A Pilot Study to Assess Inhalation Exposures among Sugarcane Workers in Guatemala: Implications for Chronic Kidney Disease of Unknown Origin

Int J Environ Res Public Health. 2020 Aug 7;17(16):5708. doi: 10.3390/ijerph17165708.


Background: Sugarcane workers in Central America experience a heavy burden of chronic kidney disease of unknown origin. We conducted a pilot study among worker proxies in Guatemala to characterize exposures to particulate matter, silica, heavy metals, and glyphosate, as well as to examine potential nephrotoxic exposures.

Methods: Air, soil, and ash samples were collected and analyzed using scanning electron microscopy, X-ray diffraction, inductively coupled plasma mass spectrometry, and an enzyme-linked immunosorbent assay.

Results: The average mass concentration for particulate matter (PM)2.5 and PM100 exposures were 360 µg/m3 (range: 32 to 1500 µg/m3) and 555 µg/m3 (range: 229 to 1170 µg/m3), respectively. The elemental composition of particles was largely silicon. The amount of crystalline silica was below 5 μg, yet the percentage of total silica was ~17% by weight. Putatively, the silica was in the amorphous form. Concentrations of aluminum and calcium ranged from 2-7 μg/m3. Glyphosate was not detectable in analyzed air samples but was detectable at concentrations ranging from 81-165 ppb in soil samples.

Conclusion: Sugarcane workers are exposed to high concentrations of particulate matter. Future studies should investigate the potential role of silica, heavy metals, and agrochemicals in the etiology of chronic kidney disease in this population.

Keywords: CKDu; exposures; kidney; particulate matter; silica; sugarcane workers.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Agricultural Workers' Diseases / chemically induced
  • Agricultural Workers' Diseases / epidemiology*
  • Air Pollutants / adverse effects*
  • Air Pollutants / analysis
  • Environmental Monitoring*
  • Guatemala / epidemiology
  • Humans
  • Inhalation Exposure / adverse effects
  • Inhalation Exposure / analysis*
  • Particulate Matter / analysis
  • Pilot Projects
  • Renal Insufficiency, Chronic / chemically induced
  • Renal Insufficiency, Chronic / epidemiology
  • Saccharum*


  • Air Pollutants
  • Particulate Matter