Rietta S Wagoner, Nicolas I López-Gálvez, Robert A Canales, Paloma I Beamer, Leslie V Farland, Frank A von Hippel, Jill G de Zapien, Cecilia B Rosales, Melissa A Furlong
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引用次数: 0
Abstract
Objective: Agricultural workers endure physically demanding, high heat work daily, increasing the risk of kidney injury and reduced kidney function. However, few studies have examined individual measures of heat exposure and risk of kidney injury and impaired function. We assessed the association between measures of heat exposure with acute kidney injury and kidney functioning among agricultural workers, compared to a group of office workers in the same region.
Methods: We recruited 77 adult males working in agriculture and 21 adult males in office jobs in Sonora, Mexico in 2019. We administered a demographic questionnaire to participants. A proxy physiological strain index (PSI), based on point measurements of heart rate and tympanic temperature, was used to estimate individual heat exposure. Kidney function was measured using the estimated glomerular filtration rate (eGFR). Kidney injury was assessed via urinary neutrophil gelatinase-associated lipocalin (uNGAL). We compared uNGAL and eGFR over time in the two study groups. We assessed proxy PSI associations with uNGAL and eGFR using linear mixed-effects models, adjusting for age, body mass index, and urinary specific gravity factor.
Results: We observed statistically significant differences between agricultural and office workers for eGFR (GM: 121.85 vs. 115.66 mL/min/1.73 m2, p = .04). Among agricultural workers, creatinine-adjusted uNGAL levels rose in summer compared to spring (GM: 4.47 vs. 1.98 mg/g creatinine, p < .01), and eGFR declined during the same period GM:(108.41 vs. 122.38 mL/min/1.73 m2, p < .01). In mixed models, proxy PSI was inversely associated with eGFR (β-coefficient:-2.87, 95% CI: -4.02, -1.72).
Conclusion: Season and proxy PSI predicted kidney functioning in agricultural workers in this study. As climate warming continues, high-risk occupational groups such as agricultural workers will face increasing heat-related health risks.
目的：农业工人每天承受高体力、高热量的工作，增加了肾脏损伤的风险，肾功能下降。然而，很少有研究检查热暴露与肾损伤和功能受损风险的个体测量。我们评估了农业工人的热暴露与急性肾损伤和肾功能之间的关系，并与同一地区的一组办公室工作人员进行了比较。方法：我们于2019年在墨西哥索诺拉招募了77名从事农业工作的成年男性和21名从事办公室工作的成年男性。我们对参与者进行了人口调查问卷。基于心率和鼓室温度点测量的代理生理应变指数（PSI）用于估计个体热暴露。用估计的肾小球滤过率（eGFR）测量肾功能。通过尿中性粒细胞明胶酶相关脂钙蛋白（uNGAL）评估肾损伤。我们比较了两个研究组的uNGAL和eGFR随时间的变化。我们使用线性混合效应模型评估代理PSI与uNGAL和eGFR的关联，调整年龄、体重指数和尿比重因子。结果：我们观察到农业和办公室工作人员的eGFR差异有统计学意义（GM: 121.85 vs 115.66 mL/min/1.73 m2, p = 0.04）。在农业工人中，肌酐调整的uNGAL水平在夏季比春季升高（GM: 4.47 vs 1.98 mg/g肌酐，p 2, p）。结论：在本研究中，季节和代用PSI预测农业工人的肾功能。随着气候持续变暖，农业工人等高危职业群体将面临越来越多的与热有关的健康风险。
期刊介绍：
The Journal of Agromedicine: Practice, Policy, and Research publishes translational research, reports and editorials related to agricultural health, safety and medicine. The Journal of Agromedicine seeks to engage the global agricultural health and safety community including rural health care providers, agricultural health and safety practitioners, academic researchers, government agencies, policy makers, and others. The Journal of Agromedicine is committed to providing its readers with relevant, rigorously peer-reviewed, original articles. The journal welcomes high quality submissions as they relate to agricultural health and safety in the areas of:
• Behavioral and Mental Health
• Climate Change
• Education/Training
• Emerging Practices
• Environmental Public Health
• Epidemiology
• Ergonomics
• Injury Prevention
• Occupational and Industrial Health
• Pesticides
• Policy
• Safety Interventions and Evaluation
• Technology
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