Preventing kidney injury among sugarcane workers: promising evidence from enhanced workplace interventions
| Autor: | Jason Glaser, Rebekah A. I. Lucas, Kristina Jakobsson, Erik Hansson, Catharina Wesseling, Jenny Apelqvist, Ulf Ekström, David H. Wegman, Ilana Weiss, Esteban Arias Monge, Christer Hogstedt, Sandra Peraza |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male intervention studies Psychological intervention Renal function Nicaragua Heat Stress Disorders Health outcomes workload Cohort Studies Toxicology 03 medical and health sciences chemistry.chemical_compound international occupational health 0302 clinical medicine Kidney injury Humans Intervention implementation Medicine 030212 general & internal medicine Cane Workplace climate Healthy Worker Effect Creatinine Farmers Dehydration biology business.industry Public Health Environmental and Occupational Health Acute Kidney Injury medicine.disease biology.organism_classification 030210 environmental & occupational health Saccharum Occupational Diseases chemistry Female renal business Glomerular Filtration Rate Kidney disease |
| Zdroj: | Occupational and Environmental Medicine |
| ISSN: | 1470-7926 1351-0711 |
| DOI: | 10.1136/oemed-2020-106406 |
| Popis: | ObjectivesTo 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.MethodsBased 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.ResultsIn 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.ConclusionKidney 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. |
| Databáze: | OpenAIRE |
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