Department of Environmental Health Engineering, Sri Ramachandra Institute of Higher Education and Research, No: 1, Ramachandra Nagar, Porur, Chennai, Tamil Nadu 600116, India.
Department of Physiology, Sri Ramachandra Institute of Higher Education and Research, No: 1, Ramachandra Nagar, Porur, Chennai, Tamil Nadu 600116, India.
Sci Total Environ. 2020 Jun 20;722:137619. doi: 10.1016/j.scitotenv.2020.137619. Epub 2020 Mar 6.
Predicted temperature rise is likely to increase the risks of development and progression of renal/urologic anomalies for workers engaged in physically exerting and high-heat occupations.
We conducted a cross-sectional study with 340 steelworkers engaged in moderate to heavy labour with ≥3 year's heat exposures and assessed Wet Bulb Globe Temperature (WBGT) and heat-strain indicators. We captured self-reported heat-strain and kidney symptoms using validated questionnaires and subjected 91 workers to renal ultrasound upon referral of an occupational health specialist to detect and confirm any structural renal anomalies/stones.
The results show that heat exposures (Avg.WBGT = 33.2 °C ± 3.8 °C) exceeded the Threshold Limit Value (TLV) for 220 workers. 95% of the workers reported symptoms of heat strain and dehydration and significant associations between heat exposures, rise in Core Body Temperature (CBT) (p = 0.0001) and Urine Specific Gravity (USG) (p = 0.018) were observed. Of the 91 workers subjected to renal ultrasound, 33% were positive for kidney/ureteral stones (n = 25) & other structural renal anomalies (n = 5). Renal/urologic anomalies were higher in the heat-exposed workers (AOR = 2.374; 95% C.I = 0.927 to 6.077; p = 0.072) 29% of workers were from exposed group and 4% were from unexposed group. Years of exposure to heat (≥5 vs <5) were significantly associated with the risk of renal anomalies/calculi.
The preliminary finding concludes that high-heat stress combined with a heavy workload and chronic dehydration are high-risk factors for adverse renal health and calls for the urgent need for cooling interventions, enhanced welfare facilities, and protective labour policies to avert adverse health consequences for few million workers in the climate change scenario.
预计气温上升可能会增加从事体力劳动和高温作业的工人发生肾脏/泌尿系统异常的风险。
我们进行了一项横断面研究，纳入了 340 名从事中重度体力劳动且暴露于高温环境超过 3 年的钢铁工人，评估了湿球黑球温度（WBGT）和热应激指标。我们使用经过验证的问卷评估了自我报告的热应激和肾脏症状，并对 91 名工人进行了肾脏超声检查，以发现和确认任何结构性肾脏异常/结石。
结果表明，220 名工人的热暴露（平均 WBGT=33.2°C±3.8°C）超过了阈限值（TLV）。95%的工人报告有热应激和脱水症状，热暴露与核心体温（CBT）升高（p=0.0001）和尿比重（USG）升高（p=0.018）显著相关。对 91 名接受肾脏超声检查的工人进行分析，有 33%的工人（n=25）存在肾结石/输尿管结石和其他结构性肾脏异常（n=5）。暴露组的肾脏/泌尿系统异常发生率更高（AOR=2.374；95%CI=0.927 至 6.077；p=0.072），其中 29%的工人来自暴露组，4%的工人来自未暴露组。暴露于高温的年限（≥5 年与<5 年）与肾脏异常/结石的风险显著相关。
初步研究结果表明，高强度热应激、重体力劳动和慢性脱水是导致肾脏健康不良的高危因素，呼吁迫切需要采取冷却干预措施、改善福利设施和制定保护性劳动政策，以避免在气候变化背景下数百万工人面临不良健康后果。
