Workload and cross-harvest kidney injury in a Nicaraguan sugarcane worker cohort
(2019) In Occupational and environmental medicine 76(11). p.818-826- Abstract
OBJECTIVES: To examine the association between workload and kidney injury in a fieldworker cohort with different levels of physically demanding work over a sugarcane harvest, and to assess whether the existing heat prevention efforts at a leading occupational safety and health programme are sufficient to mitigate kidney injury. METHODS: Biological and questionnaire data were collected before (n=545) and at the end (n=427) of harvest among field support staff (low workload), drip irrigation workers (moderate), seed cutters (high) and burned sugarcane cutters (very high). Dropouts were contacted (87%) and reported the reason for leaving work. Cross-harvest incident kidney injury (IKI) was defined as serum creatinine increase ≥0.30 mg/dL... (More)
OBJECTIVES: To examine the association between workload and kidney injury in a fieldworker cohort with different levels of physically demanding work over a sugarcane harvest, and to assess whether the existing heat prevention efforts at a leading occupational safety and health programme are sufficient to mitigate kidney injury. METHODS: Biological and questionnaire data were collected before (n=545) and at the end (n=427) of harvest among field support staff (low workload), drip irrigation workers (moderate), seed cutters (high) and burned sugarcane cutters (very high). Dropouts were contacted (87%) and reported the reason for leaving work. Cross-harvest incident kidney injury (IKI) was defined as serum creatinine increase ≥0.30 mg/dL or ≥1.5 times the baseline value, or among dropouts reporting kidney injury leading to leaving work. RESULTS: Mean cross-harvest estimated glomerular filtration rate change was significantly associated with workload, increasing from 0 mL/min/1.73 m2 in the low-moderate category to -5 mL/min/1.73 m2 in the high and -9 mL/min/1.73 m2 in the very high workload group. A similar pattern occurred with IKI, where low-moderate workload had 2% compared with 27% in the very high workload category. A healthy worker selection effect was detected, with 32% of dropouts reporting kidney injury. Fever and C reactive protein elevation were associated with kidney injury. CONCLUSIONS: Workers considered to have the highest workload had more cross-harvest kidney damage than workers with less workload. Work practices preventing heat stress should be strengthened and their role in preventing kidney damage examined further. Future occupational studies on chronic kidney disease of unknown aetiology should account for a healthy worker effect by pursuing those lost to follow-up.
(Less)
- author
- organization
- publishing date
- 2019
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- CKDu, Heat stress, Inflammation, Kidney, Workload
- in
- Occupational and environmental medicine
- volume
- 76
- issue
- 11
- pages
- 9 pages
- publisher
- BMJ Publishing Group
- external identifiers
-
- pmid:31611303
- scopus:85073182353
- ISSN
- 1470-7926
- DOI
- 10.1136/oemed-2019-105986
- language
- English
- LU publication?
- yes
- id
- cdfd5fe3-07ad-4bba-86eb-df7023fcbd8a
- date added to LUP
- 2019-10-21 12:11:53
- date last changed
- 2024-04-16 22:24:23
@article{cdfd5fe3-07ad-4bba-86eb-df7023fcbd8a,
abstract = {{<p>OBJECTIVES: To examine the association between workload and kidney injury in a fieldworker cohort with different levels of physically demanding work over a sugarcane harvest, and to assess whether the existing heat prevention efforts at a leading occupational safety and health programme are sufficient to mitigate kidney injury. METHODS: Biological and questionnaire data were collected before (n=545) and at the end (n=427) of harvest among field support staff (low workload), drip irrigation workers (moderate), seed cutters (high) and burned sugarcane cutters (very high). Dropouts were contacted (87%) and reported the reason for leaving work. Cross-harvest incident kidney injury (IKI) was defined as serum creatinine increase ≥0.30 mg/dL or ≥1.5 times the baseline value, or among dropouts reporting kidney injury leading to leaving work. RESULTS: Mean cross-harvest estimated glomerular filtration rate change was significantly associated with workload, increasing from 0 mL/min/1.73 m2 in the low-moderate category to -5 mL/min/1.73 m2 in the high and -9 mL/min/1.73 m2 in the very high workload group. A similar pattern occurred with IKI, where low-moderate workload had 2% compared with 27% in the very high workload category. A healthy worker selection effect was detected, with 32% of dropouts reporting kidney injury. Fever and C reactive protein elevation were associated with kidney injury. CONCLUSIONS: Workers considered to have the highest workload had more cross-harvest kidney damage than workers with less workload. Work practices preventing heat stress should be strengthened and their role in preventing kidney damage examined further. Future occupational studies on chronic kidney disease of unknown aetiology should account for a healthy worker effect by pursuing those lost to follow-up.</p>}},
author = {{Hansson, Erik and Glaser, Jason and Weiss, Ilana and Ekström, Ulf and Apelqvist, Jenny and Hogstedt, Christer and Peraza, Sandra and Lucas, Rebekah and Jakobsson, Kristina and Wesseling, Catharina and Wegman, David H.}},
issn = {{1470-7926}},
keywords = {{CKDu; Heat stress; Inflammation; Kidney; Workload}},
language = {{eng}},
number = {{11}},
pages = {{818--826}},
publisher = {{BMJ Publishing Group}},
series = {{Occupational and environmental medicine}},
title = {{Workload and cross-harvest kidney injury in a Nicaraguan sugarcane worker cohort}},
url = {{http://dx.doi.org/10.1136/oemed-2019-105986}},
doi = {{10.1136/oemed-2019-105986}},
volume = {{76}},
year = {{2019}},
}