Preventing kidney injury among sugarcane workers: promising evidence from enhanced workplace interventions.

Abstract:

OBJECTIVES:To 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. METHODS:Based 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. RESULTS:In 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. CONCLUSION:Kidney 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.

journal_name

Occup Environ Med

authors

Glaser J,Hansson E,Weiss I,Wesseling C,Jakobsson K,Ekström U,Apelqvist J,Lucas R,Arias Monge E,Peraza S,Hogstedt C,Wegman DH

doi

10.1136/oemed-2020-106406

subject

Has Abstract

pub_date

2020-08-01 00:00:00

pages

527-534

issue

8

eissn

1351-0711

issn

1470-7926

pii

oemed-2020-106406

journal_volume

77

pub_type

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