# Occupational Safety and Health Research (R01)

> **NIH ALLCDC R01** · TRUSTEES OF INDIANA UNIVERSITY · 2021 · $486,505

## Abstract

Abstract
An epidemic of chronic kidney disease of unknown causes (CKDu) is occurring in laborers who undertake
physical work outdoors in hot conditions. The prevalence of CKDu is predicted to escalate due to increasing
temperatures and improved diagnostics. Workers in the U.S. are at risk of CKDu. There are ~15 million
Americans who work in outdoor occupations and are often exposed to heat. It is estimated that ~15% of
workers in endemic areas will develop CKDu. By extension, there are at least 2.3 million American workers at
risk of developing CKDu. The prevailing hypothesis underlying the cause of CKDu is that heat strain (i.e.,
increases in core body temperature) and dehydration elicited by physical work in the heat brings about acute
kidney injury (AKI), and with repeated insults leads to CKDu. Notably, the incidence and severity of AKI
predicts the subsequent development of chronic kidney disease. Thus, to protect American workers against
CKDu there is a need to determine if the heat strain and dehydration exposures encountered by workers are
capable of eliciting AKI. The NIOSH heat stress and hydration recommendations aim to minimize heat strain
and dehydration. However, they were not developed with regards for renal health. Therefore, the overall
objective of this research is to determine if the NIOSH heat stress and hydration recommendations protect
workers from AKI. Specific Aim 1 will systematically determine if the NIOSH heat stress recommendations
protect workers from AKI. Moreover, Specific Aim 2 will examine if the NIOSH hydration recommendations
protect workers from AKI when undertaking physical work in the heat. Finally, Specific Aim 3 will elucidate if
the type of rehydration beverage modulates the severity of AKI induced by physical work in the heat. There is
concern and debate in the hydration recommendations regarding electrolyte prescription and the consumption
of energy drinks in heat stressed workplaces. This Specific Aim will directly inform these concerns. These
Specific Aims will study a racially/ethnically diverse cohort of adults in proportions that are congruent with
those populations who work in outdoor industries regularly exposed to heat. These participants will undertake
simulated physical work in laboratory-based studies under conditions that are representative of those
encountered in industries regularly expose to heat stress. The information gained from this project will be
disseminated in a timely manner and will inform end users and policy makers. Thus, the intermediate outcome
of our project is the translation of the obtained knowledge into the NIOSH heat stress and hydration
recommendations, embracing the NIOSH Research to Practice Initiative. This project also addresses a number
of National Occupational Research Agenda sector program items aimed at elucidating and mitigating the
health impacts of heat stress and strain in the workplace. Finally, the obtained information will serve as a
critical benchmark f...

## Key facts

- **NIH application ID:** 10172798
- **Project number:** 5R01OH011528-03
- **Recipient organization:** TRUSTEES OF INDIANA UNIVERSITY
- **Principal Investigator:** Zachary Joseph Schlader
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** ALLCDC
- **Fiscal year:** 2021
- **Award amount:** $486,505
- **Award type:** 5
- **Project period:** 2019-09-01 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10172798

## Citation

> US National Institutes of Health, RePORTER application 10172798, Occupational Safety and Health Research (R01) (5R01OH011528-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10172798. Licensed CC0.

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