Occupational Heat Exposure and the Risk of Chronic Kidney Disease of Nontraditional Origin in the United States

Details

• Personal Author:
  Bragg-Gresham J ; Chapman CL ; Glaser J ; Hansson E ; Hess HW ; Lucas RAI ; Minson CT ; Saran R ; Schlader ZJ ; Wegman, David H.
• Description:
  Occupational heat exposure is linked to the development of kidney injury and disease in individuals who frequently perform physically demanding work in the heat. For instance, in Central America, an epidemic of chronic kidney disease of non-traditional origin (CKDnt) is occurring among manual laborers, while potentially related epidemics have emerged in India and Sri Lanka. There is growing concern that workers in the United States suffer with CKDnt, but reports are limited. One of the leading hypotheses is that repetitive kidney injury caused by physical work in the heat can progress to CKDnt. Whether heat stress is the primary causal agent or accelerates existing underlying pathology remains contested. However, the current evidence supports that heat stress induces tubular kidney injury, which is worsened by higher core temperatures, dehydration, longer work durations, muscle damaging exercise, and consumption of beverages containing high levels of fructose. The purpose of this narrative mini review is to identify occupations that may place United States workers at greater risk of kidney injury and CKDnt. Specifically, we reviewed the scientific literature to characterize the demographics, environmental conditions, physiological strain (i.e., core temperature increase, dehydration, heart rate), and work durations in sectors typically experiencing occupational heat exposure, including farming, wildland firefighting, landscaping, and utilities. Overall, the surprisingly limited available evidence characterizing occupational heat exposure in United States workers supports the need for future investigations to understand this risk of CKDnt. [Description provided by NIOSH]
• Subjects:
  Agriculture Cardiovascular System Demography Environment Environmental Exposure Fires Heat Stress Disorders Hot Temperature Musculoskeletal System Occupational Health Pathology Risk Assessment Risk Factors Safety Temperature Workplace

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• Keywords:
  Agricultural Industry Agricultural Workers Author Keywords: CKDu Biomarker Demographic Characteristics Diseases Environmental Exposure Environmental Factors Exposure Levels Fire Fighting Heart Rate Heat Heat Exposure Heat Strain Heat Stress Kidney Damage Kidney Disorders Kidney Function Kidneys Landscape Services Workers Mesoamerican Nephropathy Muscle Function Muscles Risk Factors Temperature Effects Utility Workers Work Environment Workers

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• ISSN:
  0363-6119
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  District of Columbia ; Indiana ; Massachusetts ; Michigan ; Oregon ; OSHA Region 1 ; OSHA Region 10 ; OSHA Region 3 ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  321
• Issue:
  2
• NIOSHTIC Number:
  nn:20062953
• Citation:
  Am J Physiol Regul Integr Comp Physiol 2021 Aug; 321(2):R141-R151
• Contact Point Address:
  Zachary Schlader, Department of Kinesiology, School of Public Health, grid.257410.5, Indiana University, Bloomington, IN, United States
• Email:
  zschlade@indiana.edu
• Federal Fiscal Year:
  2021
• NORA Priority Area:
  Agriculture, Forestry and Fishing ; Construction
• Performing Organization:
  Indiana University, Bloomington
• Peer Reviewed:
  True
• Start Date:
  20190901
• Source Full Name:
  American Journal of Physiology: Regulatory, Integrative and Comparative Physiology
• End Date:
  20240831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:4dcb2e7d3cb75150c90e5e26a770abb91441a350f1d4f62c76645d6dc8aff6538faa5e8612dd5e9e1656d65d77bd025717e64a21a1f299a14420074d36d59db1
• Download URL:
  https://stacks.cdc.gov/view/cdc/226107/cdc_226107_DS1.pdf
• File Type:
  [PDF - 1.10 MB ]