Guatemalan Sugarcane Research Articles

Application and comparison of point-of-care devices for field evaluation of underlying health status of Guatemalan sugarcane workers.

With chronic disease prevalence on the rise globally, surveillance and monitoring are critical to improving health outcomes. Point-of-care (POC) testing can facilitate epidemiological research and enhance surveillance systems in limited resource settings, but previous research has identified bias between POC devices and laboratory testing. We compared the performance of two POC blood analyzers, the iSTAT handheld (Abbott, Princeton, NJ, USA) and the StatSensor Creatinine (Nova Biomedical, Waltham, MA, USA) to concurrent blood samples analyzed at a local laboratory that were collected from 89 agricultural workers in Guatemala. We measured creatinine and other measures of underlying health status with the POC and the lab blood samples. Pearson correlation coefficients, Bland-Altman plots, no intercept linear regression models and two-sample t-tests were used to evaluate the agreement between the POC and lab values collected across three study days and to assess differences by study day in a field setting. On average there was no observed difference between the iSTAT and lab creatinine measurements (p = 0.91), regardless of study day. Using lab creatinine as the gold standard, iSTAT creatinine results were more accurate compared to the Statsensor, which showed some bias, especially at higher values. The iSTAT had good agreement with the lab for sodium and blood urea nitrogen (BUN), but showed differences for potassium, anion gap, bicarbonate (TCO2), glucose, and hematocrit. In this tropical field setting, the research team devised a protocol to prevent the devices from overheating. In limited resource settings, POC devices carry advantages compared to traditional lab analyses, providing timely results to patients, researchers, and healthcare systems to better evaluate chronic health conditions. Technical challenges due to use of POC devices in high heat and humidity environments can be addressed using a standard protocol for transporting and operating the devices.

Toward sustainability? Contributions of the Guatemalan Sugarcane Agro‐Industry to the Sustainable Development Goals on water and energy

AbstractSustainability is a global mandate and has set agendas for regions, nations, sectors, and corporations. Because of the globalized nature of the economy, the pursuit of sustainability in one place has implications for others. The aim of this paper is to describe how a sector—the Guatemalan Sugarcane Agro‐industry (GSAI)—can make progress toward sustainability and contribute to the Sustainable Development Goals of the country in which it operates. The methodology used was a case study description, based largely on data reported by the GSAI. The main findings of the study show that the contributions of the industry to water and sanitation in its area of operations have been important, but limited, due to several factors that include issues such as: lack of political will, lack of technical capacity, financing, and appropriate legislation. On the other hand, the contributions of the GSAI to energy have been remarkable for the Guatemalan energy matrix, highlighting that cogeneration from sugarcane bagasse represents up to 30% of the electricity demand in the country during the 6‐month harvest season. Building on social corporate responsibility theory, the actions related to the goals on water and energy are explained. What was found is that the contributions of a sector, though important, are possibly not outstanding at the national scale, and that the conditions of the country limit the reach or pace of progress of the sector. An exception is the contributions toward sustainable energy and associated emissions, which are noteworthy. The interplay of actors at different scales needs to be understood if globally we are to achieve the goals. This understanding is key to put in place policies and enabling conditions for sectors to make progress faster, helping their country advance as well as contributing to sustainability of buyers in other countries or regions.

Occurrence of Occupational Injuries and Within Day Changes in Wet Bulb Temperature Among Sugarcane Harvesters

ABSTRACT Objective Climate change has implications for human health worldwide, with workers in outdoor occupations in low- to middle-income countries shouldering the burden of increasing average temperatures and more frequent extreme heat days. An overlooked aspect of the human health impact is the relationship between heat exposure and increased risk of occupational injury. In this study, we examined the association between occupational injury occurrence and changes in outdoor temperatures through the workday among a cohort of Guatemalan sugarcane harvesters. Methods Occupational injuries recorded for the 2014/2015 to 2017/2018 harvest seasons were collected from a large agribusiness employing male sugarcane harvesters in Southwest Guatemala. Wet Bulb Globe Temperature (WBGT) for the same period was collected from the El Balsamo weather station. We used a logistic mixed effects model to examine the association between injury occurrence and (1) the average WBGT during the hour injury was recorded, (2) the average WBGT during the hour prior to the injury being recorded, and (3) the change in the hourly average WBGT prior to the injury being recorded. Results There were 155 injuries recorded during the study period. Injuries were recorded most often between 14:00 and 16:00 (n = 62, 40%) followed by 8:00 and 10:00 (n = 56, 36%). There were significant differences in the average hourly WBGT and the hour in which injuries were recorded (p-value <.001). There were no observable associations between average hourly WBGT (OR: 1.00, 95%CI: 0.94, 1.05; p-value: 0.87), lagged average hourly WBGT (OR: 1.01, 95%CI: 0.97, 1.05; p-value: 0.71), or change in average hourly WBGT (OR: 0.96, 95%CI: 0.89, 1.04; p-value: 0.35) and recorded occupational injury. Conclusions This is the first study that has examined how changes in WBGT throughout the day are related to occupational injury among agricultural workers. Although this study did not demonstrate an association, there is a need for future research to examine how various measurements of WBGT exposure are related to occupational injury in agricultural worker populations.

Urinary concentrations of metals before and after volcanic eruption: a natural experiment surrounding the eruption of Volcán de Fuego, 2018.

Volcanic eruptions increase environmental heavy metal concentrations, yet little research has been performed on their extrapulmonary human health effects. We fortuitously collected biological samples in a cohort of Guatemalan sugarcane cutters in the area surrounding Volcán de Fuego before and after the June 2018 eruption. We sought to determine whether stratovolcanic activity was associated with changes in urinary concentrations of heavy metals in a cohort of sugarcane workers. In this exploratory analysis, we found significant increases in urinary arsenic, (β = 1.46, P < 0.0001), cadmium (β = 1.03, P < 0.0001), and lead (β = 0.87, P = 0.003) in participants with residential proximity to Volcán de Fuego as compared to participants farther away, suggesting that volcanic activity could be associated with acute heavy metal exposures. This natural experiment is, to our knowledge, the first of its kind and suggests a need for more research into heavy metal exposure-related health impacts of volcanic eruptions.

Body Composition, Anemia, and Kidney Function among Guatemalan Sugarcane Workers

Rates of anemia among agricultural workers, who are also at risk for kidney injury and chronic kidney disease of unknown cause (CKDu), are unknown. We evaluated body composition through the sum of three skinfolds among 203 male sugarcane cutters and assessed the relationship of variables related to nutrition, anemia (hemoglobin < 13 g/dL), and elevated hemoglobin A1c (HbA1c ≥ 5.7%) with estimated glomerular filtration rate (eGFR) using linear regression. Eleven percent of workers were at the level of essential body fat (2–5%). Anemia was present among 13% of workers, 70% of which were normochromic normocytic, a type of anemia suggesting potential underlying chronic disease. Anemia was more common among those with lower BMI and fat free mass. The prevalence of elevated HbA1c was 21%. A moderate negative correlation was found between hemoglobin and HbA1c (Pearson’s r = −0.32, p < 0.01) which suggests that HbA1c values should be interpreted with caution in populations that have high rates of anemia. Twelve percent of workers had reduced kidney function with an eGFR < 90 mL/min/1.73 m2. On average, the eGFR was 18 mL/min per 1.73 m2 lower [(95% CI:−24, −12), p < 0.01)] for those with anemia than those without, and 8 mL/min per 1.73 m2 lower among those with elevated HbA1c [(95% CI: −13, −2), p < 0.01]. Results will inform future studies examining the role of anemia in the evaluation of CKDu and interventions to improve nutrition for workers in low-resource settings.

Identity and Host Plant of Diatraea postlineella Schaus (Lepidoptera: Crambidae), the Guatemalan Sugarcane Borer

Diatraea postlineella Schaus, 1922, that we call the Guatemalan sugarcane borer, was described from Quirigua, Guatemala, based on one male specimen; the host was unknown. Recently, more specimens of D. postlineella from Guatemala were discovered and reared on sugarcane (Saccharum officinarum L.). Based on these specimens, morphological and molecular characters support the status of D. postlineella as a separate species. The DNA sequence from the COI barcode region and host plant are reported for the first time. Diatraea postlineella is closely related to D. crambidoides (Grote) and D. mitteri Solis. Photographs of the adults and their genitalia, a comparison of external characters, and a table of male and female genitalia characters to identify the three species are provided. A distribution map of the three species, which includes holotype localities and specimens used for the neighbor-joining cluster analysis, is provided.

Sugarcane Workweek Study: Mechanisms Underlying Daily Changes in Creatinine

Chronic kidney disease of unknown origin (CKDu) is an epidemic that has resulted in tens of thousands of deaths among workers in Latin America.1 It has been hypothesized that work, especially among sugarcane harvesters, contributes to the progression of disease through recurrent clinical and subclinical acute kidney injury.2-5 In a previous study, we observed that among the same cohort of Guatemalan sugarcane harvesters, subgroups experienced differing degrees of daily changes in creatinine. Workers with the largest daily fluctuations experienced the greatest decline in renal function by the end of the harvest season.

Environmental metal exposures and kidney function of Guatemalan sugarcane workers.

Background:Exposure to environmental metals can cause nephrotoxicity. There is an international epidemic of chronic kidney disease of unknown cause (CKDu). Whether metal exposures contribute to kidney dysfunction in populations at-risk for CKDu remains unresolved.Objective:Urinary metals (arsenic, cadmium, nickel, and uranium) were examined in 222 sugarcane cutters in Guatemala at three time points over one year.Methods:We explored the relationships between metal concentrations and markers of kidney function using multivariable linear mixed-effect models.Results:Arsenic, cadmium, and nickel were detected in the majority of the 340 urine samples and were generally within limits previously considered to be non-nephrotoxic. Nevertheless, higher urine cadmium was inversely associated with estimated glomerular filtration rate (eGFR) (β: −4.23, 95% confidence interval [CI]: −6.92, −1.54) and positively associated with neutrophil gelatinase-associated lipocalin (NGAL) (β: 2.92, 95% CI: 1.20, 4.64). Higher urine arsenic was also inversely associated with eGFR (β: −4.36, 95% CI: −7.07, −1.64).Significance:Our findings suggest that exposures to metals, including cadmium and arsenic, might contribute to kidney toxicity seen in workers at risk for CKDu. These findings are consistent with the potential for metal nephrotoxicity at lower than expected levels in the setting of manual work in a very hot environment.

Workplace Screening Identifies Clinically Significant and Potentially Reversible Kidney Injury in Heat-Exposed Sugarcane Workers.

An epidemic of chronic kidney disease of unknown origin (CKDu) has emerged in the past two decades in agricultural communities, characterized by progressive renal failure with a dearth of early clinical symptoms. The aim of this study is to improve understanding of the natural history of this disease and to evaluate the impact of an educational and behavioral intervention on the trajectories of renal decline among a cohort of Guatemalan sugarcane workers. We identified groups of workers based on their kidney function during a longitudinal parent study conducted among sugarcane workers during the 2016–2017 harvest season. At the study’s first time point in February 2017, workers who developed abnormal kidney function (AKF) (estimated glomerular filtration rate, eGFR, <60 mL/min per 1.73 m2) were placed in the AKF group, workers with reduced kidney function (RKF) (eGFR 60–89) were placed in the RKF group, and workers who maintained normal kidney function (NKF) (eGFR ≥ 90) were placed in the NKF group. As part of the study, a health promotion, behavioral and educational intervention centered on water, electrolytes, rest, and shade (WERS) was provided to all study participants. We then prospectively analyzed renal function at the three study time points in February, March, and April. Additional data collected from previous harvests allowed for retrospective analysis and we compared the rate of change in eGFR over the previous five years (2012 to 2016) for each identified group. Mixed effects linear regression with random intercepts for the workers was used to investigate the difference in rates of change for the three groups and to assess the impact of the intervention study on rate of change of kidney function during the study compared to each group’s prior trajectory, utilizing the retrospective data collected during the five years prior to the study intervention. Between 2012 and 2016, eGFR declined at a rate of 0.18 mL/min per 1.73 m2 per year for the NKF group (95% CI: −0.66, 0.29, p = 0.45), 2.02 per year for the RKF group (95% CI: 1.00, 3.03, p = 0.0001) and 7.52 per year for the AKF group (95% CI: 6.01, 9.04, p < 0.0001). All study groups stabilized or improved their trajectory of decline during the intervention. This study supports the need to institute WERS interventions and to include mid-harvest screening protocols and longitudinal tracking of kidney function among sugarcane workers at high risk of CKDu. Early detection of rapid kidney function decline combined with appropriate interventions hold promise for stopping or slowing progression of renal insufficiency among these workers.

Environmental metal exposures and kidney function of Guatemalan sugarcane workers

Background: Exposure to environmental metals can cause nephrotoxicity. There is an international epidemic of chronic kidney disease of unknown cause (CKDu), referred to in Latin America as Mesoamerican Nephropathy (MeN). Whether metal exposures contribute to kidney dysfunction in populations at-risk for CKDu remains unresolved.Methods: We examined the presence and concentrations of urinary heavy metals (arsenic, cadmium, and nickel) in 201 sugarcane cutters in Guatemala at three time points over one year. We explored relationships between urine metal concentrations and markers of kidney function by calculating β estimates and 95% confidence intervals of kidney function markers using multivariable linear mixed-effect models.Results: Urine arsenic, cadmium, and nickel were detected in the majority of the 332 urine samples. After adjusting for age, systolic blood pressure, Hemoglobin A1c, body mass index, time of collection, and urine creatinine, higher urine cadmium was inversely associated with estimated glomerular filtration rate (eGFR) (β: -6.11, 95% Confidence Interval [CI]: -8.83, -3.39) and positively associated with neutrophil gelatinase-associated lipocalin (NGAL) (β: 2.73, 95% CI: 1.03, 4.43). Higher urine arsenic was inversely associated with eGFR (β: -4.55, 95% CI: -7.08, -2.01).Conclusions: Our findings are suggestive of kidney toxicity due to metal exposure, as measured by urinary cadmium and arsenic.

Creatinine Fluctuations Forecast Cross-Harvest Kidney Function Decline Among Sugarcane Workers in Guatemala

BackgroundChronic kidney disease of unknown origin (CKDu) is an epidemic that disproportionately affects young agriculture workers in hot regions. It has been hypothesized that repeated acute kidney injury (AKI) may play a role in the development of disease.MethodsLatent class mixed models were used to identify groups of Guatemalan sugarcane harvesters based on their daily changes in creatinine over 6 consecutive days in 2018. Exponential smoothing state space models were used to forecast end-of-season creatinine between the identified groups. Percent change in estimated glomerular filtration rate (eGFR) across the harvest was compared between groups.ResultsTwenty-nine percent (n = 30) of the 103 workers experienced repeated severe fluctuations in creatinine across shift. The model with multiplicative error, multiplicative trend, and multiplicative seasonality was able to accurately forecast end-of-season creatinine in the severe group (mean percentage error [MPE]: −4.7%). eGFR of workers in the severe group on average decreased 20% across season compared to 11% decline for those in the moderate group (95% confidence interval for difference: −17% to 0%).ConclusionsDaily fluctuations in creatinine can be used to forecast end-of-season creatinine in sugarcane harvesters. Workers who experience repeat severe daily fluctuations in creatinine, on average, experience a greater reduction in kidney function across the season.

Risk Factors and Mechanisms Underlying Cross-Shift Decline in Kidney Function in Guatemalan Sugarcane Workers.

Identify early biomarkers and mechanisms of acute kidney injury in workers at risk of developing chronic kidney disease of unknown origin (CKDu). We assessed cross-shift changes in kidney function and biomarkers of injury in 105 healthy sugarcane workers. We obtained pre-harvest clinical data as well as daily environmental, clinical, and productivity data for each worker. The average percent decline in cross-shift estimated glomerular filtration rate (eGFR) was 21.8% (standard deviation [SD] 13.6%). Increasing wet bulb globe temperature (WBGT), high uric acid, decreased urine pH, urinary leukocyte esterase, and serum hyperosmolality were risk factors for decline in kidney function. Sugarcane workers with normal kidney function experience recurrent subclinical kidney injury, associated with elevations in biomarkers of injury that suggest exposure to high temperatures and extreme physical demands.

The impact of heat and impaired kidney function on productivity of Guatemalan sugarcane workers.

BackgroundClimate change has implications for human health and productivity. Models suggest that heat extremes affect worker health, reduce labor capacity, and commodity supply. Chronic health conditions are on the rise internationally. However there is a paucity of direct empirical evidence relating increasing temperatures to both agricultural worker health and productivity.Methods and findingsWe evaluated the relationship between temperature exposure, kidney function, and two measures of productivity—tons of commodity produced and job attrition, of 4,095 Guatemalan sugarcane cutters over a 6-month harvest. We used distributed lag non-linear models to evaluate associations between wet bulb globe temperature (WBGT) and productivity of workers with normal or impaired kidney function. The cumulative effect of exposure to a max WBGT of 34°C was 1.16 tons (95% CI: -2.87, 0.54) less sugarcane cut over the next five days by workers with impaired kidney function, compared to exposure to 29°C. Impaired kidney function was associated with premature workforce attrition. Workers starting the harvest season with impaired kidney function were more than twice as likely to leave employment (HR: 2.92, 95% CI: 1.88, 4.32).ConclusionsHeat extremes may be associated with loss of agricultural worker productivity and employment, especially among those with impaired kidney function. Agricultural workers who develop health conditions, such as kidney disease, are particularly vulnerable in the face of climate change and increasing heat extremes. The resultant loss of employment and productivity has significant implications for global commodity supplies.

Energy Intake over the Life Cycle and Human Capital Formation in Guatemalan Sugarcane Cutters

Improved nutritional intake is clearly a form of investment in human capital whenever a stream of economic benefits results beyond the immediate food-consumption period. The question that is being addressed in the present study is whether increased energy intake in the rural work force of developing countries may be expected to result in human capital formation. Of equal importance is the question related to the optimal life-cycle pattern of investments in human capital. Little evidence is available to evaluate the relative economic returns of im-

Energy intake and productivity of Guatemalan sugarcane cutters: An empirical test of the efficiency wage hypothesis part II

This paper examines additional evidence of an empirical test of the productivity-consumption relation of the efficiency wage hypothesis. A cross-sectional analysis showed sharply diminishing productivity returns to higher levels of daily energy intake of Guatemalan sugarcane cutters. No positive and consistent energy supplementation effect on the daily supply of work units could be demonstrated in a time-series analysis. Energy supplementation did not have a delayed impact on worker productivity. It is concluded that increased energy availability may not necessarily result in increased productivity of rural workers who are moderately energy deficient.

Energy intake and productivity of Guatemalan sugarcane cutters: An empirical test of the efficiency wage hypothesis part I

This study represents an empirical test of the productivity consumption relation of the efficiency wage hypothesis, which is briefly discussed here. The research setting and design of the study are described. An energy supplementation program was generally effective in raising the daily energy intake and energy expenditure levels of Guatemalan sugarcane workers who were moderately energy deficient. Increased energy availability did not result in increased energy expenditure at work, or in an increased supply of work units. The results do not provide evidence of a strong productive-energy intake relationship among these workers.

Food substitution with worker feeding programs: energy supplementation in Guatemalan sugarcane workers

An energy supplementation program provided free of charge a low energy (15 kcal) and a high energy (350 kcal) soft drink to two group of sugarcane workers in Guatemala. The high energy supplement supplied 550 kcal/day on a weekly basis. The workers tended to be moderately energy deficient before supplementation. Significant increases in total daily energy intake were obtained with the high energy supplement, but by less than the energy content of the supplement. Workers maintained energy balance with supplementation. The degree of substitution with energy supplementation was not related to the energy intake status of the workers' households. These households did generally not improve their energy intake status with worker supplementation.

Underemployment in Backward Economies: Some Additional Notes

Previous articleNext article No AccessUnderemployment in Backward Economies: Some Additional NotesHarvey LeibensteinHarvey Leibenstein Search for more articles by this author PDFPDF PLUS Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by Journal of Political Economy Volume 66, Number 3Jun., 1958 Article DOIhttps://doi.org/10.1086/258037 Views: 4Total views on this site Citations: 10Citations are reported from Crossref Copyright 1958 The University of Chicago PressPDF download Crossref reports the following articles citing this article:Abhijit Banerjee, Esther Duflo, Garima Sharma Long-Term Effects of the Targeting the Ultra Poor Program, American Economic Review: Insights 3, no.44 (Dec 2021): 471–486.https://doi.org/10.1257/aeri.20200667Morris Altman Inside the black box of the firm: Why choice, power and preferences matter for productivity and efficiency, (Jan 2020): 147–187.https://doi.org/10.1016/B978-0-12-811461-2.00007-9Subhasankar Chattopadhyay, Rima Mondal Characterisation of Economic Growth in Developing Economies with Informal Sector, Economic Papers: A journal of applied economics and policy (Aug 2016).https://doi.org/10.1111/1759-3441.12149Susan Godlonton Employment Risk and Job-Seeker Performance, SSRN Electronic Journal (Jan 2014).https://doi.org/10.2139/ssrn.2414037Haksoon Kim, Chanwoo Lim Diversity, outside directors and firm valuation: Korean evidence, Journal of Business Research 63, no.33 (Mar 2010): 284–291.https://doi.org/10.1016/j.jbusres.2009.01.013K. Basu, A. J. Felkey A theory of efficiency wage with multiple unemployment equilibria: how a higher minimum wage law can curb unemployment, Oxford Economic Papers 61, no.33 (Jun 2008): 494–516.https://doi.org/10.1093/oep/gpn018Sarbajit Chaudhuri, Dibyendu Banerjee Consumption efficiency hypothesis and the HOS model: Some counterintuitive results, Research in Economics 62, no.22 (Jun 2008): 64–71.https://doi.org/10.1016/j.rie.2008.01.002Stein Holden, Bekele Shiferaw, John Pender Non-farm income, household welfare, and sustainable land management in a less-favoured area in the Ethiopian highlands, Food Policy 29, no.44 (Aug 2004): 369–392.https://doi.org/10.1016/j.foodpol.2004.07.007Kaushik Basu The broth and the cooks: A theory of surplus labor, World Development 20, no.11 (Jan 1992): 109–117.https://doi.org/10.1016/0305-750X(92)90140-QMaarten D.C. Immink, Fernando E. Viteri Energy intake and productivity of Guatemalan sugarcane cutters, Journal of Development Economics 9, no.22 (Oct 1981): 251–271.https://doi.org/10.1016/0304-3878(81)90039-0