Abstract
Background: A high burden of kidney diseases, including acute kidney injury (AKI), has been reported among agricultural workers, mainly male workers in tropical areas. Dehydration caused by strenuous work at high temperatures and other related working conditions have been associated with AKI. The aim on this study was to estimate the incidence of AKI and study related risk factors among female agricultural workers in south of Spain working in crops under plastic, where temperatures can be similar to those observed in tropical latitudes.Methods: A hundred female agricultural workers were enrolled in south Spain (Huelva) during the summer months. For each participant we estimated (i) cross-shift incidence of AKI based on serum creatinine values according to the KDIGO definition; and (ii) presence of heat stress during work shift based on external temperature, activities conducted and clothing, according to international standard ISO 7933:2005. We also collected information on other occupational risk factors, clinical history, life-style factors and anthropometric measurements. We used logistic regression models to assess if heat stress is a risk factors for AKI among this population and explore other potential risk factors.Results and conclusions: Seven per cent of participants presented cross-shift AKI. Heat stress was not associated with AKI incidence [OR (95%CI) =0.37 (0.04,3.19)]. The only risk factor associated with AKI was lower mean estimated glomerular filtration rate (eGFR) prior to work-shift [(104.7 (16.3) versus 102.2 (20.2)], suggesting that previous kidney conditions were the main risk factor for AKI. These results are being validated with additional measurements of kidney function and injury such as cystatin C and neutrophil gelatinase-associated lipocalin (NGAL) urine levels (results will be available before the conference). Results suggest that previous kidney conditions were the main risk factor for AKI in this population of female agricultural workers.
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