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甘蔗工人在工作和家中反复受热后肾脏劳损和炎症的工作-恢复周期。

The work-recovery cycle of kidney strain and inflammation in sugarcane workers following repeat heat exposure at work and at home.

作者信息

Lucas Rebekah A I, Hansson Erik, Skinner Bethany D, Arias-Monge Esteban, Wesseling Catharina, Ekström Ulf, Weiss Ilana, Castellón Zoey E, Poveda Scarlette, Cerda-Granados Fatima I, Martinez-Cuadra William Jose, Glaser Jason, Wegman David H, Jakobsson Kristina

机构信息

School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.

La Isla Network, Washington, DC, USA.

出版信息

Eur J Appl Physiol. 2025 Mar;125(3):639-652. doi: 10.1007/s00421-024-05610-3. Epub 2024 Oct 5.

Abstract

PURPOSE

To examine heat exposure at work and home and the work-recovery cycle and temporal variation of kidney strain, muscle injury and inflammation biomarkers in sugarcane workers.

METHODS

20 male sugarcane workers (age: 33 ± 7 years) with a workplace Rest.Shade.Hydration (RSH) intervention were observed over 4 days, at the end (18 h post-shift recovery) and beginning of a work week (42 h post-shift recovery). Measures included work intensity (heart rate), gastro-intestinal temperature, estimated body core temperature (using heart rate), fluid consumption, pre- and post-work blood and urine samples, physical activity (accelerometery) away from work, plus ambient heat exposure at work and home.

RESULTS

On workdays, workers awakened at approx. 02:40 after 5 h sleep in ~ 30 °C. Across work shifts, daily average WBGT ranged from 26 to 29 °C (cooler than normal) and average workload intensity ranged from 55 to 58%HR. Workers reported consuming ~ 8 L of water and ~ 4 × 300 mL bags of electrolyte fluid each day. Serum creatinine, cystatin C and creatine phosphokinase markedly increased post-work and decreased during recovery; serum potassium did the opposite (all p < 0.01). Biomarker concentration changes were similar between recovery periods (18 h vs. 42 h; all p > 0.27). C-reactive protein was the highest at the end of the work week (p = 0.01).

CONCLUSION

Despite RSH intervention, cross-shift kidney strain was marked (recovering overnight) and systemic inflammation increased over the work week. Thus, biomonitoring of kidney function in occupational populations should be performed before a work shift at any point in the work week. This is essential knowledge for field studies and surveillance.

摘要

目的

研究甘蔗工人在工作和家庭中的热暴露情况、工作-恢复周期以及肾脏劳损、肌肉损伤和炎症生物标志物的时间变化。

方法

对20名男性甘蔗工人(年龄:33±7岁)进行了为期4天的观察,观察时间为工作周结束时(轮班后恢复18小时)和开始时(轮班后恢复42小时),这些工人所在工作场所实施了休息、遮阳、补水(RSH)干预措施。测量指标包括工作强度(心率)、胃肠道温度、估计的身体核心温度(使用心率)、液体摄入量、工作前后的血液和尿液样本、工作之外的身体活动(加速度计测量),以及工作和家庭中的环境热暴露情况。

结果

工作日期间,工人们在约30°C的环境中睡5小时后,大约在02:40醒来。在整个轮班期间,每日平均湿球黑球温度(WBGT)在26至29°C之间(比正常温度低),平均工作量强度在55%至58%心率之间。工人们报告称每天饮用约8升水和约4袋300毫升的电解质液。血清肌酐、胱抑素C和肌酸磷酸激酶在工作后显著升高,恢复期间下降;血清钾则相反(所有p<0.01)。恢复期间(18小时与42小时)生物标志物浓度变化相似(所有p>0.27)。C反应蛋白在工作周结束时最高(p=0.01)。

结论

尽管实施了RSH干预措施,但跨轮班的肾脏劳损仍很明显(夜间恢复),且在工作周内全身炎症增加。因此,职业人群的肾功能生物监测应在工作周的任何时间点轮班前进行。这对于现场研究和监测至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec99/11889006/3898c2139115/421_2024_5610_Fig1_HTML.jpg

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