Workload and cross-harvest kidney injury in a Nicaraguan sugarcane worker cohort

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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 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.

Detaljer

Författare
  • Erik Hansson
  • Jason Glaser
  • Ilana Weiss
  • Ulf Ekström
  • Jenny Apelqvist
  • Christer Hogstedt
  • Sandra Peraza
  • Rebekah Lucas
  • Kristina Jakobsson
  • Catharina Wesseling
  • David H. Wegman
Enheter & grupper
Externa organisationer
  • La Isla Network
  • Göteborgs universitet
  • London School of Hygiene and Tropical Medicine
  • Karolinska Institute
  • University of Birmingham
  • Sahlgrenska University Hospital
  • University of Massachusetts Lowell
  • University of El Salvador
Forskningsområden

Ämnesklassifikation (UKÄ) – OBLIGATORISK

  • Miljömedicin och yrkesmedicin

Nyckelord

Originalspråkengelska
Sidor (från-till)818-826
Antal sidor9
TidskriftOccupational and environmental medicine
Volym76
Utgåva nummer11
StatusPublished - 2019
PublikationskategoriForskning
Peer review utfördJa