A work and off-work evaluation of female workers’ heat and particulate matter exposures and kidney health in Guatemala

Abstract

Background

An increasing number of women are performing farm labor in agrarian societies due to the out-migration of men impacted by the effects of climate change. Thus, it is important to understand how changing climatic conditions affect women's risk of occupational heat stress and other health issues.

Methods

For this longitudinal pilot study, we characterized repeat individual-level particulate matter (PM₅, aerodynamic diameter of ≤ 5 micrometers) and heat exposures and measured kidney function markers during workdays and rest days among female sugarcane workers in Guatemala. We used logistic mixed models with repeated measures to evaluate associations between kidney function and exposures.

Results

We observed that 45 % of the workers had reduced kidney function (estimated glomerular filtration rate [eGFR] < 90 mL/min/1.73 m²) during the study. Levels of dehydration based on a urinary specific gravity >1.020 (28 %), acidic urine (30 %), and low potassium levels (31 %) were common. Environmental exposures (PM₅ and heat index) were significantly higher on workdays compared to rest days. Reduced kidney function was associated with increasing median heat index (odds ratio [OR]: 1.63, 95 % confidence interval [CI]: 1.29–2.08), low urine pH (OR: 4.21, 95 % CI: 1.08–16.40), and municipal drinking water source (OR: 6.52, 95 % CI: 1.23–34.57).

Discussion

The results from this study suggest that repeated occupational exposure to high levels of heat contributes to a reduction in renal function among these workers.

Conclusions

These findings can inform preventive strategies to better address women's health in the workplace, such as reducing heat stress and dehydration.