Occupational heat exposure and the risk of chronic kidney disease of nontraditional origin in the United States

Occupational heat exposure is linked to the development of kidney injury and disease in individuals who frequently perform physically demanding work in the heat. For instance, in Central America, an epidemic of chronic kidney disease of nontraditional origin (CKDnt) is occurring among manual laborers, whereas potentially related epidemics have emerged in India and Sri Lanka. There is growing concern that workers in the United States suffer with CKDnt, but reports are limited. One of the leading hypotheses is that repetitive kidney injury caused by physical work in the heat can progress to CKDnt. Whether heat stress is the primary causal agent or accelerates existing underlying pathology remains contested. However, the current evidence supports that heat stress induces tubular kidney injury, which is worsened by higher core temperatures, dehydration, longer work durations, muscle damaging exercise, and consumption of beverages containing high levels of fructose. The purpose of this narrative review is to identify occupations that may place US workers at greater risk of kidney injury and CKDnt. Specifically, we reviewed the scientific literature to characterize the demographics, environmental conditions, physiological strain (i.e., core temperature increase, dehydration, heart rate), and work durations in sectors typically experiencing occupational heat exposure, including farming, wildland firefighting, landscaping, and utilities. Overall, the surprisingly limited available evidence characterizing occupational heat exposure in US workers supports the need for future investigations to understand this risk of CKDnt.

Medienart:

E-Artikel

Erscheinungsjahr:

2021

Erschienen:

2021

Enthalten in:

Zur Gesamtaufnahme - volume:321

Enthalten in:

American journal of physiology. Regulatory, integrative and comparative physiology - 321(2021), 2 vom: 01. Aug., Seite R141-R151

Sprache:

Englisch

Beteiligte Personen:

Chapman, Christopher L [VerfasserIn]
Hess, Hayden W [VerfasserIn]
Lucas, Rebekah A I [VerfasserIn]
Glaser, Jason [VerfasserIn]
Saran, Rajiv [VerfasserIn]
Bragg-Gresham, Jennifer [VerfasserIn]
Wegman, David H [VerfasserIn]
Hansson, Erik [VerfasserIn]
Minson, Christopher T [VerfasserIn]
Schlader, Zachary J [VerfasserIn]

Links:

Volltext

Themen:

Biomarker
Exercise
Heat strain
Heat stress
Journal Article
Mesoamerican nephropathy
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.
Review

Anmerkungen:

Date Completed 07.10.2021

Date Revised 02.08.2022

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1152/ajpregu.00103.2021

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM32709009X