Hydration Status, Kidney Function, and Kidney Injury in Florida Agricultural Workers

Mix, Jacqueline; Elon, Lisa; Mac, Valerie; Flocks, Joan; Economos, Eugenia; Tovar-Aguilar, Antonio; Hertzberg, Vicki; McCauley, Linda

doi:10.1097/jom.0000000000001261

Cited by 87 publications

(91 citation statements)

References 32 publications

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“…Agricultural workers participate in strenuous tasks and experience an array of occupational risks and hazards. High humidity and extreme ambient temperatures coupled with heavy physical labor and low fluid consumption place individuals at risk for heat strain and dehydration, serious and commonly underreported hazards in the agricultural industry [1][2][3][4][5]. As the number of hot days and heatwaves is expected to increase globally, it is expected that vulnerable populations, such as agricultural workers, will experience increased heat-related morbidity and mortality [1,[6][7][8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

An Occupational Heat Stress and Hydration Assessment of Agricultural Workers in North Mexico

Wagoner

López-Gálvez

Zapien

et al. 2020

IJERPH

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Expanding agribusiness in Northern Mexico has increased demand for workers from Southern Mexico, with hundreds of thousands migrating for work annually. Extreme temperatures, physical labor, and low fluid consumption place workers at risk for heat strain and dehydration, commonly underreported hazards in the agricultural industry. The objectives of this pilot study were to assess heat exposure and hydration status of a population of migratory agricultural workers in Northern Mexico throughout the grape harvest season. In addition to demographic information, environmental conditions, hydration status, and core body temperatures were collected. The majority listed Chiapas as their home state, nearly half spoke an Indigenous language, and none had completed high school. The wet-bulb globe temperature was significantly higher during the harvest and post-harvest seasons compared to the pre-harvest season. Across the different seasons, the majority were dehydrated post-shift, and mean core body temperature of workers was not significantly different. This project highlights the need for targeted interventions to improve hydration and prevent heat stress in this region. As the number of warm days is expected to rise each year worldwide, it will be increasingly important to engage in practices to protect vulnerable populations, such as migratory agriculture workers.

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Section: Introductionmentioning

confidence: 99%

An Occupational Heat Stress and Hydration Assessment of Agricultural Workers in North Mexico

Wagoner

López-Gálvez

Zapien

et al. 2020

IJERPH

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show abstract

“…There have been an estimated 20,000 deaths in Central America attributed to the epidemic of “Mesoamerican Nephropathy”[ 7 , 8 ], making it a major cause of mortality among an otherwise young and able-bodied demographic. While initial reports focused on rates of chronic kidney disease (CKD) in these populations[ 9 , 10 ], more recent studies suggest agricultural workers are at high risk for recurrent episodes of acute kidney injury (AKI)[ 11 , 12 ], which may contribute to the later development of CKD[ 13 ]. For example, Moyce et al recently reported elevated rates of cumulative AKI among agricultural workers in California, with an 11.8% rate of AKI in a single day of summer field work[ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Unadjusted point of care creatinine results overestimate acute kidney injury incidence during field testing in Guatemala

et al. 2018

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ObjectiveAcute kidney injury (AKI) occurs at high rates among agricultural workers (12–33%) in tropical environments. Because of the remote locations affected, traditional laboratory services are often unavailable. In this study we compare point of care (POC) creatinine values to standardized laboratory values, and examine the effect of POC testing on the interpretation of AKI rates under tropical field conditions.MethodsBlood samples were collected from 104 sugarcane workers from two time points in January 2018 as a derivation cohort, and from 105 workers from February to April 2017 as a validation cohort. Finger stick and venipuncture samples were drawn at the end of a worker’s shift to measure creatinine. Laboratory samples were tested in Guatemala City, Guatemala, in duplicate using the Jaffe Generation 2 method. An adjustment factor to improve agreement with serum creatinine was statistically derived and validated, and then used to determine impact on observed rates of acute kidney injury based on across shift changes in creatinine.ResultsPOC creatinine and serum creatinine measures showed that POC consistently overestimated the creatinine by an average of 22% (95% CI: 19.8%, 24.7%) and the disagreement appeared greater at higher values of serum creatinine. An adjustment factor of 0.7775 was applied, which led to significantly greater agreement between the two measures. Rates of AKI in the two combined groups fell from 72% before adjustment to 57% afterwards.ConclusionsPOC testing under tropical field conditions routinely overestimates creatinine compared to laboratory testing, which leads to overestimation of rates of acute kidney injury. The application of an adjustment factor significantly improved the accuracy of the POC value.

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“…That there is a blurred distinction between heat-related illness and injury is understandable given that heat exposure, dehydration and hyperthermia can be linked to both. As shown in this study and in the literature, heat-associated traumatic injury can also refer not only to external bodily injuries but also thermal damage to organs and tissues such as the brain, muscles [39] and kidneys [40].…”

Section: Discussionmentioning

confidence: 54%

Using a Qualitative Phenomenological Approach to Inform the Etiology and Prevention of Occupational Heat-Related Injuries in Australia

Hansen

Williams

Hanson-Easey

et al. 2020

IJERPH

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Epidemiological evidence has shown an association between exposure to high temperatures and occupational injuries, an issue gaining importance with environmental change. The aim of this study was to better understand contributing risk factors and preventive actions based on personal experiences. Interviews were conducted with 21 workers from five Australian states using a critical phenomenological approach to capture the lived experiences of participants, whilst exploring contextual factors that surround these experiences. Two case studies are presented: a cerebrovascular injury and injuries among seasonal horticulture workers. Other accounts of heat-related injuries and heat stress are also presented. Risk factors were classified as individual, interpersonal and organizational. In terms of prevention, participants recommended greater awareness of heat risks and peer-support for co-workers. Adding value to current evidence, we have provided new insights into the etiology of the health consequences of workplace heat exposure with workers identifying a range of influencing factors, prevention measures and adaptation strategies. Underpinning the importance of these are future climate change scenarios, suggesting that extended hot seasons will lead to increasing numbers of workers at risk of heat-stress and associated occupational injuries.

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Hydration Status, Kidney Function, and Kidney Injury in Florida Agricultural Workers

Abstract: A strikingly high prevalence of dehydration and AKI exists in Florida agricultural workers.

Cited by 87 publications

References 32 publications

An Occupational Heat Stress and Hydration Assessment of Agricultural Workers in North Mexico

An Occupational Heat Stress and Hydration Assessment of Agricultural Workers in North Mexico

Unadjusted point of care creatinine results overestimate acute kidney injury incidence during field testing in Guatemala

Using a Qualitative Phenomenological Approach to Inform the Etiology and Prevention of Occupational Heat-Related Injuries in Australia

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