A5081550721- Climate Change and Health Impacts
- Chronic Kidney Disease and Diabetes
- Air Quality and Health Impacts
- Heavy Metal Exposure and Toxicity
- Thermoregulation and physiological responses
- Mosquito-borne diseases and control
- Dialysis and Renal Disease Management
- Occupational Health and Safety Research
- Agriculture and Farm Safety
- Workplace Health and Well-being
- Energy and Environment Impacts
- Malaria Research and Control
- Healthcare Systems and Reforms
- Global Public Health Policies and Epidemiology
- Quality and Safety in Healthcare
- Alcohol Consumption and Health Effects
- Telemedicine and Telehealth Implementation
- Heat shock proteins research
- Mobile Health and mHealth Applications
- Birth, Development, and Health
- Electrolyte and hormonal disorders
- Acute Kidney Injury Research
- Health, Environment, Cognitive Aging
- Pesticide Exposure and Toxicity
- Environmental Justice and Health Disparities
Colorado School of Public Health
2016-2025
University of Colorado Anschutz Medical Campus
2018-2025
Colorado Department of Public Health and Environment
2022
University of Colorado Denver
2016-2021
Newman University
2018-2020
Lockheed Martin (Canada)
2020
Children's Hospital Colorado
2016
HealthPartners
2016
Center for Global Health
2016
Agricultural workers worldwide exposed to heat stress could be at the risk of kidney injury, which lead chronic disease an unknown origin (CKDu). Hydration has been promoted as a key measure reduce injury. In presence hydration intervention, incidence acute injury (AKI) was calculated in sugarcane worker population Guatemala and several factors were evaluated. We measured function beginning end work shift three time points 517 workers. defined AKI increase serum creatinine 26.5 µmol/L or 50%...
Identify early biomarkers and mechanisms of acute kidney injury in workers at risk developing chronic disease unknown origin (CKDu).We assessed cross-shift changes function 105 healthy sugarcane workers. We obtained pre-harvest clinical data as well daily environmental, clinical, productivity for each worker.The average percent decline estimated glomerular filtration rate (eGFR) was 21.8% (standard deviation [SD] 13.6%). Increasing wet bulb globe temperature (WBGT), high uric acid, decreased...
IntroductionSugarcane workers are exposed to potentially hazardous agrochemicals, including pesticides, heavy metals, and silica. Such occupational exposures present health risks have been implicated in a high rate of kidney disease seen these workers.MethodsTo investigate potential biomarkers mechanisms that could explain chronic (CKD) among this worker population, paired urine samples were collected from sugarcane cutters at the beginning end harvest season Guatemala. Workers then...
In recent years, malaria (Plasmodium vivax and Plasmodium falciparum) has been successfully controlled in the Ecuador–Peru coastal border region. The aim of this study was to document control effort identify best practices lessons learned that are applicable other vector-borne diseases. A proximal outcome evaluation conducted robust elimination programme El Oro Province, Ecuador, Tumbes Region, Peru. Data collection efforts included a series workshops with local public health experts who...
Objectives: To characterize kidney function of sugarcane workers in Guatemala over the 6-month harvest and identify risk factors associated with changes function. Methods: Demographic biological data were collected for 330 cutters at beginning end harvest. Multivariable regression analyses used to assess related Results: A decline across was observed 36% participants. Risk this included working a particular plantation mill, local area compared highland workers, current smokers. Conclusion:...
An epidemic of chronic kidney disease (CKD) has been observed in Central America among workers the sugarcane fields. One hypothesis is that CKD may be caused by recurrent heat stress and dehydration, potentially hyperuricemia. Accordingly, we developed a murine model injury associated with stress. In current experiment, tested whether treatment allopurinol (a xanthine oxidase inhibitor reduces serum urate) provides renal protection against dehydration. Eight-week-old male C57BL/6 mice were...
Total Worker Health® (TWH) leadership training, targeting organizational leaders who influence workplace safety, health, and well-being, offers a promising avenue for lasting positive change. However, the efficacy of such training in diverse communities, especially low- middle-income countries (LMICs) as Latin America, remains underexplored. We conducted comprehensive evaluation TWH program within major American agribusiness operating Guatemala, Nicaragua, Mexico. The followed best...
Abstract Background There is an international epidemic of chronic kidney disease unknown cause (CKDu) in agricultural working populations. Particulate air pollution a likely contributing factor populations at risk for CKDu, but there little personal breathing zone data these workers. Methods We collected 1 to 3 particulate matter <5 microns (PM5) gravimetric measurements 143 male sugarcane harvesters over 2 seasons and concurrent ambient samples using sampling pumps cyclone inlets as...
Climate change has implications for human health and productivity. Models suggest that heat extremes affect worker health, reduce labor capacity, commodity supply. Chronic conditions are on the rise internationally. However there is a paucity of direct empirical evidence relating increasing temperatures to both agricultural productivity.We evaluated relationship between temperature exposure, kidney function, two measures productivity-tons produced job attrition, 4,095 Guatemalan sugarcane...
Background: Sugarcane workers in Central America experience a heavy burden of chronic kidney disease unknown origin. We conducted pilot study among worker proxies Guatemala to characterize exposures particulate matter, silica, metals, and glyphosate, as well examine potential nephrotoxic exposures. Methods: Air, soil, ash samples were collected analyzed using scanning electron microscopy, X-ray diffraction, inductively coupled plasma mass spectrometry, an enzyme-linked immunosorbent assay....
Objective Acute kidney injury (AKI) occurs at high rates among agricultural workers (12–33%) in tropical environments. Because of the remote locations affected, traditional laboratory services are often unavailable. In this study we compare point care (POC) creatinine values to standardized values, and examine effect POC testing on interpretation AKI under field conditions. Methods Blood samples were collected from 104 sugarcane two time points January 2018 as a derivation cohort, 105...
Exposure to extreme heat impacts millions of people worldwide and outdoor workers are among the populations most affected by hot temperatures. Heat stress induces several biological responses in humans, including production shock proteins (HSP) antibodies against HSP (anti-HSP) which may play a central role body's cellular response environment.
Quantifying mosquito biting rates for specific locations enables estimation of mosquito-borne disease risk, and can inform intervention efforts. Measuring itself is fraught with ethical concerns, so the landing rate mosquitoes on humans often used as a proxy measure. Southern coastal Ecuador was historically endemic malaria (Plasmodium falciparum Plasmodium vivax), although successful control efforts in 2000s eliminated autochthonous transmission (since 2011). This study presents an analysis...
As global temperatures continue to rise it is imperative understand the adverse effects this will pose workers laboring outdoors. The purpose of study was investigate relationship between increases in wet bulb globe temperature (WBGT) and risk occupational injury or dehydration among agricultural workers. We used data collected by an agribusiness Southwest Guatemala over course four harvest seasons Poisson generalized linear modelling for analysis. Our analyses suggest a 3% increase recorded...
Chronic kidney disease of unknown origin (CKDu) is an epidemic that disproportionately affects young agriculture workers in hot regions. It has been hypothesized repeated acute injury (AKI) may play a role the development disease.Latent class mixed models were used to identify groups Guatemalan sugarcane harvesters based on their daily changes creatinine over 6 consecutive days 2018. Exponential smoothing state space forecast end-of-season between identified groups. Percent change estimated...
Objectives: To evaluate impact of electrolyte supplementation on hydration status and health outcomes in Guatemalan agricultural workers performing heavy work under hot climatic conditions. Methods: A 3-week pragmatic trial was conducted with a group 50 during the 2017 to 2018 sugarcane harvest. Workers received an intervention 2 3 weeks. Blood urine samples were collected each week. Results: Increased intake resulted less muscle injury. Kidney function maintained across period. adequately...
<b><i>Background:</i></b> Vasopressin is elevated in response to heat and dehydration has been postulated have a role the chronic kidney disease of unknown origin being observed Central America. The aims this study were examine whether vasopressin pathway, as measured by copeptin, associated with presence dysfunction, higher fluid intake lower circulating copeptin thereby preserves health among sugarcane workers exposed hot conditions....
Total Worker Health® (TWH) is a framework for integrating worker and workplace safety, health, well-being, which has achieved success in European US settings. However, the not been implemented Latin America or agricultural sectors, leaving large vulnerable populations underrepresented implementation evaluation of these strategies to improve safety promote health well-being. This study presents case how TWH approach can be applied multinational American agribusiness. We describe process...
High temperatures and air pollution exposure are individually known risks to human health, with amplifying adverse health effects during periods of co-exposure. This study compared co-occurring individual-level exposures particulate matter (PM5, aerodynamic diameter ≤5 μm) heat among women in residential agricultural settings Guatemala. We measured personal ambient PM5, temperature, humidity 21 female sugarcane workers the fields on their off days. similar a group 30 community members not...
Introduction Chronic kidney disease of unknown origin (CKDu) is an epidemic concentrated in agricultural communities Central and South America, including young, male sugarcane harvesters. The purpose this analysis to understand early changes function among a cohort first-time harvesters determine risk factors for decline. Methods Joint latent class mixed models were used model sub-population trajectory over the course 4 years (2012–2016). Probability weighted logistic regression was personal...