Pilot test of the DEGREE protocol, CKDu module, and point-of-care device measurements in outdoor Hispanic workers.

Details

• Personal Author:
  Delclos GL ; Figueroa-Solis E ; Gimeno Ruiz de Porras D
• Description:
  Introduction: Comparison studies of estimated glomerular filtration rate (eGFR) are limited by lack of protocols using standardized creatinine measurements. Use of Point-of-Care (POC) measurements that require a smaller amount of blood, no transporting of specimens, and can be immediately analyzed in the field is attractive, but their accuracy outside of healthcare settings has been questioned. There is also little standardization on questionnaires designed to gather information on risk factors for "CKD of unknown origin" (CKDu). Objective: To field test the Disadvantaged Populations eGFR Epidemiology Study (DEGREE) protocol, a CKDu risk factor module from the Second Central American Survey of Working Conditions and Health, and POC testing of renal function with the i-STAT (Abbott Laboratories, Abbott Park, Illinois)/Chem8+ in outdoor workers in different seasons. Methods: Cross-sectional study of 55 Hispanic workers in Houston. Inclusion criteria were: 1) ≥ 18 years; 2) working outdoors ≥ 20 hours/week; 3) no prior diagnosis or medications for diabetes, renal or cardiovascular disease. Interviewer-administered DEGREE and CKDu module questionnaires and a urine sample were completed indoors; anthropometrics, blood pressure and paired blood samples for POC and isotope dilution mass spectrometry (IDMS) were completed outdoors during November-December (winter) 2017 and April-May (spring) 2018. Correlations between POC and IDMS were compared between coldest/hottest temperatures, lowest/highest humidity, and lowest/highest heat index. Results: Outdoor temperatures ranged from 60 degrees F to 90 degrees F, relative humidity from 25% to 99%, and heat index from 34 degrees F to 106 degrees F. Administration of the DEGREE protocol and CKDu module averaged 10 and 5 minutes, respectively; questions were easily understood. Average eGFR was 114.07 ml/min/1.73m2 (SD = 15.18) in the winter and 105.81 ml/min/1.73m2 (SD = 18.21) in the spring. Hemoglobin measurements were strongly correlated during the coldest temperatures (60 degrees F to 70 degrees F) and lowest heat index reported (34 degrees F to 69 degrees F) (r=0.97); in the hottest temperatures (80 degrees F to 90 degrees F) and the highest heat index (90 degrees F to 106 degrees F), this correlation was lower (r=0.84). The Bland-Altman plots for hemoglobin showed that, on average, the POC iSTAT results were 3.58% higher than with IDMS. Serum creatinine measurements correlated well (r=0.93) and blood urea nitrogen (BUN) (r=0.96) across the range of temperatures, humidity levels, and heat index. On average, POC-derived creatinine and BUN values were 0.18% and 0.72% higher than IDMS, respectively. Technical limitations with the POC included "out of range" readings and disabled cartridge testing when temperatures were above 85 degrees F or below 65 degrees F, but these resolved when the instrument was brought indoors for a few minutes. Limitations with the IDMS method included hemolyzed specimens, which affected glucose, sodium and potassium levels, but minimally affected BUN and creatinine. Conclusion: Implementation of the DEGREE protocol and CKDu module was straightforward, well understood and conducted in a reasonable period of time. The POC device performed adequately in the field insofar as renal function measurements, but required some adjustment in methods when temperature readings were out of range. [Description provided by NIOSH]
• Subjects:
  Blood Health Care Facilities Workforce And Services Hematologic Tests Occupational Health Safety
• Keywords:
  Blood tests; Kidney function; Kidneys; Medical equipment; Outdoor workers
• Publisher:
  National Institute of Environmental Health Sciences (NIEHS)
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Abstract or Summary
• Place as Subject:
  OSHA Region 6 ; Texas
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  26-27
• NIOSHTIC Number:
  nn:20065450
• Citation:
  Third International Workshop on Chronic Kidney Diseases of Uncertain/Non-traditional Etiology in Mesoamerica and Other Regions, March 20-22, 2019, San José, Costa Rica. Research Triangle Park, NC: National Institute of Environmental Health Sciences (NIEHS), 2019 Mar; :26-27
• Contact Point Address:
  Erika Figueroa-Solis, The University of Texas Health Science Center at Houston School of Public Health
• Federal Fiscal Year:
  2019
• Performing Organization:
  University of Texas Health Science Center, Houston
• Peer Reviewed:
  False
• Start Date:
  20050701
• Source Full Name:
  Third International Workshop on Chronic Kidney Diseases of Uncertain/Non-traditional Etiology in Mesoamerica and Other Regions, March 20-22, 2019, San José, Costa Rica
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:82b4e42dd59f9d262b2f88e0f2abd6ef442165f2ae056f30838303acdc2f13d5fefba118a7e326e4b37e88e22da512c62c62b00c86f3af96494e90711e73d6aa
• Download URL:
  https://stacks.cdc.gov/view/cdc/249442/cdc_249442_DS1.pdf
• File Type:
  [PDF - 2.88 MB ]