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. 2018 Oct 5;13(10):e0205181.
doi: 10.1371/journal.pone.0205181. eCollection 2018.

The impact of heat and impaired kidney function on productivity of Guatemalan sugarcane workers

Miranda Dally  1   2 , Jaime Butler-Dawson  1   2 , Lyndsay Krisher  1   2 , Andrew Monaghan  3 , David Weitzenkamp  1   4 , Cecilia Sorensen  2   5 , Richard J Johnson  2   6 , Elizabeth J Carlton  2   7 , Claudia Asensio  8 , Liliana Tenney  1   2   7 , Lee S Newman  1   2   7   9   10
Affiliations

The impact of heat and impaired kidney function on productivity of Guatemalan sugarcane workers

Miranda Dally et al. PLoS One. .

Abstract

Background: Climate change has implications for human health and productivity. Models suggest that heat extremes affect worker health, reduce labor capacity, and commodity supply. Chronic health conditions are on the rise internationally. However there is a paucity of direct empirical evidence relating increasing temperatures to both agricultural worker health and productivity.

Methods and findings: We evaluated the relationship between temperature exposure, kidney function, and two measures of productivity-tons of commodity produced and job attrition, of 4,095 Guatemalan sugarcane cutters over a 6-month harvest. We used distributed lag non-linear models to evaluate associations between wet bulb globe temperature (WBGT) and productivity of workers with normal or impaired kidney function. The cumulative effect of exposure to a max WBGT of 34°C was 1.16 tons (95% CI: -2.87, 0.54) less sugarcane cut over the next five days by workers with impaired kidney function, compared to exposure to 29°C. Impaired kidney function was associated with premature workforce attrition. Workers starting the harvest season with impaired kidney function were more than twice as likely to leave employment (HR: 2.92, 95% CI: 1.88, 4.32).

Conclusions: Heat extremes may be associated with loss of agricultural worker productivity and employment, especially among those with impaired kidney function. Agricultural workers who develop health conditions, such as kidney disease, are particularly vulnerable in the face of climate change and increasing heat extremes. The resultant loss of employment and productivity has significant implications for global commodity supplies.

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Conflict of interest statement

This evaluation was partially supported by Pantaleon. This does not alter our adherence to PLOS ONE policies on sharing data and material.

Figures

Fig 1
Fig 1. Demonstration of sugarcane cutting in practice. Photo credit: Amanda Walker.
(Left) Sugarcane cutter using a machete to cut sugarcane. (Right) Cut sugarcane being collected and stacked.
Fig 2
Fig 2. The daily mean WBGT along with average daily tons produced, through the 2015–2016 sugarcane harvest.
Fig 3
Fig 3. Cumulative association and 95% confidence interval over five-day lag between temperature and average daily tons produced.
(Top) Temperature was defined using the 95th percentile of WBGT during the work-shift with a reference of 29°C (Bottom) Temperature was defined using the mean work-shift WBGT with a reference 27°C. (Left) Impaired kidney function: eGFR < 60 ml/min/1.73 m2. (Right) Functioning kidneys: eGFR ≥ 60 ml/min/1.73 m2.
Fig 4
Fig 4. Cumulative association and 95% confidence interval over five-day lag between temperature and average daily tons produced. November and May removed.
(Top) Temperature was defined using the 95th percentile of WBGT during the work-shift with a reference of 29°C (Bottom) Temperature was defined using the mean work-shift WBGT with a reference 27°C. (Left) Impaired kidney function: eGFR < 60 ml/min/1.73 m2. (Right) Functioning kidneys: eGFR ≥ 60 ml/min/1.73 m2.
Fig 5
Fig 5. Kaplan Meier estimated survival curves for attrition stratified by kidney function.
(Impaired kidney function) eGFR < 60 ml/min/1.73 m2 represented by the dashed lined. (Functioning kidneys) eGFR ≥ 60 ml/min/1.73 m2 represented by the solid line.
See this image and copyright information in PMC

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