenburg, 405 30 Gothenburg, Sweden
| | - Alice McGushin
- Institute for Global Health, University College London, London WC1E 6BT, UK
| | - Ina Kelly
- Irish Medical Organisation, D02 Y322 Dublin, Ireland
- Public Health Medicine Environment and Health Group, Health Service Executive, D08 W2A8 Dublin, Ireland
| | - Niall Roche
- Centre for Global Health, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - Anne Stauffer
- Health and Environment Alliance, 1210 Brussels, Belgium
| | - Debbi Stanistreet
- Department of Public Health and Epidemiology, School of Population Health, RCSI University of Medicine and Health Sciences, 123 St Stephen’s Green, D02 YN77 Dublin, Ireland
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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.
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Affiliation(s)
- Mabel Aoun
- Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
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