Intervention to reduce heat stress and improveefficiency among sugarcane workers in El Salvador – Phase 1

Background: Chronic heat stress and dehydration from strenuous work in hot environments is considered an essential component of the chronic kidney disease epidemic in Central America. Objective: 1) To assess feasibility of providing an intervention modeled on OSHA’s Water.Rest.Shade program (W.R.S.) during sugarcane cutting: 2) to prevent heat stress and dehydration without decreasing productivity. Methods: Mid-way through the 6-month harvest the intervention introduced W.R.S. practices. A 60-person cutting group was provided water supplied in individual backpacks, mobile shaded rest areas and scheduled rest periods. Ergonomically improved machetes and efficiency strategies were also implemented. Health data (anthropometric, blood, urine, questionnaires) were collected pre-harvest, preintervention, mid-intervention and at the end of harvest. A subsample participated in focus group discussions. Daily wet bulb globe temperatures (WBGT) were recorded. The employer provided individual production records. Results: Over the harvest WBGT was >26°C from 9 AM onwards reaching average maximum of 29.3 ±1.7°C, around 13:00. Post-intervention self-reported water consumption increased 25%. Symptoms associated with heat stress and with dehydration decreased. Individual daily production increased from 5.1 to a high of 7.3 tons/person/day post-intervention. This increase was greater than in other cutting groups at the company. Focus groups reported a positive perception of components of the W.R.S. and the new machete and cutting programs. Conclusion: A W.R.S. intervention is feasible in sugarcane fields and appears to markedly reduce the impact of the heat stress conditions for the workforce. With proper attention to work practices, production can be maintained with less impact on worker health.