John Elenjickal E, Valson Anna T, George Reena, Grace Phanny J, Anthony Parimala, Jose Nisha, Mani Selvin S R, Johny Joseph, Alam Rizwan, Lalwani Manish, Eapen Jeethu Joseph, Yusuf Sabina, Thomas Athul, Alexander Suceena, David Vinoi George, Christudoss Pamela, Mammen Joy, Varughese Santosh
Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India.
Department of Clinical Biochemistry, Christian Medical College, Vellore, Tamil Nadu, India.
Indian J Nephrol. 2025 Mar-Apr;35(2):243-252. doi: 10.25259/ijn_386_23. Epub 2024 Jun 29.
The job profile of security officers in tropical countries involves prolonged standing in hot conditions causing heat stress as well as complications of sedentary lifestyle. The objectives of this study were to estimate the prevalence of noncommunicable diseases and heat stress in security officers and analyze factors affecting heat stress and estimated glomerular filtration rate (eGFR).
This was an observational cross-sectional study conducted among security personnel working at a tertiary care hospital in South India during the hottest months of March to May 2020. Screening camps were conducted during which anthropometric measurements were taken and blood was collected for hemoglobin, creatinine, and fasting glucose estimation. Urine dipstick analysis for glucose, protein, pH, and red and white blood cells were done on early morning voided sample. Heat stress was assessed by a validated 18-item questionnaire called heat strain score index (HSSI). A structured questionnaire was prepared for surveillance of risk factors of noncommunicable diseases.
A total of 678 security officers were screened. Majority (659/678, 97.2%) were men and mean age of the cohort was 45.4 ± 9.2 years. Fifty-two percent (355/678) of participants were engaged in outdoor work for a median duration of 6 (IQR, 0-8) hours/day. Prevalence of obesity, diabetes, hypertension, and chronic kidney disease (CKD) were 70.9, 25.5, 15.9 and 1.3 percentage, respectively. Half of the cohort (324/678) had definite heat stress and 0.9% (6/678) developed CKD of undetermined etiology. Heat stress was higher in those working outdoors and longer employment duration and lower in those with abdominal obesity. eGFR was lower in older officers, smokers, hypertensives, and those with longer employment duration, but was unaffected by HSSI scores.
Kidney function was unaffected by high levels of heat stress experienced by security personnel working at a tertiary hospital in South India. Future studies are needed to understand the pathomechanisms of differential impacts of heat stress on kidney function of agricultural various worker categories.
热带国家保安人员的工作内容包括长时间在炎热环境中站立，这会导致热应激以及久坐生活方式带来的并发症。本研究的目的是评估保安人员中非传染性疾病和热应激的患病率，并分析影响热应激和估计肾小球滤过率（eGFR）的因素。
这是一项观察性横断面研究，于2020年3月至5月最炎热的月份，在印度南部一家三级护理医院工作的保安人员中进行。设立了筛查营地，期间进行人体测量，并采集血液用于血红蛋白、肌酐和空腹血糖的检测。对清晨的排尿样本进行尿试纸分析，检测葡萄糖、蛋白质、pH值以及红细胞和白细胞。通过一份经过验证的包含18个项目的问卷“热应激评分指数（HSSI）”来评估热应激。还准备了一份结构化问卷，用于监测非传染性疾病的危险因素。
共筛查了678名保安人员。大多数（659/678，97.2%）为男性，队列的平均年龄为45.4±9.2岁。52%（355/678）的参与者从事户外工作，每天工作时间中位数为6（四分位间距，0 - 8）小时。肥胖、糖尿病、高血压和慢性肾脏病（CKD）的患病率分别为70.9%、25.5%、15.9%和1.3%。队列中有一半（324/678）存在明确的热应激，0.9%（6/678）患有病因不明的CKD。户外工作者和工作时间较长者的热应激较高，腹部肥胖者的热应激较低。年龄较大的保安人员、吸烟者、高血压患者以及工作时间较长者的eGFR较低，但不受HSSI评分的影响。
在印度南部一家三级医院工作的保安人员所经历的高水平热应激并未影响其肾功能。未来需要开展研究，以了解热应激对不同类别农业工人肾功能产生不同影响的病理机制。
