Occupational Studies

Research of Chronic Kidney Disease of non-traditional etiology in Central America has found that workers in specific industries, including agricultural workers, miners, port workers, brickmakers, and construction workers, are highly affected by the disease. Workers performing specific job tasks are seen to be at higher risk. These findings suggest that occupational factors likely play a role in CKDnt.

The two primary hypotheses for occupational exposures that could be leading to the observed increase prevalence of CKDnt among workers are 1) heat stress 2) agrichemical exposures.

Heavy physical activity combined with hot ambient temperatures in low lying regions of Central America put workers at high risk of heat stress. In these conditions, it can be challenging to replace the fluids lost to sweat, leading to dehydration. Such heat stress and dehydration can restrict blood flow to the kidneys and result in acute kidney injury (AKI). Repetitive instances of AKI are hypothesized to contribute to the development of CKDnt. With increasing temperatures due to climate change, heat stress and dehydration are an increasing threat to worker health.

Agrichemicals are commonly used in agricultural worksites across the globe. Some workers, such as pesticide applicators and pesticide mixers, work directly with agrichemicals, whereas others could be in contact with them indirectly in the fields. Evidence suggests that some agrichemicals, such as glyphosate, are nephrotoxic. However, it is unknown whether exposures to agrichemicals at worksites are contributing to the CKDnt epidemic.

Additional environmental factors that may or may not be associated with occupational exposures, are also hypothesized to potentially play a role in the development of CKDnt. These include heavy metals, infectious disease, and nephrotoxic medications. As such, in our studies of occupational risk factors of CKDnt, we also collect data regarding environmental risk factors that may be outside of the workplace.

MANOS, the MesoAmerican Nephropathy Study, is designed to focus on the three main hypotheses of heat stress and dehydration, agrichemical exposure, and heavy metals exposure.

Our Occupational Exposures Studies to date:

MesoAmerican Nephropathy Occupational Study (MANOS)