Hydration Status, Kidney Function, and Kidney Injury in Florida Agricultural Workers.

OBJECTIVE: Recent findings suggest that laboring in hot occupational environments is related to kidney damage in agricultural workers. We examined hydration status and kidney function in 192 Florida agricultural workers. METHODS: Blood and urine samples were collected over 555 workdays during the summers of 2015 and 2016. Urine-specific gravity (USG), serum creatinine, and other kidney function markers were examined pre- and post-shift on each workday. Multivariable mixed modeling was used to examine the association of risk factors with hydration status and acute kidney injury (AKI). RESULTS: Approximately 53% of workers were dehydrated (USG ≥1.020) pre-shift and 81% post-shift; 33% of participants had AKI on at least one workday. The odds of AKI increased 47% for each 5-degree (°F) increase in heat index. CONCLUSION: A strikingly high prevalence of dehydration and AKI exists in Florida agricultural workers.

Heat Illnesses in the Emergency Department: A Hot Topic.

The RESEARCH TO PRACTICE column is intended to improve the research critique skills of the advanced practice registered nurse (APRN) and to assist with the translation of research into practice. For each column, a topic and a particular research study are selected. The stage is set with a case presentation. The research article is then reviewed and critiqued, and the findings are discussed in relation to the case presented. Our current column discusses factors associated with heat-related hospitalizations and deaths with implications for APRN practice and public health prevention strategies using the following study: . Summertime acute heat illness in U.S. emergency departments from 2006 through 2010: Analysis of a nationally representative sample. Environmental Health Perspectives, 122(11), 1209-1215. Our case involves an adolescent athlete with sickle cell trait participating in athletic practice during the summer.

Female farmworkers' perceptions of heat-related illness and pregnancy health.

Although agricultural workers have elevated risks of heat-related illnesses (HRI), pregnant farmworkers exposed to extreme heat face additional health risk, including poor pregnancy health and birth outcomes. Qualitative data from five focus groups with 35 female Hispanic and Haitian nursery and fernery workers provide details about the women's perceptions of HRI and pregnancy. Participants believe that heat exposure can adversely affect general, pregnancy, and fetal health, yet feel they lack control over workplace conditions and that they lack training about these specific risks. These data are being used to develop culturally appropriate educational materials emphasizing health promoting and protective behaviors during pregnancy.