title: Heat strain, volume depletion and kidney function in California agricultural workers.
abstract: Agricultural work can expose workers to increased risk of heat strain and volume depletion due to repeated exposures to high ambient temperatures, arduous physical exertion and limited rehydration. These risk factors may result in acute kidney injury (AKI).
  
  
  
  We estimated AKI cumulative incidence in a convenience sample of 283 agricultural workers based on elevations of serum creatinine between preshift and postshift blood samples. Heat strain was assessed based on changes in core body temperature and heart rate. Volume depletion was assessed using changes in body mass over the work shift. Logistic regression models were used to estimate the associations of AKI with traditional risk factors (age, diabetes, hypertension and history of kidney disease) as well as with occupational risk factors (years in farm work, method of payment and farm task).
  
  
  
  35 participants were characterised with incident AKI over the course of a work shift (12.3%). Workers who experienced heat strain had increased adjusted odds of AKI (1.34, 95% CI 1.04 to 1.74). Piece rate work was associated with 4.24 odds of AKI (95% CI 1.56 to 11.52). Females paid by the piece had 102.81 adjusted odds of AKI (95% CI 7.32 to 1443.20).
  
  
  
  Heat strain and piece rate work are associated with incident AKI after a single shift of agricultural work, though gender differences exist. Modifications to payment structures may help prevent AKI.
authors.affiliation: Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, California, USA.
authors.forename: Sally
authors.initials: S
authors.lastname: Moyce
authors.affiliation: Department of Public Health Sciences, University of California, Davis, Davis, California, USA.
authors.forename: Diane
authors.initials: D
authors.lastname: Mitchell
authors.affiliation: Department of Public Health Sciences, University of California, Davis, Davis, California, USA.
authors.forename: Tracey
authors.initials: T
authors.lastname: Armitage
authors.affiliation: Department of Pediatrics, University of California, Davis, Davis, California, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Tancredi
authors.affiliation: Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, California, USA.
authors.forename: Jill
authors.initials: J
authors.lastname: Joseph
authors.affiliation: Department of Public Health Sciences, University of California, Davis, Davis, California, USA.
authors.forename: Marc
authors.initials: M
authors.lastname: Schenker
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000453:epidemiology* / Q000209:etiology*; D000328:Adult; D000382:Agricultural Workers' Diseases / Q000097:blood / Q000453:epidemiology* / Q000209:etiology*; D000383:Agriculture; D015992:Body Mass Index; D002140:California / Q000453:epidemiology; D003404:Creatinine / Q000097:blood; D000067565:Farmers; D005260:Female; D005919:Glomerular Filtration Rate; D018882:Heat Stress Disorders / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D006358:Hot Temperature / Q000009:adverse effects*; D006801:Humans; D016015:Logistic Models; D008297:Male; D013058:Mass Spectrometry; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D016273:Occupational Exposure / Q000009:adverse effects*; D012307:Risk Factors; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D003404:Creatinine