DescriptionChronic kidney disease unrelated to diabetes or hypertension is epidemic in Central America. Sugarcane workers are among the most affected with heat stress and dehydration suggested as central elements. An intervention on these factors accompanied by productivity improvements was piloted in El Salvador during the 2014-15 and 2015-16 harvests. The intervention adapted OSHA’s Water.Rest.Shade (W.R.S.) hot work guidelines in a cohort of three groups of sugarcane cutters (totaling 275 individuals). Measures included local climatic measures (QuesTemp, WeatherHawk), heat and dehydration symptoms (questionnaires), biological measures (i.e., urine and blood samples, heart rate, body temperature, and body movement), productivity data (via employer production records), descriptive observations, a standardized interview and focus groups. Wet Bulb Globe Temperature exceeded OSHA’s limits for continuous work from 9 AM onwards and exceeded OSHA’s highest limit (requiring 75% rest/hour) for 10% of hours worked inland and 38% of hours worked at the coast. Post-intervention self-reported water consumption increased 25%. Symptom surveys suggested reduction in most heat stress and/or dehydration symptoms. Daily production increased almost 50% post intervention exceeding productivity increases for most other cutting groups. Focus groups reported positive perception of both the W.R.S. program and the productivity improvements. Preliminary analysis of kidney function show decreased eGFR during the first two months of work before receiving the intervention but did not decrease further thereafter. A W.R.S. and efficiency intervention is feasible for manual sugarcane cutters. The intervention demonstrated reduced heat stress symptoms and higher intake of water. Although impossible to separate the effects of the intervention, W.R.S. in combination with efficiency measures also improved individual productivity without negative effects on health and well-being. Initial adoption by participants and the company is encouraging, as is interest demonstrated by labor ministries of El Salvador and Costa Rica.
|Period||18 Feb 2016|
|Held at||U.S. Army Research Institute of Environmental Medicine, United States|