Protection Resilience Efficiency and Prevention for workers in industrial agriculture in a changing climate

气候变化下工业农业工人的保护、恢复、效率和预防

• 批准号: NE/T013702/1
• 负责人: Rebekah Lucas
• 金额: $ 47.94万
• 依托单位: University of Birmingham
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2020
• 资助国家: 英国
• 起止时间: 2020 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=NE%2FT013702%2F1
• 关键词: Protection; Resilience; Efficiency; Prevention; workers

For over three decades, an epidemic of chronic kidney disease (CKD), not related to well-known risk factors like diabetes and hypertension, and thus named CKD of unknown origin (CKDu) has been detected in agricultural and other heavy labourers in Central America, especially sugarcane workers. CKDu is also increasingly observed in manual rural workers in other hot regions, such as Sri Lanka, India, and Egypt. There are probably multiple risk factors for CKDu, as for most non-communicable diseases, but there is a growing body of evidence that labour practices, specifically strenuous work in heat without sufficient rest or hydration, is an important driver of the disease. Thus, this disease can be seen as having a direct link to climate change and is likely to become even more prevalent in the near future unless workplace heat stress is mitigated. As a response to this disease, members of the current project consortia have collectively implemented the Adelante Initiative at a large sugarcane mill in Nicaragua. Adelante is a scientific evaluation of workplace interventions that focus on adequate water and rest in shade together with improved ergonomics, aiming to prevent CKDu in workers while preserving productivity. The PREP program will build on the Adelante Initiative and will have three different themes: I. To evaluate the immediate and long-term impact of a Water, Rest, and Shade intervention on workforce health (kidney health and heat related symptoms) and productivity in the sugar industry; II. To examine the economic and social impacts on individuals, families, communities, the company and health systems affected by CKDu and whether workplace interventions to reduce heat stress and the risk for CKDu aids resilience, including mitigating migration pressures; III. To examine the policies, or absence of policies (at multiple administrative scales) that have contributed to the CKDu disease and what policies are required to effectively address it in a future changing climate. This program is an interdisciplinary effort that brings together researchers with expertise in occupational hygiene, medicine, health economics, plus social and political sciences. The research methods range from advanced physiological measurements, focus groups and interviews, document analysis, to semi-structured interviews and participatory workshops. Using this coordinated, interdisciplinary approach we will evaluate how occupational health and safety interventions affects worker's health at an individual level as well as the social and economic effects in the local community, and company return-of-investment. Together with workers, management, certifying institutions, national authorities, and consumers we will build toolkits and educational materials for those affected and those wishing to improve protection for workers in industrial agricultural and other manual outdoor work. Our findings will be broadly shared via scientific communications, workshops with worker/management, production of web-based material, films for the general public, and collaboration with media. PREP will enhance our knowledge on risk factors for CKDu in industrial agricultural workers in a hot climate, and produce evidence-based toolkits and other educational material for prevention of heat stress and its consequences, directed to the industry, governments and other stakeholders. By furthering our understanding of where and who are affected, while providing viable solutions, we can help governments and industry take a proactive and cost-effective approach to address CKDu and its associated challenges. There is a need to demonstrate that such an investment will be more economical than suffering the social and economic impact of doing nothing or inadequately attempting to treat an issue that is likely to get worse in a warming world.

三十多年来，在中美洲的农业和其他重体力劳动者，特别是甘蔗工人中发现了一种与糖尿病和高血压等众所周知的危险因素无关的慢性肾脏疾病（CKD）的流行，因此被称为来历不明的CKD （CKDu）。在其他热点地区，如斯里兰卡、印度和埃及，CKDu也越来越多地出现在农村体力劳动者身上。与大多数非传染性疾病一样，CKDu可能有多种风险因素，但越来越多的证据表明，劳动实践，特别是在没有充分休息或补水的情况下在高温下剧烈工作，是该病的一个重要驱动因素。因此，这种疾病可以被视为与气候变化有直接联系，并且在不久的将来可能会变得更加普遍，除非工作场所的热压力得到缓解。为应对这一疾病，目前项目财团的成员在尼加拉瓜的一家大型甘蔗厂集体实施了阿德兰特倡议。Adelante是对工作场所干预措施的科学评估，重点是充足的水和阴凉休息，以及改进的人体工程学，旨在防止工人的CKDu，同时保持生产力。PREP项目将建立在阿德兰特倡议的基础上，并将有三个不同的主题：1 .评估水、休息和阴凉干预对制糖业劳动力健康（肾脏健康和热相关症状）和生产力的直接和长期影响；2。研究CKDu对个人、家庭、社区、公司和卫生系统的经济和社会影响，以及减少热应激和CKDu风险的工作场所干预措施是否有助于恢复力，包括减轻迁移压力；3。检查导致CKDu疾病的政策或政策缺失（在多个行政尺度上），以及在未来气候变化中需要哪些政策来有效应对CKDu疾病。这个项目是一个跨学科的努力，汇集了职业卫生、医学、卫生经济学以及社会和政治科学方面的专业研究人员。研究方法包括先进的生理测量，焦点小组和访谈，文献分析，半结构化访谈和参与式研讨会。使用这种协调的跨学科方法，我们将评估职业健康和安全干预措施如何在个人层面上影响工人的健康，以及当地社区的社会和经济影响，以及公司的投资回报。我们将与工人、管理层、认证机构、国家主管部门和消费者一道，为受影响者和希望加强对工业、农业和其他户外体力劳动工人的保护的人编写工具包和教材。我们的发现将通过科学传播、与工人/管理人员的研讨会、制作基于网络的材料、面向公众的电影以及与媒体的合作得到广泛分享。PREP将提高我们对炎热气候下工业农业工人CKDu风险因素的认识，并针对行业、政府和其他利益相关者制作基于证据的工具包和其他教育材料，以预防热应激及其后果。通过进一步了解哪些地方和哪些人受到影响，同时提供可行的解决方案，我们可以帮助政府和行业采取积极的、具有成本效益的方法来解决CKDu及其相关挑战。有必要证明，这样的投资将比不作为或不充分地试图处理一个可能在变暖的世界中变得更糟的问题而遭受社会和经济影响更经济。

项目成果

Markers of kidney tubular and interstitial injury and function among sugarcane workers with cross-harvest serum creatinine elevation.

• DOI: 10.1136/oemed-2021-107989
• 发表时间: 2022-06
• 期刊: Occupational and environmental medicine
• 影响因子: 4.9

The Prevention of Occupational Heat Stress in Sugarcane Workers in Nicaragua-An Interpretative Phenomenological Analysis.

• DOI: 10.3389/fpubh.2021.713711
• 发表时间: 2021
• 期刊: Frontiers in public health
• 影响因子: 5.2
• 作者: Pacheco-Zenteno F;Glaser J;Jakobsson K;Weiss I;Arias-Monge E;Gyllensten K
• 通讯作者: Gyllensten K

Pathophysiological Mechanisms by which Heat Stress Potentially Induces Kidney Inflammation and Chronic Kidney Disease in Sugarcane Workers

• DOI: 10.3390/nu12061639
• 发表时间: 2020-06-01
• 期刊: NUTRIENTS
• 影响因子: 5.9
• 作者: Hansson, Erik;Glaser, Jason;Wegman, David H.
• 通讯作者: Wegman, David H.

Targeting workload to ameliorate risk of heat stress in industrial sugarcane workers.

• DOI: 10.5271/sjweh.4057
• 发表时间: 2023-01-01
• 期刊: Scandinavian journal of work, environment & health
• 作者: Lucas RAI;Skinner BD;Arias-Monge E;Jakobsson K;Wesseling C;Weiss I;Poveda S;Cerda-Granados FI;Glaser J;Hansson E;Wegman DH
• 通讯作者: Wegman DH

Insulation and Evaporative Resistance of Clothing for Sugarcane Harvesters and Chemical Sprayers, and Their Application in PHS Model-Based Exposure Predictions

• DOI: 10.3390/ijerph17093074
• 发表时间: 2020-05-01
• 期刊: INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
• 作者: Kuklane, Kalev;Toma, Robert;Lucas, Rebekah A., I
• 通讯作者: Lucas, Rebekah A., I