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. 2020 Mar;63(3):258-268.
doi: 10.1002/ajim.23076. Epub 2019 Nov 26.

Acute kidney injury and workload in a sample of California agricultural workers

Sally Moyce  1 , Tracey Armitage  2 , Diane Mitchell  2 , Marc Schenker  2
Affiliations

Acute kidney injury and workload in a sample of California agricultural workers

Sally Moyce et al. Am J Ind Med. 2020 Mar.

Abstract

Background: Kidney damage is associated with an increased workload in high ambient temperatures and may represent a pathway to chronic kidney disease of unknown origin in agricultural workers. We tested the associations of workload and heat with acute kidney dysfunction in California agricultural workers.

Methods: We recruited a convenience sample of 471 agricultural workers from 29 farms in California during two summer harvest seasons. The sustained 3-minute maximum workload was estimated using accelerometer data collected from Actical monitors and individual heat load through elevations in core body temperature. Acute kidney injury (AKI) was defined by a change in serum creatinine of ≥0.3 mg/dL or ≥1.5 times the preshift creatinine over the course of the work shift. Associations between AKI and workload were modeled using logistic regression, controlling for demographic, physiologic, and occupational variables.

Results: Of the total, 357 workers (75.8%) had accelerometer readings in the moderate workload category, 93 (19.7%) had readings in the vigorous category. 177 (36%) had elevations of core body temperature ≥1°C; 72 workers (14.9%) demonstrated evidence of AKI after a single day of agricultural work. The workload category was associated with an increased adjusted odds of AKI (1.92; 95% confidence interval, 1.05-3.51). Piece-rate work was also associated with increased adjusted odds of AKI (3.02; 95% CI, 1.44-6.34).

Conclusions: Heavy occupational workload and piece-rate work were associated with acute effects on the renal health of agricultural workers. This indicates that occupations requiring high physical effort put workers at risk for AKI, possibly independent of ambient and core body temperature. Changes to agricultural practices may reduce the risk of renal disorders for these workers.

Keywords: acute kidney injury; agricultural workers; chronic kidney disease of unknown origin; metabolic equivalents; occupational risk factors; temperature.

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Conflict of interest statement

Disclosure (Authors): The authors declare no conflicts of interest.

Figures

Figure 1.
Figure 1.
Percent of workers with AKI in workload categories
See this image and copyright information in PMC

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