Impacts of Climate Change and Heat Stress on Farmworkers' Health: A Scoping Review

Moussa El Khayat, Dana A Halwani, Layal Hneiny, Ibrahim Alameddine, Mustapha A Haidar, Rima R Habib, Moussa El Khayat, Dana A Halwani, Layal Hneiny, Ibrahim Alameddine, Mustapha A Haidar, Rima R Habib

Abstract

Due to the continuous rise of global temperatures and heatwaves worldwide as a result of climate change, concerns for the health and safety of working populations have increased. Workers in the food production chain, particularly farmworkers, are especially vulnerable to heat stress due to the strenuous nature of their work, which is performed primarily outdoors under poor working conditions. At the cross-section of climate change and farmworkers' health, a scoping review was undertaken to summarize the existing knowledge regarding the health impacts associated with climate change and heat stress, guide future research toward better understanding current and future climate change risks, and inform policies to protect the health and safety of agricultural workers. A systematic search of 5 electronic databases and gray literature websites was conducted to identify relevant literature published up until December 2021. A total of 9045 records were retrieved from the searches, of which 92 articles were included in the final review. The majority of the reviewed articles focused on heat-related illnesses (n = 57) and kidney diseases (n = 28). The risk factors identified in the reviewed studies included gender, dehydration, heat strain, wearing inappropriate clothing, workload, piece-rate payment, job decision latitude, and hot environmental conditions. On the other hand, various protective and preventive factors were identified including drinking water, changing work hours and schedule of activities, wearing appropriate clothing, reducing soda consumption, taking breaks in shaded or air-conditioned areas, and increasing electrolyte consumption in addition to improving access to medical care. This review also identified various factors that are unique to vulnerable agricultural populations, including migrant and child farmworkers. Our findings call for an urgent need to expand future research on vulnerable agricultural communities including migrant workers so as to develop effective policies and interventions that can protect these communities from the effects of heat stress.

Keywords: agricultural workers; climate change; farmworkers; global warming; heat exposure; heat stress; occupational health.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2022 El Khayat, Halwani, Hneiny, Alameddine, Haidar and Habib.

Figures

Figure 1
Figure 1
Flow chart of selection process for included studies.
Figure 2
Figure 2
Geographical distribution of the included studies. “n” denotes the number of publications in each country; USA, United States of America.

References

    1. IPCC . AR6 Climate Change 2021: The Physical Science Basis. Available from:
    1. Perkins SE. A review on the scientific understanding of heatwaves—Their measurement, driving mechanisms, and changes at the global scale. Atmos Res. (2015). 164:242–67. 10.1016/j.atmosres.2015.05.014
    1. NASA. Global Temperature. (2021). Available from:
    1. Perkins-Kirkpatrick SE, Lewis SC. Increasing trends in regional heatwaves. Nat Commun. (2020) 11:3357. 10.1038/s41467-020-16970-7
    1. IPCC . Global warming of 1.5°C. Available from:
    1. IPCC . Special Report on Climate Change and Land. Available from:
    1. Li D, Yuan J, Kopp RE. Escalating global exposure to compound heat-humidity extremes with warming. Environ Res Lett. (2020) 15:064003. 10.1088/1748-9326/ab7d04
    1. Green H, Bailey J, Schwarz L, Vanos J, Ebi K, Benmarhnia T. Impact of heat on mortality and morbidity in low and middle income countries: A review of the epidemiological evidence and considerations for future research. Environ Res. (2019) 171:80–91. 10.1016/j.envres.2019.01.010
    1. Song X, Wang S, Hu Y, Yue M, Zhang T, Liu Y, et al. . Impact of ambient temperature on morbidity and mortality: an overview of reviews. Sci Total Environ. (2017) 586:241–254. 10.1016/j.scitotenv.2017.01.212
    1. Amegah AK, Rezza G, Jaakkola JJ. Temperature-related morbidity and mortality in Sub-Saharan Africa: a systematic review of the empirical evidence. Environ Int. (2016) 91:133–49. 10.1016/j.envint.2016.02.027
    1. Atwoli L, Baqui AH, Benfield T, Bosurgi R, Godlee F, Hancocks S, et al. . Call for emergency action to limit global temperature increases, restore biodiversity, and protect health. BMJ. (2021) 374:n1734. 10.1136/bmj.n1734
    1. NIOSH . Criteria for a Recommended Standard Occupational Exposure to Heat and Hot Environments. Available from:
    1. ACGIH . TLVs and BEIs: Based on the Documentation of the Threshold Limit Values for Chemical Substances and Physical Agents & Biological Exposure Indices. Cincinnati. Available from:
    1. Parsons K. Human Thermal Environments: The Effects of Hot, Moderate, and Cold Environments on Human Health, Comfort, and Performance, Third Edition. (2014). p. 1–586. 10.1201/b16750
    1. Holmér I. Protective clothing in hot environments. Ind Health. (2006) 44:404–13. 10.2486/indhealth.44.404
    1. Xiang J, Bi P, Pisaniello D, Hansen A. Health impacts of workplace heat exposure: an epidemiological review. Ind Health. (2014) 52:91–101. 10.2486/indhealth.2012-0145
    1. Flouris AD, Dinas PC, Ioannou LG, Nybo L, Havenith G, Kenny GP, et al. . Workers' health and productivity under occupational heat strain: a systematic review and meta-analysis. Lancet Planet Health. (2018) 2:e521–31. 10.1016/S2542-5196(18)30237-7
    1. Kjellstrom T, Lemke B, Otto M, Hyatt O, Dear K. Occupational Heat Stress: Contribution to WHO Project on “Global Assessment of the Health Impacts of Climate Change”, Which Started in 2009. Available from:
    1. ILO . Working on a Warmer Planet: The Impact of Heat Stress on Labour Productivity and Decent Work. Available from:
    1. Tigchelaar M, Battisti DS, Spector JT. Work Adaptations Insufficient to Address Growing Heat Risk for U.S. Agricultural Workers. Environ Res Lett. (2020) 15:094035. 10.1088/1748-9326/ab86f4
    1. Petropoulos ZE, Ramirez-Rubio O, Scammell MK, Laws RL, Lopez-Pilarte D, Amador JJ, et al. . Brooks, climate trends at a hotspot of chronic kidney disease of unknown causes in Nicaragua, 1973–2014. Int J Environ Res Public Health. (2021) 18:5418 10.3390/ijerph18105418
    1. Gubernot DM, Anderson GB, Hunting KL. Characterizing occupational heat-related mortality in the United States. 2000–2010: an analysis using the Census of Fatal Occupational Injuries database. Am J Ind Med. (2015) 58:203–11. 10.1002/ajim.22381
    1. Frimpong K, Van Etten EJE, Oosthuzien J, Fannam Nunfam V. Heat exposure on farmers in northeast Ghana. Int J Biometeorol. (2017) 61:397–406. 10.1007/s00484-016-1219-7
    1. Crowe J, Wesseling C, Solano BR, Umaña MP, Ramírez AR, Kjellstrom T, et al. . Heat exposure in sugarcane harvesters in Costa Rica. Am J Ind Med. (2013) 56:1157–64. 10.1002/ajim.22204
    1. Sahu S, Sett M, Kjellstrom T. Heat exposure, cardiovascular stress and work productivity in rice harvesters in India: implications for a climate change future. Ind Health. (2013) 51:424–31. 10.2486/indhealth.2013-0006
    1. Staal Wästerlund D. Managing Heat in Agricultural Work: Increasing Worker Safety and Productivity by Controlling Heat Exposure. Available from:
    1. Spector JT, Krenz J, Blank KN. Risk factors for heat-related illness in Washington crop workers. J Agromed. (2015) 20:349–59. 10.1080/1059924X.2015.1047107
    1. Moyce S, Mitchell D, Armitage T, Tancredi D, Joseph J, Schenker M. Heat strain, volume depletion and kidney function in California agricultural workers. Occup Environ Med. (2017) 74:402–9. 10.1136/oemed-2016-103848
    1. Hansen AL, Williams S, Hanson-Easey S, Varghese BM, Bi P, Heyworth J, et al. . Using a qualitative phenomenological approach to inform the etiology and prevention of occupational heat-related injuries in Australia. Int J Environ Res Public Health. (2020) 17:846. 10.3390/ijerph17030846
    1. Fleischer NL, Tiesman HM, Sumitani J, Mize T, Amarnath KK, Bayakly AR, et al. . Public health impact of heat-related illness among migrant farmworkers. Am J Prev Med. (2013) 44:199–206. 10.1016/j.amepre.2012.10.020
    1. Habib RR, Mikati D, Hojeij S, El Asmar K, Chaaya M, Zurayk R. Associations between poor living conditions and multi-morbidity among Syrian migrant agricultural workers in Lebanon. Eur J Public Health. (2016) 26:1039–44. 10.1093/eurpub/ckw096
    1. Öztaş D, Koc A, Akbaba M. Living conditions, access to healthcare services, and occupational health and safety conditions of migrant seasonal agricultural workers in the Çukurova Region. J Agromed. (2018) 23:262–9. 10.1080/1059924X.2018.1470048
    1. Castañeda A, Doan D, Newhouse D, Nguyen MC, Uematsu H, Azevedo JP. A new profile of the global poor. World Develop. (2018) 101:250–67. 10.1016/j.worlddev.2017.08.002
    1. ILO . ILO Global Estimates on Migrant Workers: Results and Methodology. Available from:
    1. FAO . Migration, Agriculture and Climate Change: Reducing Vulnerabilities and Enhancing Resilience. Available from:
    1. Caxaj CS, Cohen A. “I Will Not Leave My Body Here”: Migrant Farmworkers' Health and Safety Amidst a Climate of Coercion. Int J Environ Res Public Health. (2019) 16:2643. 10.3390/ijerph16152643
    1. Habib RR, Ziadee M, Abi Younes E, Harastani H. Syrian refugee child workers: Gender differences in ergonomic exposures and musculoskeletal health. Appl Ergon. (2020) 83:102983. 10.1016/j.apergo.2019.102983
    1. Hiott AE, Grzywacz JG, Davis SW, Quandt SA, Arcury TA. Migrant farmworker stress: mental health implications. J Rural Health. (2008) 24:32–9. 10.1111/j.1748-0361.2008.00134.x
    1. Svensson M, Urinboyev R, Svensson A, Lundqvist P, Littorin M, Albin M. Migrant agricultural workers and their socio-economic, occupational and health conditions—a literature review. SSRN Working Papers Ser. (2013). 10.2139/ssrn.2297559
    1. Mirabelli MC, Quandt SA, Crain R, Grzywacz JG, Robinson EN, Vallejos QM, et al. . Symptoms of heat illness among Latino farm workers in North Carolina. Am J Prev Med. (2010) 39:468–71. 10.1016/j.amepre.2010.07.008
    1. Sadiq LS, Hashim Z, Osman M. The Impact of Heat on Health and Productivity among Maize Farmers in a Tropical Climate Area. J Environ Public Health. (2019) 2019:9896410. 10.1155/2019/9896410
    1. Sen J, Nag PK. Human susceptibility to outdoor hot environment. Sci Total Environ. (2019) 649:866–75. 10.1016/j.scitotenv.2018.08.325
    1. Wesseling C, Glaser J, Rodríguez-Guzmán J, Weiss I, Lucas R, Peraza S, et al. . Chronic kidney disease of non-traditional origin in Mesoamerica: a disease primarily driven by occupational heat stress. Rev Panam Salud Publica. (2020) 44:e15. 10.26633/RPSP.2020.15
    1. Venugopal V, Rojas-Valverde D, Robles A, Arias E, Glaser J, Dally M. Report From the Third International Workshop on Chronic Kidney Diseases of Uncertain/Non-Traditional Etiology in Mesoamerica and Other Regions. Available from:
    1. Smith DJ, Pius LM, Plantinga LC, Thompson LM, Mac V, Hertzberg VS. Heat stress and kidney function in farmworkers in the US: a scoping review. J Agromed. (2021) 31:1–10. 10.1080/1059924X.2021.1893883
    1. Riccò M. Air temperature exposure and agricultural occupational injuries in the Autonomous Province of Trento (2000-2013, North-Eastern Italy). Int J Occup Med Environ Health. (2018) 31:317–31. 10.13075/ijomeh.1896.01114
    1. Spector JT, Bonauto DK, Sheppard L, Busch-Isaksen T, Calkins M, Adams D, et al. . A case-crossover study of heat exposure and injury risk in outdoor agricultural workers. PLoS ONE. (2016) 11:e0164498. 10.1371/journal.pone.0164498
    1. Tricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H, Levac D, et al. . PRISMA Extension for Scoping Reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. (2018) 169:467–73. 10.7326/M18-0850
    1. Arcury TA, Arnold TJ, Quandt SA, Chen H, Kearney GD, Sandberg JC, et al. . Health and occupational injury experienced by Latinx child farmworkers in North Carolina, USA. Int J Environ Res Public Health. (2019) 17:248. 10.3390/ijerph17010248
    1. Arcury TA, Summers P, Talton JW, Chen H, Sandberg JC, Spears Johnson CR, et al. . Heat illness among North Carolina Latino farmworkers. J Occup Environ Med. (2015). 57:1299–304. 10.1097/JOM.0000000000000552
    1. Arnold TJ, Arcury TA, Sandberg JC, Quandt SA, Talton JW, Mora DC, et al. . Heat-related illness among Latinx child farmworkers in North Carolina: a mixed-methods study. New Solut. (2020) 30:111–26. 10.1177/1048291120920571
    1. Bethel JW, Harger R. Heat-related illness among Oregon farmworkers. Int J Environ Res Public Health. (2014) 11:9273–85. 10.3390/ijerph110909273
    1. Budhathoki NK, Zander KK. Socio-economic impact of and adaptation to extreme heat and cold of farmers in the food bowl of Nepal. Int J Environ Res Public Health. (2019) 16:1578. 10.3390/ijerph16091578
    1. Crowe J, Nilsson M, Kjellstrom T, Wesseling C. Heat-related symptoms in sugarcane harvesters. Am J Ind Med. (2015) 58:541–8. 10.1002/ajim.22450
    1. Kearney GD, Hu H, Xu X, Hall MB, Balanay JA. Estimating the prevalence of heat-related symptoms and sun safety-related behavior among Latino farmworkers in Eastern North Carolina. J Agromed. (2016) 21:15–23. 10.1080/1059924X.2015.1106377
    1. 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 Agromed. (2020) 25:190–200. 10.1080/1059924X.2019.1670312
    1. Mutic AD, Mix JM, Elon L, Mutic NJ, Economos J, Flocks J, et al. . Classification of Heat-related illness symptoms among Florida farmworkers. J Nurs Scholarsh. (2018) 50:74–82. 10.1111/jnu.12355
    1. Smith DJ, Ferranti EP, Hertzberg VS, Mac V. Knowledge of heat-related illness first aid and self-reported hydration and heat-related illness symptoms in migrant farmworkers. Workplace Health Saf. (2021) 69:15–21. 10.1177/2165079920934478
    1. Bodin T, García-Trabanino R, Weiss I, Jarquín E, Glaser J, Jakobsson K, et al. . Intervention to reduce heat stress and improve efficiency among sugarcane workers in El Salvador: Phase 1. Occup Environ Med. (2016) 73:409–16. 10.1136/oemed-2016-103555
    1. Arcury TA, Quandt SA, Arnold TJ, Chen H, Daniel SS. Occupational Injuries of Latinx Child Farmworkers in North Carolina: associations with work safety culture. J Occup Environ Med. (2020) 62:853–8. 10.1097/JOM.0000000000001982
    1. Culp K, Tonelli S. Heat-related illness in midwestern hispanic farmworkers: a descriptive analysis of hydration status and reported symptoms. Workplace Health Saf. (2019) 67:168–78. 10.1177/2165079918813380
    1. Pogacar T, Crepinšek Z, Bogataj L, Nybo L. Comprehension of climatic and occupational heat stress amongst agricultural advisers and workers in Slovenia. Acta Agriculturae Slovenica. (2017) 109:545–54. 10.14720/aas.2017.109.3.06
    1. Riccò M, Vezzosi L, Bragazzi NL, Balzarini F. Heat-related illnesses among pesticide applicators in North-Eastern Italy (2017). J Agromed. (2020) 25:52–64. 10.1080/1059924X.2019.1606745
    1. Frimpong K, Oosthuizen JD, Van Etten EJ. Experiences of heat stress vulnerability and climate change among farmers in Ghana. J Environ Earth Sci. (2014) 4:100–110.
    1. Alemu Gelaye K, Debalke G, Awoke Ayele T, Fekadu Wolde H, Sisay MM, Teshome DF, et al. . Occupational health problems among seasonal and migrant farmworkers in Ethiopia: a cross-sectional study. Risk Manage Healthcare Policy. (2021) 14:4447–56. 10.2147/RMHP.S323503
    1. Silpasuwan P, Sujirarat D, Kongtip P, Inbamrung S, Woskie S. Hazard exposure with health and safety outcomes hinder the work ability of salt farm workers in Thailand. Sumer J Med Healthc. (2019) 2:125–33.
    1. How V, Singh S, Dang T, Guo HR. Factors associated with health-risk perception of heat waves among agroecological and conventional farmers in the tropics. Int J Clim Change Impacts Resp. (2021) 14:45–60. 10.18848/1835-7156/CGP/v14i01/45-60
    1. Venugopal V, Latha PK, Shanmugam R, Krishnamoorthy M, Omprashanth R, Lennqvist R, et al. . Epidemiological evidence from south Indian working population-the heat exposures and health linkage. J Expo Sci Environ Epidemiol. (2021) 31:177–86. 10.1038/s41370-020-00261-w
    1. Kiatkitroj K, Arphorn S, Tangtong C, Maruo SJ, Ishimaru T. Risk factors associated with heat-related illness among sugarcane farmers in Thailand. Ind Health. (2021). 10.2486/indhealth.2021-0161
    1. Lumingu HMM, Dessureault P. Physiological responses to heat strain: a study on personal monitoring for young workers. J Therm Biol. (2009). 34:299–305. 10.1016/j.jtherbio.2009.04.001
    1. Wagoner RS, López-Gálvez NI, de Zapien JG, Griffin SC, Canales RA, Beamer PI. An occupational heat stress and hydration assessment of agricultural workers in North Mexico. Int J Environ Res Public Health. (2020) 17:2102. 10.3390/ijerph17062102
    1. Gun RT, Budd GM. Effects of thermal, personal and behavioural factors on the physiological strain, thermal comfort and productivity of Australian shearers in hot weather. Ergonomics. (1995) 38:1368–84. 10.1080/00140139508925195
    1. Biggs C, Paterson M, Maunder E. Hydration status of South African forestry workers harvesting trees in autumn and winter. Ann Occup Hyg. (2011) 55:6–15. 10.1093/annhyg/meq068
    1. Mac VVT, Tovar-Aguilar JA, Elon L, Hertzberg V, Economos R, McCauley LA. Elevated core temperature in Florida fernery workers: results of a pilot study. Workplace Health Saf. (2019). 67:470–80. 10.1177/2165079919849466
    1. Vega-Arroyo AJ, Mitchell DC, Castro JR, Armitage TL, Tancredi DJ, Bennett DH, et al. . Impacts of weather, work rate, hydration, and clothing in heat-related illness in California farmworkers. Am J Ind Med. (2019) 62:1038–46. 10.1002/ajim.22973
    1. Das B, Ghosh T, Gangopadhyay S. Prevalence of musculoskeletal disorders and occupational health problems among groundnut farmers of West Bengal, India. J Hum Ergol (Tokyo). (2013) 42:1–12. 10.11183/jhe.42.14
    1. Das B, Ghosh T, Gangopadhyay S. Child work in agriculture in West Bengal, India: assessment of musculoskeletal disorders and occupational health problems. J Occup Health. (2013) 55:244–58. 10.1539/joh.12-0185-OA
    1. Mitchell DC, Castro J, Armitage TL, Vega-Arroyo AJ, Moyce SC, Tancredi DJ, et al. . Recruitment, methods, and descriptive results of a physiologic assessment of Latino farmworkers: the California Heat Illness Prevention Study. J Occup Environ Med. (2017) 59:649–58. 10.1097/JOM.0000000000000988
    1. Mac VVT. Characterizing Heat-Related Illness in Florida Farmworkers: A Feasibility Study (2016).
    1. Lundgren K, Kuklane K, Venugopal V. Occupational heat stress and associated productivity loss estimation using the PHS model (ISO 7933): a case study from workplaces in Chennai, India. Glob Health Action. (2014) 7:25283. 10.3402/gha.v7.25283
    1. Stoklosa H, Kunzler N, Ma ZB, Luna JCJ, de Vedia GM, Erickson TB. Pesticide exposure and heat exhaustion in a migrant agricultural worker: a case of labor trafficking. Ann Emerg Med. (2020) 76:215–8. 10.1016/j.annemergmed.2020.03.007
    1. CDC . Heat related Deaths among Crop Workers—United States, 1992-2006 (2008).
    1. Miller CW. Heat exhaustion in tractor drivers. Occup Health. (1982) 34:361–5.
    1. Mohammadian M, Heidari H, Charkhloo E, Dehghani A. Heat stress and physiological and perceptual strains of date harvesting workers in palm groves in Jiroft. Work. (2020) 66:625–36. 10.3233/WOR-203205
    1. Grimbuhler S, Viel JF. Heat stress and cardiac strain in French vineyard workers. Ann Work Expo Health. (2021) 65:390–6. 10.1093/annweh/wxaa115
    1. Sandsund M, Wiggen Ø, Holmen IM, Thorvaldsen T. Work strain and thermophysiological responses in Norwegian fish farming—a field study. Ind Health. (2021). 10.2486/indhealth.2020-0259
    1. Ioannou LG, Mantzios K, Tsoutsoubi L, Nintou E, Vliora M, Gkiata P, et al. . Occupational heat stress: multi-country observations and interventions. Int J Environ Res Public Health. (2021) 18:6303. 10.3390/ijerph18126303
    1. Hamerezaee M, Dehghan SF, Golbabaei F, Fathi A, Zamanian Z. Comparison of different heat stress indices for assessing farmers' exposure to heat stress. Iran J Publ Health. (2020) 49:1810−2. 10.18502/ijph.v49i9.4107
    1. Raju DSSK, Kiranmayi P, Vijaya Rachel K. Climate change and chronic kidney disease. Asian J Pharm Clin Res. (2014) 7:53–7. Available online at:
    1. Fitria L, Prihartono NA, Ramdhan DH, Wahyono TYM, Kongtip P, Woskie S. Environmental and occupational risk factors associated with chronic kidney disease of unknown etiology in West Javanese rice farmers, Indonesia. Int J Environ Res Public Health. (2020) 17:4521. 10.3390/ijerph17124521
    1. Ekiti ME, Zambo JB, Assah FK, Agbor VN, Kekay K, Ashuntantang G. Chronic kidney disease in sugarcane workers in Cameroon: a cross-sectional study. BMC Nephrol. (2018) 19:10. 10.1186/s12882-017-0798-9
    1. Butler-Dawson J, Krisher L, Yoder H, Dally M, Sorensen C, Johnson RJ, et al. . Evaluation of heat stress and cumulative incidence of acute kidney injury in sugarcane workers in Guatemala. Int Arch Occup Environ Health. (2019) 92:977–90. 10.1007/s00420-019-01426-3
    1. Moyce S, Mitchell D, Vega A, Schenker M. Hydration choices, sugary beverages, and kidney injury in agricultural workers in California. J Nurs Scholarsh. (2020) 52:369–78. 10.1111/jnu.12561
    1. Moyce S, Joseph J, Tancredi D, Mitchell D, Schenker M. Cumulative incidence of acute kidney injury in California's agricultural workers. J Occup Environ Med. (2016) 58:391–7. 10.1097/JOM.0000000000000668
    1. Moyce S, Armitage T, Mitchell D, Schenker M. Acute kidney injury and workload in a sample of California agricultural workers. Am J Ind Med. (2020) 63:258–68. 10.1002/ajim.23076
    1. Kupferman J, Ramírez-Rubio O, Amador JJ, López-Pilarte D, Wilker EH, Laws RL, et al. . Acute kidney injury in sugarcane workers at risk for Mesoamerican nephropathy. Am J Kidney Dis. (2018) 72:475–82. 10.1053/j.ajkd.2018.04.014
    1. Mix J, Elon L, Vi Thien Mac V, Flocks J, Economos E, Tovar-Aguilar AJ, et al. . Hydration status, kidney function, and kidney injury in Florida agricultural workers. J Occup Environ Med. (2018) 60:e253–60. 10.1097/JOM.0000000000001261
    1. Glaser J, Hansson E, Weiss I, Wesseling C, Jakobsson K, Ekström U, et al. . Preventing kidney injury among sugarcane workers: promising evidence from enhanced workplace interventions. Occup Environ Med. (2020) 77:527–34. 10.1136/oemed-2020-106406
    1. Hansson E, Glaser J, Jakobsson K, Weiss I, Wesseling C, Lucas RAI, et al. . Pathophysiological mechanisms by which heat stress potentially induces kidney inflammation and chronic kidney disease in sugarcane workers. Nutrients. (2020) 12:1639. 10.3390/nu12061639
    1. Hansson E, Glaser J, Weiss I, Ekström U, Apelqvist J, Hogstedt C, et al. . Workload and cross-harvest kidney injury in a Nicaraguan sugarcane worker cohort. Occup Environ Med. (2019) 76:818–26. 10.1136/oemed-2019-105986
    1. Luque JS, Bossak BH, Davila CB, JA Tovar-Aguilar JA. “I Think the Temperature was 110 Degrees!”: work safety discussions among hispanic farmworkers. J Agromed. (2019) 24:15–25. 10.1080/1059924X.2018.1536572
    1. Crowe J, van Wendel de Joode B, Wesseling C. A pilot field evaluation on heat stress in sugarcane workers in Costa Rica: what to do next? Glob Health Action. (2009) 2. 10.3402/gha.v2i0.2062
    1. Lam M, Krenz J, Palmández P, Negrete M, Perla M, Murphy-Robinson H, Spector JT. Identification of barriers to the prevention and treatment of heat-related illness in Latino farmworkers using activity-oriented, participatory rural appraisal focus group methods. BMC Public Health. (2013) 13:1004. 10.1186/1471-2458-13-1004
    1. Wilmsen C, de Castro AB, Bush D, Harrington MJ. System failure: work organization and injury outcomes among Latino forest workers. J Agromed. (2019) 24:186–96. 10.1080/1059924X.2019.1567421
    1. Laws RL, Brooks DR, Amador JJ, Weiner DE, Kaufman JS, Ramírez-Rubio O, et al. . Biomarkers of kidney injury among Nicaraguan sugarcane workers. Am J Kidney Dis. (2016) 67:209–17. 10.1053/j.ajkd.2015.08.022
    1. Laws RL, Brooks DR, Amador JJ, Weiner DE, Kaufman JS, Ramírez-Rubio O, et al. . Changes in kidney function among Nicaraguan sugarcane workers. Int J Occup Environ Health. (2015) 21:241–50. 10.1179/2049396714Y.0000000102
    1. Sorensen CJ, Butler-Dawson J, Dally M, Krisher L, Griffin BR, Johnson RJ, et al. . Risk factors and mechanisms underlying cross-shift decline in kidney function in Guatemalan sugarcane workers. J Occup Environ Med. (2019) 61:239–50. 10.1097/JOM.0000000000001529
    1. López-Gálvez N, Wagoner R, Canales RA, Ernst K, Burgess JL, de Zapien J, et al. . Longitudinal assessment of kidney function in migrant farm workers. Environ Res. (2021) 202:111686. 10.1016/j.envres.2021.111686
    1. García-Trabanino R, Jarquín E, Wesseling C, Johnson RJ, González-Quiroz M, Weiss I, et al. . Heat stress, dehydration, and kidney function in sugarcane cutters in El Salvador—a cross-shift study of workers at risk of Mesoamerican nephropathy. Environ Res. (2015) 142:746–55. 10.1016/j.envres.2015.07.007
    1. Wesseling C, Aragón A, González M, Weiss I, Glaser J, Rivard CJ, et al. . Heat stress, hydration and uric acid: a cross-sectional study in workers of three occupations in a hotspot of Mesoamerican nephropathy in Nicaragua. BMJ Open. (2016) 6:e011034. 10.1136/bmjopen-2016-011034
    1. Pundee R, Kongtip P, Nankongnab N, Anutrakulchai S, Robson MG, Woskie S. Cross-shift change of acute kidney injury biomarkers in sugarcane farmers and cutters. Hum Ecol Risk Assess. (2021) 27:1170–87. 10.1080/10807039.2020.1812049
    1. Raines N, González M, Wyatt C, Kurzrok M, Pool C, Lemma T, et al. . Risk factors for reduced glomerular filtration rate in a Nicaraguan community affected by Mesoamerican nephropathy. MEDICC Rev. (2014) 16:16–22. 10.37757/MR2014.V16.N2.4
    1. Butler-Dawson J, Krisher L, Asensio C, Cruz A, Tenney L, Weitzenkamp D, et al. . Risk factors for declines in kidney function in sugarcane workers in Guatemala. J Occup Environ Med. (2018) 60:548–58. 10.1097/JOM.0000000000001284
    1. Jayasekara KB, Kulasooriya PN, Wijayasiri KN, Rajapakse ED, Dulshika DS, Bandara P, et al. . Relevance of heat stress and dehydration to chronic kidney disease (CKDu) in Sri Lanka. Prev Med Rep. (2019) 15:100928. 10.1016/j.pmedr.2019.100928
    1. Culp K, Tonelli S, Ramey SL, Donham K, Fuortes L. Preventing heat-related illness among Hispanic farmworkers. Aaohn J. (2011) 59:23–32. 10.1177/216507991105900104
    1. Bethel JW, Spector JT, Krenz J. Hydration and cooling practices among farmworkers in Oregon and Washington. J Agromed. (2017) 22:222–8. 10.1080/1059924X.2017.1318100
    1. Stoecklin-Marois M, Hennessy-Burt T, Mitchell D, Schenker M. Heat-related illness knowledge and practices among California hired farm workers in The MICASA Study. Ind Health. (2013) 51:47–55. 10.2486/indhealth.2012-0128
    1. Flocks J, Vi Thien Mac V, Runkle J, Tovar-Aguilar JA, Economos J, McCauley LA. Female farmworkers' perceptions of heat-related illness and pregnancy health. J Agromed. (2013) 18:350–58. 10.1080/1059924X.2013.826607
    1. Frimpong K, Odonkor S, Kuranchie F, Nunfam V. Evaluation of heat stress impacts and adaptations: perspectives from smallholder rural farmers in Bawku East of Northern Ghana. Heliyon. (2020) 6:e03679. 10.1016/j.heliyon.2020.e03679
    1. Toupin D, LeBel L, Dubeau D, Imbeau D, Bouthillier L. Measuring the productivity and physical workload of brushcutters within the context of a production-based pay system. Forest Policy Econ. (2007) 9:1046–55. 10.1016/j.forpol.2006.10.001
    1. Mitchell DC, Castro J, Armitage TL, Tancredi DJ, Bennett DH, Schenker MB. Physical activity and common tasks of California farm workers: California Heat Illness Prevention Study (CHIPS). J Occup Environ Hyg. (2018) 15:857–69. 10.1080/15459624.2018.1519319
    1. Quandt SA, Arnold TJ, Mora DC, Sandberg JC, Daniel SS, Arcury TA. Hired Latinx child farm labor in North Carolina: the demand-support-control model applied to a vulnerable worker population. Am J Ind Med. (2019) 62:1079–90. 10.1002/ajim.23039
    1. Pan Q, Sumner DA, Mitchell DC, Schenker M. Compensation incentives and heat exposure affect farm worker effort. PLoS ONE. (2021) 16:e0259459. 10.1371/journal.pone.0259459
    1. OSHA. OSHA Technical Manual. Section III Chapter 4: Heat Stress. (1999). Available from:
    1. UNDP . Climate Change and Labor: Impacts of Heat in the Workplace. Available from:
    1. Wegman DH, Apelqvist J, Bottai M, Ekström U, García-Trabanino R, Glaser J, et al. . Intervention to diminish dehydration and kidney damage among sugarcane workers. Scand J Work Environ Health. (2018) 44:16–24. 10.5271/sjweh.3659
    1. OSHA . Using the Heat Index: A Guide for Employers. Available from:
    1. Arcury TA, Estrada JM, Quandt SA. Overcoming language and literacy barriers in safety and health training of agricultural workers. J Agromed. (2010) 15:236–48. 10.1080/1059924X.2010.486958
    1. Viveros-Guzmán A, Gertler M. Latino Farmworkers in Saskatchewan: language barriers and health and safety. J Agromed. (2015) 20:341–8. 10.1080/1059924X.2015.1048400
    1. Farquhar SA, Goff NM, Shadbeh N, Samples J, Ventura S, Sanchez V, et al. . Occupational health and safety status of indigenous and Latino farmworkers in Oregon. J Agric Saf Health. (2009) 15:89–102. 10.13031/2013.25417
    1. Oxfam . Human Cost of Sugar: Living and Working Conditions of Migrant Cane cutters in Maharashtra. Available from:
    1. Lucas RAI, Bodin T, García-Trabanino R, Wesseling C, Glaser J, Weiss I, et al. . Heat stress and workload associated with sugarcane cutting—an excessively strenuous occupation! Extrem Physiol Med. (2015) 4:A23. 10.1186/2046-7648-4-S1-A23
    1. Leite MR, Zanetta DMT, Trevisan IB, Burdmann EA, Santos UP. Sugarcane cutting work, risks, and health effects: a literature review. Rev Saude Publica. (2018) 52:80. 10.11606/s1518-8787.2018052000138
    1. Roncal-Jimenez C, Lanaspa MA, Jensen T, Sanchez-Lozada LG, Johnson RJ. Mechanisms by which dehydration may lead to chronic kidney disease. Ann Nutr Metab. (2015) 66:10–3. 10.1159/000381239
    1. Roncal-Jimenez C, García-Trabanino R, Barregard L, Lanaspa MA, Wesseling C, Harra T, et al. . Heat stress nephropathy from exercise-induced uric acid crystalluria: a perspective on Mesoamerican nephropathy. Am J Kidney Dis. (2016) 67:20–30. 10.1053/j.ajkd.2015.08.021
    1. Chapman CL, Johnson BD, Sackett JR, Parker MD, Schlader ZJ. Soft drink consumption during and following exercise in the heat elevates biomarkers of acute kidney injury. Am J Physiol Regul Integr Comp Physiol. (2019) 316:R189. 10.1152/ajpregu.00351.2018
    1. Correa-Rotter R, Wesseling C, Johnson RJ. CKD of unknown origin in Central America: the case for a Mesoamerican nephropathy. Am J Kidney Dis. (2014) 63:506–20. 10.1053/j.ajkd.2013.10.062
    1. Weiner DE, McClean MD, Kaufman JS, Brooks DR. The Central American epidemic of CKD. Clin J Am Soc Nephrol. (2013) 8:504–11. 10.2215/CJN.05050512
    1. González-Quiroz M, Pearce N, Caplin B, Nitsch D. What do epidemiological studies tell us about chronic kidney disease of undetermined cause in Meso-America? A systematic review and meta-analysis. Clin Kidney J. (2018) 11:496–506. 10.1093/ckj/sfx136
    1. Lunyera J, Mohottige D, Von Isenburg M, Jeuland M, Patel UD, Stanifer JW. CKD of uncertain etiology: a systematic review. Clin J Am Soc Nephrol. (2016) 11:379–85. 10.2215/CJN.07500715
    1. Orantes-Navarro CM, Herrera-Valdés R, Almaguer-López M, López-Marín L, Vela-Parada XF, Hernandez-Cuchillas M, et al. . Toward a comprehensive hypothesis of chronic interstitial nephritis in agricultural communities. Adv Chronic Kidney Dis. (2017) 24:101–6. 10.1053/j.ackd.2017.01.001
    1. Correa-Rotter R, García-Trabanino R. Mesoamerican nephropathy. Semin Nephrol. (2019) 39:263–71. 10.1016/j.semnephrol.2019.02.004
    1. Glaser J, Lemery J, Rajagopalan B, Diaz HF, García-Trabanino R, Taduri G, et al. . Climate change and the emergent epidemic of ckd from heat stress in rural communities: the case for heat stress nephropathy. Clin J Am Soc Nephrol. (2016) 11:1472–83. 10.2215/CJN.13841215
    1. Valcke M, Levasseur ME, Soares da Silva A, Wesseling C. Pesticide exposures and chronic kidney disease of unknown etiology: an epidemiologic review. Environ Health. (2017) 16:49. 10.1186/s12940-017-0254-0
    1. Grubenhoff JA, du Ford K, Roosevelt GE. Heat-related illness. Clin Pediatric Emerg Med. (2007) 8:59–64. 10.1016/j.cpem.2007.02.006
    1. Mix JM, Elon LVV, Mac T, Flocks J, Economos J, Tovar-Aguilar AJ, et al. . Physical activity and work activities in Florida agricultural workers. Am J Ind Med. (2019) 62:1058–67. 10.1002/ajim.23035
    1. Habib RR, Hojeij S, Elzein K. Gender in occupational health research of farmworkers: a systematic review. Am J Ind Med. (2014) 57:1344–67. 10.1002/ajim.22375
    1. OSHA . Water. Rest. Shade (n.d.). Available from:
    1. Habibi P, Moradi G, Moradi A, Heydari A. The impacts of climate change on occupational heat strain in outdoor workers: A systematic review. Urban Clim. (2021) 36:100770. 10.1016/j.uclim.2021.100770
    1. NIOSH. Heat Stress—Heat Related Illness. (2018). Available from:
    1. ILO . Global Employment Trends 2014: Risk of a jobless recovery? Available from:
    1. Kjellstrom T, Briggs D, Freyberg C, Lemke B, Otto M, Hyatt O. Heat, human performance, and occupational health: a key issue for the assessment of global climate change impacts. Annu Rev Public Health. (2016) 37:97–112. 10.1146/annurev-publhealth-032315-021740
    1. Varghese BM, Hansen A, Bi P, Pisaniello D. Are workers at risk of occupational injuries due to heat exposure? A comprehensive literature review. Safety Sci. (2018) 110:380–92. 10.1016/j.ssci.2018.04.027
    1. Kjellstrom T, Butler AJ, Lucas RM, Bonita R. Public health impact of global heating due to climate change: potential effects on chronic non-communicable diseases. Int J Public Health. (2010) 55:97–103. 10.1007/s00038-009-0090-2
    1. Cianconi P, Betrò S, Janiri L. The impact of climate change on mental health: a systematic descriptive review. Front Psychiatry. (2020) 11:74. 10.3389/fpsyt.2020.00074
    1. Hills AP, Mokhtar N, Byrne NM. Assessment of physical activity and energy expenditure: an overview of objective measures. Front Nutr. (2014) 1:5. 10.3389/fnut.2014.00005
    1. Wegman D, Crowe J, Hogstedt C, Jakobsson K, Wesseling C. Mesoamerican Nephropathy: Report from the Second International Research Workshop on MeN (2016).
    1. Moda HM, Filho WL, Minhas A. Impacts of climate change on outdoor workers and their safety: some research priorities. Int J Environ Res Public Health. (2019) 16:3458. 10.3390/ijerph16183458
    1. Chirico F, Taino G. Climate change and occupational health of outdoor workers: an urgent call to action for European policymakers. Environ Dis. (2019) 3:77–9. 10.4103/ed.ed_15_18
    1. Chirico F, Magnavita N. The significant role of health surveillance in the occupational heat stress assessment. Int J Biometeorol. (2019) 63:193–4. 10.1007/s00484-018-1651-y
    1. Yengoh GT, Ardö J. Climate Change and the Future Heat Stress Challenges among Smallholder Farmers in East Africa. Atmosphere. (2020) 11:753. 10.3390/atmos11070753
    1. Chan APC, Yi W, Wong FKW. Evaluating the effectiveness and practicality of a cooling vest across four industries in Hong Kong. Facilities. (2016) 34:511–34. 10.1108/F-12-2014-0104
    1. Choi JW, Kim MJ, Lee JY. Alleviation of heat strain by cooling different body areas during red pepper harvest work at WBGT 33 degrees C. Ind Health. (2008) 46:620–8. 10.2486/indhealth.46.620
    1. Chan AP, Song W, Yang Y. Meta-analysis of the effects of microclimate cooling systems on human performance under thermal stressful environments: potential applications to occupational workers. J Therm Biol. (2015) 49–50:16–32. 10.1016/j.jtherbio.2015.01.007
    1. Lundgren K, Kuklane K, Gao C, Holmér I. Effects of heat stress on working populations when facing climate change. Ind Health. (2013) 51:3–15. 10.2486/indhealth.2012-0089

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