Preventing kidney injury among sugarcane workers : Promising evidence from enhanced workplace interventions
(2020) In Occupational and environmental medicine 77(8). p.527-534- Abstract
Objectives: To assess if improvement of working conditions related to heat stress was associated with improved kidney health outcomes among sugarcane harvest workers in Chichigalpa, Nicaragua, a region heavily affected by the epidemic of chronic kidney disease of non-traditional origin. Methods: Based on our findings during the 2017-2018 harvest (harvest 1), recommendations that enhanced the rest schedule and improved access to hydration and shade were given before the 2018-2019 harvest (harvest 2). Actual work conditions during harvest 2 were then observed. Serum creatinine (SCr) was measured before and at end-harvest, and cross-harvest changes in estimated glomerular filtration rate (eGFR) and incident kidney injury (IKI, ie, SCr... (More)
Objectives: To assess if improvement of working conditions related to heat stress was associated with improved kidney health outcomes among sugarcane harvest workers in Chichigalpa, Nicaragua, a region heavily affected by the epidemic of chronic kidney disease of non-traditional origin. Methods: Based on our findings during the 2017-2018 harvest (harvest 1), recommendations that enhanced the rest schedule and improved access to hydration and shade were given before the 2018-2019 harvest (harvest 2). Actual work conditions during harvest 2 were then observed. Serum creatinine (SCr) was measured before and at end-harvest, and cross-harvest changes in estimated glomerular filtration rate (eGFR) and incident kidney injury (IKI, ie, SCr increase by ≥0.30 mg/dL or ≥1.5 times the baseline value) were compared between harvest 1 and harvest 2 for three jobs with different physical workloads using regression modelling. Workers who left during harvest were contacted at home, to address the healthy worker selection effect. Results: In burned cane cutters, mean cross-harvest eGFR decreased 6 mL/min/1.73 m2 (95% CI 2 to 9 mL/min/1.73 m2) less and IKI was 70% (95% CI 90% to 50%) lower in harvest 2 as compared with harvest 1 data. No such improvements were seen among seed cutters groups with less successful intervention implementation. Conclusion: Kidney injury risk was again elevated in workers with strenuous jobs. The results support further efforts to prevent kidney injury among sugarcane workers, and other heat-stressed workers, by improving access to water, rest and shade. The distinction between design and implementation of such interventions should be recognised.
(Less)
- author
- organization
- publishing date
- 2020-07
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- climate, international occupational health, intervention studies, renal, workload
- in
- Occupational and environmental medicine
- volume
- 77
- issue
- 8
- pages
- 8 pages
- publisher
- BMJ Publishing Group
- external identifiers
-
- scopus:85085308547
- pmid:32404530
- ISSN
- 1351-0711
- DOI
- 10.1136/oemed-2020-106406
- language
- English
- LU publication?
- yes
- id
- 568afbd6-ea3b-42e2-85cd-26a1007a8253
- date added to LUP
- 2020-06-16 12:57:15
- date last changed
- 2024-05-29 14:29:57
@article{568afbd6-ea3b-42e2-85cd-26a1007a8253,
abstract = {{<p>Objectives: To assess if improvement of working conditions related to heat stress was associated with improved kidney health outcomes among sugarcane harvest workers in Chichigalpa, Nicaragua, a region heavily affected by the epidemic of chronic kidney disease of non-traditional origin. Methods: Based on our findings during the 2017-2018 harvest (harvest 1), recommendations that enhanced the rest schedule and improved access to hydration and shade were given before the 2018-2019 harvest (harvest 2). Actual work conditions during harvest 2 were then observed. Serum creatinine (SCr) was measured before and at end-harvest, and cross-harvest changes in estimated glomerular filtration rate (eGFR) and incident kidney injury (IKI, ie, SCr increase by ≥0.30 mg/dL or ≥1.5 times the baseline value) were compared between harvest 1 and harvest 2 for three jobs with different physical workloads using regression modelling. Workers who left during harvest were contacted at home, to address the healthy worker selection effect. Results: In burned cane cutters, mean cross-harvest eGFR decreased 6 mL/min/1.73 m<sup>2</sup> (95% CI 2 to 9 mL/min/1.73 m<sup>2</sup>) less and IKI was 70% (95% CI 90% to 50%) lower in harvest 2 as compared with harvest 1 data. No such improvements were seen among seed cutters groups with less successful intervention implementation. Conclusion: Kidney injury risk was again elevated in workers with strenuous jobs. The results support further efforts to prevent kidney injury among sugarcane workers, and other heat-stressed workers, by improving access to water, rest and shade. The distinction between design and implementation of such interventions should be recognised.</p>}},
author = {{Glaser, Jason and Hansson, Erik and Weiss, Ilana and Wesseling, Catharina and Jakobsson, Kristina and Ekström, Ulf and Apelqvist, Jenny and Lucas, Rebekah and Arias Monge, Esteban and Peraza, Sandra and Hogstedt, Christer and Wegman, David H.}},
issn = {{1351-0711}},
keywords = {{climate; international occupational health; intervention studies; renal; workload}},
language = {{eng}},
number = {{8}},
pages = {{527--534}},
publisher = {{BMJ Publishing Group}},
series = {{Occupational and environmental medicine}},
title = {{Preventing kidney injury among sugarcane workers : Promising evidence from enhanced workplace interventions}},
url = {{http://dx.doi.org/10.1136/oemed-2020-106406}},
doi = {{10.1136/oemed-2020-106406}},
volume = {{77}},
year = {{2020}},
}