Am J Ind Med

Background Kidney damage is associated with increased workload in high ambient temperatures, and may represent a pathway to chronic kidney disease of unknown origin in agricultural workers. We tested the associations of workload and heat with acute kidney dysfunction in California agricultural workers. Methods We recruited a convenience sample of 471 agricultural workers from 29 farms in California during two summer harvest seasons. Sustained 3-minute maximum workload was estimated using accelerometer data collected from Actical monitors and individual heat load through elevations in core body temperature. Acute kidney injury (AKI) was defined by a change in serum creatinine of ≥0.3mg/dL or ≥1.5 times the pre-shift creatinine over the course of the work shift. Associations between AKI and workload were modeled using logistic regression, controlling for demographic, physiologic, and occupational variables. Results 357 workers (75.8%) had accelerometer readings in the moderate workload category, 93 (19.7%) had readings in the vigorous category. 177 (36%) had elevations of core body temperature ≥1°C. 72 workers (14.9%) demonstrated evidence of AKI after a single day of agricultural work. Workload category was associated with an increased adjusted odds of AKI (1.92, 95% confidence interval (CI) 1.05-3.51). Piece rate work was also associated with increased adjusted odds of AKI (3.02, 95% CI1.44-6.34). Conclusions Heavy occupational workload and piece-rate work were associated with acute effects on renal health of agricultural workers. This indicates that occupations requiring high physical effort put workers at risk for AKI, possibly independent of ambient and core body temperature. Changes to agricultural practices may reduce the risk for renal disorders for these workers.

31773783

PMC7002174

CDC Public Access