Heat Stress and Determinants of Kidney Health Among Agricultural Workers in the United States: An Integrative Review.

Agricultural workers in the United States (U.S.) are exposed to occupational heat stress, increasing their risk of adverse kidney outcomes. The aim of this integrative review was to explore the relationship between occupational heat stress and kidney health among U.S. agricultural workers. PubMed, EMBASE, Scopus, and Google Scholar were searched for original research articles on this relationship among U.S. agricultural workers. Studies were screened and reviewed by two independent reviewers in three phases: title and abstract screening, full text screening, and data extraction. The search yielded 278 articles; 14 were included in the final analysis. Heat stress was commonly measured using core body temperature changes, heat index, and wet-bulb globe temperature. Acute kidney injury (AKI) incidence following a single work shift was up to 43%. Occupational heat stress and piece-rate compensation increased the odds for developing AKI. The use of cooling bandanas and water mixed with electrolytes are promising interventions for mitigating the effect of heat stress on kidney health outcomes. The results confirm that occupational heat stress influences kidney health for U.S. agricultural workers. The mechanisms of this relationship have not been fully elucidated. More studies exploring heat protection interventions are needed.