Occupational Heat Stress and Kidney Health in Salt Pan Workers

• Introduction: Work in heat affects millions of workers. Although kidney function in agricultural workers is increasingly researched, nonagricultural studies are scarce. In coastal salt pans, the absence of occupa-tional exposures to pesticides and other toxicants allows assessment of heat stress alone.Methods: Seven Indian salt pans were surveyed from 2017 to 2020. Job-specific workload was assessed. Heat stress was characterized as exceeding the wet bulb globe temperature (WBGT)-threshold limit value (TLV) for high and moderate workloads. Preshift and postshift heart rates (HRs), tympanic temperatures, and urine specific gravity (USG) were measured for 352 workers, as were sweat rates (SwR), serum creatinine (SCr), serum uric acid, and urine dipstick. Estimated glomerular filtration rate (eGFR; ml/min per 1.73 m2) was computed. Heat-strain symptoms were assessed using questionnaires.Results: The mean WBGT was 30.5 & PLUSMN; 1.3 & DEG;C (summer) and 27.8 & PLUSMN; 1.9 & DEG;C (winter). Water intake during the workday was low, median was one Litre, and most workers (87%) exceeded the TLV for heat stress. Dehydration-related symptoms were frequent in those with high-heat stress, as were cross-shift increases in temperature (& GE;1 & DEG;C; 15%), a high USG (& GE;1.020; 28%), and a high SwR (& GE;1 l/h; 53%). An eGFR of 60 to 89 ml/min per 1.73 m2 was observed in 41% of all workers examined, and 7% had eGFR below 60 ml/min per 1.73 m2. The odds ratio for eGFR <90 ml/min per 1.73 m2 in workers exceeding the TLV, compared to workers below this limit, adjusted for age and gender was 2.9 (95% CI: 1.3-6.4).Conclusion: Workplace interventions to prevent heat stress and dehydration in the salt pans and other at -risk industries are urgently required. The findings strengthen the notion that high-heat stress and limited hydration is a risk factor for kidney dysfunction.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Urology and Nephrology (hsv//eng)

Keyword

heat strain

occupational heat stress

reduced kidney function

salt

pan

WBGT

agricultural communities

disease

hypertension

etiology

epidemic

india

Urology & Nephrology

Publication and Content Type

ref (subject category)

art (subject category)