Abstract

This longitudinal study evaluated renal function and acute kidney injury (AKI) over time in US agricultural workers. We followed Florida agricultural workers from January 2020 to August 2022, collecting blood and urine preworkday and postworkday during five visits. Preworkday estimated glomerular filtration rate function in all participants was lower in summers but relatively consistent over time. In participants who worked almost exclusively in fernery operations (piece-rate compensation), we observed a high incidence of postworkday AKI in 2020 (21%) that increased to 43% by the end of the study. In comparison, 11% of nursery workers (hourly compensation) had AKI, and this rate was fairly stable. AKI risk over time differs according to the type of agricultural work. Piece rate workers who are incentivized to forgo rest breaks and hydration to earn higher wages demonstrate steadily increasing rates of AKI.

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