Heat-related Illness

HRI-related Research from SCCAHS

Cycle 2 Highlights

Christopher Vulpe, MD, PhD – Professor, Physiological Sciences, College of Veterinary Medicine, University of Florida

Development of urinary biomarkers of occupational stress in agricultural workers

Unexplained kidney disease in many parts of the world, particularly in young farm workers, is driving concern for the health of U.S. farm workers. The Vulpe research lab evaluates whether heat and agricultural chemicals contribute to kidney disease. The investigative team is evaluating individual and combined impacts of agricultural chemical exposure and occupational heat stress on the development of renal disease in agricultural workers. The study uses an established rodent model system to directly assess the relationship between chronic exposure to occupationally relevant agricultural chemicals of concern and heat stress, both individually and in combination, and the development of renal disease. Efforts are being made to identify biomarkers of renal disease in agricultural workers with evidence of acute and chronic kidney disease of unknown etiology.  This work isproviding an essential evaluation of the risks to renal health posed by key occupational exposures in agricultural workers and enable the development of occupational health strategies to mitigate adverse outcomes.

Yi Guo, PhD – Associate Professor, Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida

Norman Beatty, MD – Assistant Professor, Division of Infectious Diseases and Global Medicine, College of Medicine, University of Florida

Detection of Chronic Kidney Disease of Unknown Etiology in Florida by Repurposing a Statewide Data Infrastructure for Surveillance

This project conducts surveillance of chronic kidney disease of uncertain etiology (CKDu) in Florida, searching particularly in agricultural workers. The project serves to expand an existing data infrastructure that is being used for surveillance of other conditions, the OneFlorida Data Trust. The team conducts intensive epidemiological and statistical analyses to look for hot spots of CKDu both generally and in known agricultural workers and determine associations with agricultural operations of particular types.

Cycle 1 Highlights

John Luque, PhD – Associate Professor, Behavioral Sciences/Health Education, Florida A&M University

Aplicación Movil para Prevenir Agotamiento por Calor (AMPAC)

Pilot study of mobile app monitoring to prevent heat-related symptoms among Hispanic Farmworkers Farmworkers and supervisors or crew leaders showed enthusiasm for using the Heat Safety Tool. Since most farmworkers have smartphones, downloading the free app is feasible for them to download in most instances. Crew leaders using the heat safety app rated the app very highly on relevance, functionality, value and privacy. Farmworkers did not report being overly concerned about HRI based on their survey responses. Nevertheless, 19% of farmworkers had experienced nonspecific symptoms from working in the heat, such as headache, dizziness, and nausea. In the multivariate linear regression model, farmworkers had lower heat safety knowledge scores if they were H-2A visa holders, female, and only “a little bit concerned,” compared to others who were “very concerned” about working in the heat. The resultsof this study indicate the need for continued heat safety training for both crew leaders and farmworkers to reduce the risk of HRI, especially among less experienced farmworkers.

Linda McCauley, PhD, RN, FAAN, FAAOHN – Dean, School of Nursing, Emory University

Heat Stress and Biomarkers of Renal Disease

The documentary, Facing the Sun, was released on March 1st, 2019 and documents the problem of heat illness, the research addressing it, and the goal of working with employers to make workplaces safer. In the video, you will hear from SCCAHS researchers and affiliates in regards to the research project, in addition to SCCAHS partners (https://vimeo.com/307365857). This film was accepted to the Global Health Film Festival hosted by the American Public Health Association in November 2019. This film is featured on the SCCAHS webpage in conjunction with the State of the Science White Paper for Heat Illness (https://www.sccahs.org/index.php/2019/02/05/girasole-documentary-facing-the-sun/).

HRI-related Publications

Following is a list of research publications on this topic.

Houser, M. C., Mac, V., Smith, D. J., Chicas, R. C., Xiuhtecutli, N., Flocks, J. D., Elon, L., Tansey, M. G., Sands, J. M., McCauley, L., & Hertzberg, V. S. (2021). Inflammation-Related Factors Identified as Biomarkers of Dehydration and Subsequent Acute Kidney Injury in Agricultural Workers. Biological research for nursing, 23(4), 676–688. https://doi.org/10.1177/10998004211016070 PMCID: PMC8726423.

Mac V, Elon L, Mix J, Tovar-Aguilar A, Flocks J, Economos E, Hertzberg V, McCauley L. Risk Factors for Reaching Core Body Temperature Thresholds in Florida Agricultural Workers. J Occup Environ Med. 2021 May 1;63(5):395-402. doi: 10.1097/JOM.0000000000002150. PMID: 33560064.

Mac VV, Elon L, Smith DJ, Tovar-Aguilar A, Economos E, Flocks J, Hertzberg V, McCauley L. A modified physiological strain index for workplace-based assessment of heat strain experienced by agricultural workers. Am J Ind Med. 2021 Apr;64(4):258-265. doi: 10.1002/ajim.23230. Epub 2021 Feb 4. PMID: 33543496.

Luque JS, Becker A, Bossak BH, Grzywacz JG, Tovar-Aguilar JA, Guo Y. Knowledge and Practices to Avoid Heat-Related Illness among Hispanic Farmworkers along the Florida-Georgia Line. J Agromedicine. 2020 Apr;25(2):190-200. doi: 10.1080/1059924X.2019.1670312. Epub 2019 Sep 23. PMID: 31544652; PMCID: PMC7075471.

Mac VVT, Hertzberg V, McCauley LA. Examining Agricultural Workplace Micro and Macroclimate Data Using Decision Tree Analysis to Determine Heat Illness Risk. J Occup Environ Med. 2019 Feb;61(2):107-114. doi: 10.1097/JOM.0000000000001484. PMID: 30335678; PMCID: PMC6367045.

Mutic AD, Mix JM, Elon L, Mutic NJ, Economos J, Flocks J, Tovar-Aguilar AJ, McCauley LA. Classification of Heat-Related Illness Symptoms Among Florida Farmworkers. J Nurs Scholarsh. 2018 Jan;50(1):74-82. doi: 10.1111/jnu.12355. Epub 2017 Oct 12. PMID: 29024370.

Mac VV, Tovar-Aguilar JA, Flocks J, Economos E, Hertzberg VS, McCauley LA. Heat Exposure in Central Florida Fernery Workers: Results of a Feasibility Study. J Agromedicine. 2017;22(2):89-99. doi: 10.1080/1059924X.2017.1282906. PMID: 28118110; PMCID: PMC5682629.

Hertzberg V, Mac V, Elon L, Mutic N, Mutic A, Peterman K, Tovar-Aguilar JA, Economos E, Flocks J, McCauley L. Novel Analytic Methods Needed for Real-Time Continuous Core Body Temperature Data. West J Nurs Res. 2017 Jan;39(1):95-111. doi: 10.1177/0193945916673058. Epub 2016 Oct 22. PMID: 27756853; PMCID: PMC5797491.