Intervention to diminish dehydration and kidney damage among sugarcane workers

Abstract

Strenuous work in hot environments is associated with negative impacts on biomarkers of kidney function over the workday and over five months. Appropriate access to water, rest and shade during work offers relief from high levels of heat stress and reduces effects on kidney function.Affiliation: University of Massachusetts Lowell, 7 Camden Place, Cambridge, MA 02138, USA. david_wegman@uml.eduThe following article refers to this text: 2018;44(1):1-2

Chronic kidney disease of non-traditional origin in Mesoamerica: a disease primarily driven by occupational heat stress

“…The start of the harvest, when workers acclimatize to the physically demanding work, was associated with the largest cross-shift differences in hydration and kidney function (47). In a waterrest-shade intervention study in El Salvador, the cross-shift decline in eGFR related to workload (tons cut); moreover, the intervention appeared to reduce cross-shift kidney function decline (48). In Guatemala, an ostensibly intense hydration regimen was implemented, but indicators of poor hydration were still associated with kidney function decline and biomarkers of kidney injury during the workday (49).…”

“…Cross-shift evaluations have been conducted in sugarcane cutters in Costa Rica, Nicaragua, El Salvador and Guatemala. Without exception, these studies concluded that cross-shift physiologic and biomarker changes were compatible with recurrent dehydration from strenuous work in hot environments (45)(46)(47)(48)(49)(50). Three studies examining multiple cross-shifts documented repeated dehydration over the day (45,47,48).…”

“…Without exception, these studies concluded that cross-shift physiologic and biomarker changes were compatible with recurrent dehydration from strenuous work in hot environments (45)(46)(47)(48)(49)(50). Three studies examining multiple cross-shifts documented repeated dehydration over the day (45,47,48). In one, 27% of cane-cutters started already with high urine specific gravity (≥1025) in at least one out of three observed shifts and 52% had high urine specific gravity at least once at the end of the shifts, indicating that dehydration occurred over the workday and that overnight recovery was insufficient (45).…”

Mortalidad por enfermedad renal crónica en el Perú: tendencias nacionales 2003-2015

“…diabetes mellitus tipo 2 e hipertensión arterial), se podría hablar de ERC de etiología desconocida. Para dicha condición se han descrito otros factores de riesgo como deshidratación crónica (frecuente en sujetos que trabajan en el campo) (22) , exposición a pesticidas (aunque la evidencia es limitada) (23,24) , e infección por leptospirosis (evidencia aún escasa) (25) . Estas causas, aunque secundarias en relación a los factores de riesgo preponderantes, se deben tener en mente para no sólo sospechar -y así descartar-ERC en pacientes con antecedentes de diabetes o hipertensión.…”

Chronic kidney disease of unknown or nontraditional origin: a new global epidemic?

“…Diversos estudios han demostrado deshidratación en estos trabajadores durante la jornada y un deterioro de su función renal a lo largo de una temporada de cosecha. Según los resultados del Programa WE, -un estudio de intervención en cortadores de caña en El Salvador -, la provisión de agua, descanso y sombra parece detener el deterioro de la función renal durante la cosecha 10 . A nivel experimental se ha mostrado que ratones expuestos a calor sin poder hidratarse durante el día desarrollan daño túbulo-intersticial renal.…”