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Longitudinal Renal Function Degradation Among Florida Agricultural Workers.
Roxana C Chicas1, Lisa Elon, Nezahualcoyotl Xiuhtecutli
1From the Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia (R.C.C., N.X., M.C.H., V.H., L.M.C.); Rollins School of Public Health, Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia (L.E.); Farmworker Association of Florida, Apopka, Florida (N.X.); Rollins School of Public Health, Emory University, Atlanta, Georgia (D.L., L.B.); Department of Medicine, Emory University, Atlanta, Georgia (T.M.); and Division of Renal Medicine, Department of Medicine, Emory University, Atlanta, Georgia (J.M.S.).
Agricultural workers face increasing kidney injury risk, especially those paid by piece rate, who are incentivized to skip breaks and hydration. This trend highlights occupational hazards in farming.
Area of Science:
- Occupational health
- Nephrology
- Environmental health
Background:
- Agricultural workers face unique occupational health challenges.
- Renal function and acute kidney injury (AKI) are critical health outcomes in this population.
- Understanding temporal trends in kidney health is essential for targeted interventions.
Purpose of the Study:
- To longitudinally evaluate renal function and AKI incidence in US agricultural workers.
- To compare AKI risk across different agricultural work types and compensation structures.
Main Methods:
- A longitudinal study followed Florida agricultural workers from January 2020 to August 2022.
- Blood and urine samples were collected pre- and post-workday during five visits.
- Renal function (e.g., estimated glomerular filtration rate) and AKI were assessed.
Main Results:
- Preworkday kidney function was lower in summers but stable over time.
- Fernery workers (piece-rate) showed a significant increase in postworkday AKI from 21% in 2020 to 43% by study end.
- Nursery workers (hourly) had a stable AKI rate of 11%.
Conclusions:
- AKI risk progression varies significantly based on agricultural work type.
- Piece-rate compensation in agricultural work is associated with increasing AKI rates, likely due to incentives that discourage rest and hydration.
- Occupational safety interventions should consider compensation structures and work practices.
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