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Mazumder H, Mondol MH, Rahman M, Khan R, Doza S, Unicomb L, Jahan F, Mukhopadhyay A, Makris KC, Caban-Martinez A, Iqbal R, Ahmed F, Creencia L, Shamsudduha M, Mzayek F, Jia C, Zhang H, Musah A, Fleming LE, Mou X, Kovesdy CP, Gribble MO, Naser AM. Sex-Specific Association of Ambient Temperature With Urine Biomarkers in Southwest Coastal Bangladesh. Kidney Int Rep 2024; 9:1860-1875. [PMID: 38899224 PMCID: PMC11184407 DOI: 10.1016/j.ekir.2024.03.002] [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: 11/10/2023] [Revised: 02/23/2024] [Accepted: 03/04/2024] [Indexed: 06/21/2024] Open
Abstract
Introduction Men are vulnerable to ambient heat-related kidney disease burden; however, limited evidence exists on how vulnerable women are when exposed to high ambient heat. We evaluated the sex-specific association between ambient temperature and urine electrolytes, and 24-hour urine total protein, and volume. Methods We pooled a longitudinal 5624 person-visits data of 1175 participants' concentration and 24-hour excretion of urine electrolytes and other biomarkers (24-hour urine total protein and volume) from southwest coastal Bangladesh (Khulna, Satkhira, and Mongla districts) during November 2016 to April 2017. We then spatiotemporally linked ambient temperature data from local weather stations to participants' health outcomes. For evaluating the relationships between average ambient temperature and urine electrolytes and other biomarkers, we plotted confounder-adjusted restricted cubic spline (RCS) plots using participant-level, household-level, and community-level random intercepts. We then used piece-wise linear mixed-effects models for different ambient temperature segments determined by inflection points in RCS plots and reported the maximum likelihood estimates and cluster robust standard errors. By applying interaction terms for sex and ambient temperature, we determined the overall significance using the Wald test. Bonferroni correction was used for multiple comparisons. Results The RCS plots demonstrated nonlinear associations between ambient heat and urine biomarkers for males and females. Piecewise linear mixed-effects models suggested that sex did not modify the relationship of ambient temperature with any of the urine parameters after Bonferroni correction (P < 0.004). Conclusion Our findings suggest that women are as susceptible to the effects of high ambient temperature exposure as men.
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Affiliation(s)
- Hoimonty Mazumder
- Division of Epidemiology, Biostatistics, and Environmental Health; School of Public Health, The University of Memphis, Memphis, Tennessee, USA
| | - Momenul Haque Mondol
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada; Department of Statistics, University of Barishal, Barishal-8254, Bangladesh
| | - Mahbubur Rahman
- International Centre for Diarrheal Disease Research, Bangladesh, Bangladesh
| | - Rizwana Khan
- International Centre for Diarrheal Disease Research, Bangladesh, Bangladesh
| | - Solaiman Doza
- Environmental and Occupational Health, School of Biological and Population Health Sciences, Oregon State University, Oregon, USA
| | - Leanne Unicomb
- International Centre for Diarrheal Disease Research, Bangladesh, Bangladesh
| | - Farjana Jahan
- International Centre for Diarrheal Disease Research, Bangladesh, Bangladesh
| | - Ayesha Mukhopadhyay
- Division of Epidemiology, Biostatistics, and Environmental Health; School of Public Health, The University of Memphis, Memphis, Tennessee, USA
| | - Konstantinos C. Makris
- Cyprus International Institute for Environmental and Public Health, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Alberto Caban-Martinez
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Romaina Iqbal
- Department of Community Health Sciences, Aga Khan University, Pakistan
| | - Faruk Ahmed
- Department of Engineering Technology, The University of Memphis, Memphis, Tennessee, USA
| | - Lota Creencia
- College of Fisheries and Aquatic Sciences, Western Philippines University, Palawan, Philippines
| | - Mohammad Shamsudduha
- Institute for Risk and Disaster Reduction, University College London, London, UK
| | - Fawaz Mzayek
- Division of Epidemiology, Biostatistics, and Environmental Health; School of Public Health, The University of Memphis, Memphis, Tennessee, USA
| | - Chunrong Jia
- Division of Epidemiology, Biostatistics, and Environmental Health; School of Public Health, The University of Memphis, Memphis, Tennessee, USA
| | - Hongmei Zhang
- Division of Epidemiology, Biostatistics, and Environmental Health; School of Public Health, The University of Memphis, Memphis, Tennessee, USA
| | - Anwar Musah
- Department of Geography, University College London, London, UK
| | - Lora E. Fleming
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, Cornwall, UK
| | - Xichen Mou
- Division of Epidemiology, Biostatistics, and Environmental Health; School of Public Health, The University of Memphis, Memphis, Tennessee, USA
| | - Csaba P. Kovesdy
- Division of Nephrology, University of Tennessee Health Science Centre, Memphis, Tenessee; USA
| | - Matthew O. Gribble
- Department of Medicine, Division of Occupational, Environmental, and Climate Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Abu Mohd Naser
- Division of Epidemiology, Biostatistics, and Environmental Health; School of Public Health, The University of Memphis, Memphis, Tennessee, USA
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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.
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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
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Abstract
PURPOSE OF REVIEW In the 1990s, a type of chronic kidney disease with unknown cause (CKDu) was identified in Central America and Sri Lanka. Patients lacked hypertension, diabetes, glomerulonephritis, or other usual causes of kidney failure. Affected patients are predominantly male agricultural workers aged 20-60 years, living in economically disadvantaged areas with poor access to medical care. Patients typically present late and progress to end-stage kidney disease within 5 years, resulting in social and economic hardship for families, regions, and countries. This review covers the current state of knowledge for this disease. RECENT FINDINGS The prevalence of CKDu is increasing in known endemic regions and across the globe, reaching epidemic proportions. There is primary tubulointerstitial injury with secondary glomerular and vascular sclerosis. No definitive etiologic factors have been identified, and these may vary or overlap in different geographic locations. The leading hypotheses include exposure to agrochemicals, heavy metals and trace elements, and kidney injury from dehydration/heat stress. Infections and lifestyle factors may play a role, but are likely not key. Genetic and epigenetic factors are beginning to be explored. SUMMARY CKDu is a leading cause of premature death in young-to-middle-aged adults in endemic regions and has become a public health crisis. Studies are underway to investigate clinical, exposome, and omics factors, and hopefully will provide insights into pathogenetic mechanisms resulting in biomarker discovery, preventive measures, and therapeutics.
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Affiliation(s)
- Cynthia C Nast
- Department of Pathology, Cedars-Sinai Medical Center, Los Angeles, California, USA
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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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