# Occupational Heat Exposure and Renal Dysfunction

> **NIH ALLCDC R01** · EMORY UNIVERSITY · 2021 · $586,240

## Abstract

Agricultural workers are an occupational sector particularly vulnerable to heat-related illness. Occupational
exposure to heat can result in injuries, disease, reduced productivity, and death and these risks have been well
documented in NIOSH priority documents on occupational exposure to heat and hot environments. In addition
to these known heat-related health threats, in recent years researchers have theorized that hot environmental
temperatures and strenuous work may play a role in the development of chronic kidney disease of unknown
etiology (CKDu), a disease that strikes young otherwise healthy, agricultural workers, and has been reported in
many tropical countries and resulted in tens of thousands of deaths. The burden of chronic kidney disease is
growing globally with increasing incidence and prevalence of individuals requiring replacement therapy, with
poor outcomes and high cost. Among agricultural workers, it has been hypothesized that heat exposure,
dehydration, volume depletion, and the combination of heat and/or other exposures may play a role in the
development of decreased renal function. Most of the studies of CKDu have been conducted on agricultural
workers in Central America and other countries with rising environmental temperatures. Our current research
on physiologic response to heat among agricultural workers in Florida has revealed that ½ of the workers start
their workday with concentrated urine, and 3 of them end their workday in this state and that among 192
workers followed over the course of 2-3 workdays, 33% had serum creatinine increases indicative of acute
kidney injury (AKI) on at least one workday. The most significant predictor for AKI was increase in heat index.
Motivated by these intriguing observations and in alignment with the NIOSH strategic priority to reduce
chronic disease in workers, we propose to recruit and study a cohort of 90 Florida agricultural workers over a
two year period to examine the inter-relationships between environmental heat exposure, biomarkers of renal
function, persistence of AKI and indicators of renal function degradation. Specifically, we aim to: 1) Determine
if renal biomarkers, AKI, and sustained decrease in renal function are associated with environmental and
exertional heat exposure in heat-exposed agricultural workers over two years; 2) Use non-targeted
metabolomic analysis to explore physiologic pathways of AKI and degradation of renal function in agricultural
workers; 3) Determine if exposure to pesticides commonly used on Florida crops are independently associated
or modify observed changes in renal function, and if these relationships are modified by factors such as
smoking and pain medication use; and 4) Using an r2p approach, develop an educational intervention toolkit
for workers and other relevant stakeholders (e.g., health care providers and agricultural employers) aimed to
promote hydration and healthy renal function. The outputs and outcomes of this study will yield ...

## Key facts

- **NIH application ID:** 10176133
- **Project number:** 5R01OH011782-03
- **Recipient organization:** EMORY UNIVERSITY
- **Principal Investigator:** Linda A. McCauley
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** ALLCDC
- **Fiscal year:** 2021
- **Award amount:** $586,240
- **Award type:** 5
- **Project period:** 2019-08-01 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10176133

## Citation

> US National Institutes of Health, RePORTER application 10176133, Occupational Heat Exposure and Renal Dysfunction (5R01OH011782-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10176133. Licensed CC0.

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