نبذة مختصرة : BACKGROUND: There is growing attention on occupational heat stress in Central America, as workers in this region are affected by a unique form of chronic kidney disease. Previous studies have examined wet bulb globe temperatures and estimated metabolic rates to assess heat stress, but there are limited data characterizing heat strain among these workers. OBJECTIVE: The aims were to characterize heat stress and heat strain and examine whether job task, break duration, hydration practices, and kidney function were associated with heat strain. METHODS: We used data from the MesoAmerican Nephropathy Occupational Study, a cohort of 569 outdoor workers in El Salvador and Nicaragua who underwent workplace exposure monitoring, including continuous measurement of core body temperature (Tc), heart rate (HR), physical activity, and wet bulb globe temperature (WBGT), over the course of three days in January 2018 - May 2018. Participants represented five industries: sugarcane, corn, plantain, brickmaking, and construction. RESULTS: Median WBGTs were relatively high (>27 °C) at most sites, particularly when work shifts spanned the afternoon hours (e.g., 29.2 °C among plantain workers). Sugarcane workers, especially cane cutters in both countries and Nicaraguan agrichemical applicators, had the highest estimated metabolic rates (medians: 299-318 kcal/hr). Most workers spent little time on break (<10% of the shift), as determined by physical activity data. Overall, sugarcane workers-particularly those in Nicaragua-experienced the highest Tc and HR values. However, a few workers in other industries reached high Tc (>39 °C) as well. Impaired kidney function (estimated glomerular filtration rate <90 mL/min/1.73 m2) was associated with higher Tc and HR values, even after adjustment. SIGNIFICANCE: This is the largest study to-date examining heat stress and strain among outdoor workers in Central America. Workers at sugar companies regularly experienced Tc > 38°C (76.9% of monitored person-days at Nicaraguan companies; ...
Relation: Journal of Exposure Science and Environmental Epidemiology; https://www.ncbi.nlm.nih.gov/pubmed/37041408; http://dx.doi.org/10.1038/s41370-023-00537-x; Z.E. Petropoulos, S.A. Keogh, E. Jarquín, D. López-Pilarte, J.J. Amador Velázquez, R. García-Trabanino, M.R. Amador Sánchez, R. Guevara, A. Gruener, D.R. Allen, J.H. Leibler, I.S. Delgado, M.D. McClean, D.J. Friedman, D.R. Brooks, M.K. Scammell. 2023. "Heat stress and heat strain among outdoor workers in El Salvador and Nicaragua." Journal of Exposure Science and Environmental Epidemiology, Volume 33, Issue 4, pp.622-630. https://doi.org/10.1038/s41370-023-00537-x; https://hdl.handle.net/2144/48302; 825779
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