Biomarkers of Kidney Function and Injury Across Fire Seasons and During a Mid-Season Fire Incident in the Wildland Firefighter Exposure and Health Effect (WFFEHE) Study

Details

• Journal Article:
  American Journal of Industrial Medicine
• Personal Author:
  Pinkerton, Lynne E. ; Luckhaupt, Sara E. ; Bertke, Stephen J. ; Butler, Corey R. ; Hales, Thomas R. ; DuBose, Kathleen M. ; Ramirez-Cardenas, Alejandra ; Sammons, Deborah ; Toennis, Christine ; West, Molly R. ; Hale, Christa R.
• Description:
  Background: Occupational heat stress among wildland firefighters (WFFs) performing arduous work or working in hot work environments may cause kidney dysfunction and injury. Methods: Kidney function and injury biomarkers (serum and urine) were measured among 39 WFFs pre- and post-fire season in 2018-2019. The same biomarkers were measured in 19 of these 39 WFFs over 3 days during a 2019 mid-season fire incident. Median differences in biomarker concentrations across the fire season and across the mid-season incident were evaluated using the Sign test. The primary outcome of interest was the cystatin C-based estimated glomerular filtration rate (eGFRcys). Results: The eGFRcys decreased (median difference = -5 mL/min/1.73 m2; interquartile range [IQR] = -8, -2 mL/min/1.73 m2; p = 0.008), and 53% of participants lost ≥ 2% of their body weight across the first day of the mid-season fire incident. Median eGFRcys did not decrease across the fire season (median difference = 0 mL/min/1.73 m2; IQR = -5, 5 mL/min/1.73 m2; p = 0.52). The albumin-creatinine ratio and the ratios of urine kidney injury molecule-1 and neutrophil gelatinase-associated lipocalin concentrations to urine osmolality increased across ≥ 1 day during the mid-season incident. Conclusions: A temporary decrease in kidney function and changes in biomarkers of kidney injury were observed during a wildland fire incident. Additional research is warranted to confirm these findings, assess associations with occupational heat stress, and determine whether persistent, clinically relevant kidney injury and dysfunction occur among WFFs over time. The findings also support the need for continued efforts to promote optimal hydration of WFFs.
• Subjects:
  Biomarkers Firefighters Fires Heat Stress Disorders Kidney Occupational Health Safety
• Keywords:
  Author Keywords: Firefighters; Kidney Function; Wildfire; Wildland Biomarkers; Heat Stress; Kidney Function; Wildland Fires; Fire Fighters; Hot Environments; Wildfires; Kidney Damage;
• Source:
  Am J Ind Med 2025 Oct; 68(10):829-844
• ISSN:
  0271-3586
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  Ohio ; West Virginia ; Colorado ; Montana ; Chicago Region [OSHA] ; Philadelphia Region [OSHA] ; Denver Region [OSHA]
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  DFSE - Division of Field Studies and Engineering ; WSD - Western States Division ; DSR - Division of Safety Research ; DSI - Division of Science Integration ; HELD - Health Effects Laboratory Division
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  16 pdf pages
• Volume:
  68
• Issue:
  10
• NIOSHTIC Number:
  nn:20071345
• Contact Point Address:
  Sara E. Luckhaupt, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Division of Field Studies and Engineering, Cincinnati, Ohio, USA
• Email:
  pks8@cdc.gov
• Federal Fiscal Year:
  2026
• Peer Reviewed:
  True
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:72c237bb3efa267c0139bad4eef46cf0b6f6e3a1cbe79429e19501319b5d690e8c9c1b1be8a55a3ff8d6bd646f7b845c5f3b528b2ef6c352eddd7f022ce037b1
• Download URL:
  https://stacks.cdc.gov/view/cdc/258820/cdc_258820_DS1.pdf
• File Type:
  [PDF - 979.68 KB ]