A Systems-Based Approach for the Prevention of Heat-Associated Kidney Disease in Latin American Workers.

IF 3.2 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Annals of Global Health Pub Date : 2025-08-19 eCollection Date: 2025-01-01 DOI:10.5334/aogh.4760
Miranda Dally, Lyndsay Krisher, Diana Jaramillo, Lee S Newman, Joaquin Barnoya
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Abstract

Background: The prevalence of chronic kidney disease and other non-communicable diseases in Guatemala has been rising. Recently, chronic kidney disease of non-traditional origin (CKDnt) has been identified among occupational cohorts and linked to heavy workloads in hot environments. Objective: To describe a systems-based community participatory approach to occupational safety and health. Methods: Over the last eight years, academic researchers have partnered with a large agribusiness in Southwest Guatemala to address the health, safety, and well-being concerns of workers, especially in relation to CKDnt. This case study presents the Total Worker Health® approach used to develop, implement, and evaluate interventions to address potential causes of CKDnt. The results of these interventions are presented using the Consolidated Framework for Implementation Research and RE-AIM. Findings: A Total Worker Health (TWH) approach addressing both transactional and transformational organizational behavior change to reduce the incidence of reduced kidney function in this workforce can be successfully implemented. Our findings highlight the need for collaborative approaches to the development and implementation of strategies to adapt to climate change in the workplace. The sustainability of interventions needs constant re-evaluation to adapt to changing contexts. Discussion: This case study illustrates a practical, evidence-based TWH approach to address the immediate impacts of heat stress and nephrotoxins on the kidney health of sugarcane workers in Guatemala. It also illustrates the importance of multi-modal interventions implemented and evaluated in a dissemination and implementation science framework informed by the community that is at risk. The principles underlying our approach may have applicability and generalizability to less extreme circumstances, and beyond those with heat-associated kidney disease.

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拉丁美洲工人热相关性肾病预防的系统方法
背景:危地马拉慢性肾病和其他非传染性疾病的发病率一直在上升。最近,非传统来源的慢性肾脏疾病(CKDnt)已在职业队列中被确定,并与高温环境中的繁重工作负荷有关。目的:描述一种基于系统的社区参与式职业安全与健康方法。方法:在过去的八年中,学术研究人员与危地马拉西南部的一家大型农业综合企业合作,解决工人的健康、安全和福祉问题,特别是与CKDnt有关的问题。本案例研究介绍了用于开发、实施和评估干预措施以解决CKDnt潜在原因的总工人健康®方法。这些干预措施的结果是利用实施研究综合框架和再评估目标提出的。研究结果:一个全面的员工健康(TWH)方法解决交易和转型的组织行为改变,以减少肾功能下降的发生率在这一劳动力可以成功实施。我们的研究结果强调了制定和实施适应工作场所气候变化战略的合作方法的必要性。干预措施的可持续性需要不断重新评估,以适应不断变化的情况。讨论:本案例研究说明了一种实用的、基于证据的TWH方法,以解决危地马拉甘蔗工人热应激和肾毒素对肾脏健康的直接影响。它还说明了在有风险的社区知情的传播和实施科学框架中实施和评估多模式干预措施的重要性。我们方法的基本原则可能适用于不太极端的情况,并且超出了与热相关的肾脏疾病。
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来源期刊
Annals of Global Health
Annals of Global Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
5.30
自引率
3.40%
发文量
95
审稿时长
11 weeks
期刊介绍: ANNALS OF GLOBAL HEALTH is a peer-reviewed, open access journal focused on global health. The journal’s mission is to advance and disseminate knowledge of global health. Its goals are improve the health and well-being of all people, advance health equity and promote wise stewardship of the earth’s environment. The journal is published by the Boston College Global Public Health Program. It was founded in 1934 by the Icahn School of Medicine at Mount Sinai as the Mount Sinai Journal of Medicine. It is a partner journal of the Consortium of Universities for Global Health.
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