Protection Resilience Efficiency and Prevention for workers in industrial agriculture in a changing climate
Lead Research Organisation:
University of Birmingham
Department Name: Sport, Exercise & Rehabilitation Science
Abstract
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.
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.
Planned Impact
Translating data from research into usable information for policymakers in the private and public sector, and the participants in our research, is essential to ensuring our efforts have tangible impact.
Our partners at La Isla Network (LIN) excels at engagement and dissemination of findings and will add significantly to the value of the outputs related to the results and scientific publications derived from the program. Our engagement and dissemination activities can be broken down into five categories.
1) Scientific
The interdisciplinary and mixed methodology used in this project determines that a broad academic audience in the fields of physiology, nephrology, epidemiology, occupational health and public health will be reached. Dissemination of the projects findings through CENCAM, the International Society of Nephrology International Consortium of Collaborators on Chronic Kidney Disease of Unknown Etiology and the DEGREE initiative will advance work examining the etiology and prevalence of CKDu. Scientific dissemination of PREP's findings will advance work examining the etiology of CKDu. It will also benefit academics designing and evaluating occupational interventions for other industries with similar exposures.
2) Press engagement
We will utilize the press and leading journalists to disseminate our findings in the public sphere. Press coverage of the problem, CKDu among the workforce, and proposed solutions (including safer work practices), will drive interest, increased awareness of CKDu, heat stress, its risks and its amelioration and create a space for more impactful policy design and implementation. This will be beneficial to all stakeholders from workers to the scientific community.
3) Narrative documentation
We will create short photo stories, videos, and other content to document and translate our research findings as well as the impact of the disease and mitigating efforts. Researchers, stakeholders and policy makes all benefit from informed and dedicated documentation of the impact of CKDu and what is being done to address it. This raises awareness and also can serve as a means for study participants to have agency over their experience.
4) Stakeholder empowerment and engagement
PREP's outputs must be translatable for practical applications in industry and governments. An important aspect of our work will be to create actionable toolkits and information for those affected and wishing to improve protections for workers and those that are able to assess the risks in their supply chains and industries. This information will be made available to Development banks, producers, brands, researchers, certification bodies and workers.
5) Policy engagement in the private and public sector
Building off themes I, II and III, if findings are relevant to immediate policy needs (e.g., limiting exposure to high core temperatures among workers with a heavy workload) we will work with organizations such as the Pan-American Health Organization, International Labor Organization and relevant health, labor and environmental ministries to provide guidance on reasonable but effective regulation. By addressing identified risks, via theme III, we will mitigate liabilities and costs for brands and governments, as well as strengthening certification standards. For communities this should translate into fewer affected individuals, and for governments, lower costs in treating those affected.
Our partners at La Isla Network (LIN) excels at engagement and dissemination of findings and will add significantly to the value of the outputs related to the results and scientific publications derived from the program. Our engagement and dissemination activities can be broken down into five categories.
1) Scientific
The interdisciplinary and mixed methodology used in this project determines that a broad academic audience in the fields of physiology, nephrology, epidemiology, occupational health and public health will be reached. Dissemination of the projects findings through CENCAM, the International Society of Nephrology International Consortium of Collaborators on Chronic Kidney Disease of Unknown Etiology and the DEGREE initiative will advance work examining the etiology and prevalence of CKDu. Scientific dissemination of PREP's findings will advance work examining the etiology of CKDu. It will also benefit academics designing and evaluating occupational interventions for other industries with similar exposures.
2) Press engagement
We will utilize the press and leading journalists to disseminate our findings in the public sphere. Press coverage of the problem, CKDu among the workforce, and proposed solutions (including safer work practices), will drive interest, increased awareness of CKDu, heat stress, its risks and its amelioration and create a space for more impactful policy design and implementation. This will be beneficial to all stakeholders from workers to the scientific community.
3) Narrative documentation
We will create short photo stories, videos, and other content to document and translate our research findings as well as the impact of the disease and mitigating efforts. Researchers, stakeholders and policy makes all benefit from informed and dedicated documentation of the impact of CKDu and what is being done to address it. This raises awareness and also can serve as a means for study participants to have agency over their experience.
4) Stakeholder empowerment and engagement
PREP's outputs must be translatable for practical applications in industry and governments. An important aspect of our work will be to create actionable toolkits and information for those affected and wishing to improve protections for workers and those that are able to assess the risks in their supply chains and industries. This information will be made available to Development banks, producers, brands, researchers, certification bodies and workers.
5) Policy engagement in the private and public sector
Building off themes I, II and III, if findings are relevant to immediate policy needs (e.g., limiting exposure to high core temperatures among workers with a heavy workload) we will work with organizations such as the Pan-American Health Organization, International Labor Organization and relevant health, labor and environmental ministries to provide guidance on reasonable but effective regulation. By addressing identified risks, via theme III, we will mitigate liabilities and costs for brands and governments, as well as strengthening certification standards. For communities this should translate into fewer affected individuals, and for governments, lower costs in treating those affected.
Publications
Chapman CL
(2021)
Occupational heat exposure and the risk of chronic kidney disease of nontraditional origin in the United States.
in American journal of physiology. Regulatory, integrative and comparative physiology
Glaser J
(2020)
Preventing kidney injury among sugarcane workers: promising evidence from enhanced workplace interventions.
in Occupational and environmental medicine
Glaser J
(2022)
Workplace Intervention for Heat Stress: Essential Elements of Design, Implementation, and Assessment.
in International journal of environmental research and public health
Hansson E
(2024)
Impact of heat and a rest-shade-hydration intervention program on productivity of piece-paid industrial agricultural workers at risk of chronic kidney disease of nontraditional origin.
in Annals of work exposures and health
Hansson E
(2021)
An ecological study of chronic kidney disease in five Mesoamerican countries: associations with crop and heat.
in BMC public health
Hansson E
(2022)
Markers of kidney tubular and interstitial injury and function among sugarcane workers with cross-harvest serum creatinine elevation.
in Occupational and environmental medicine
Kuklane K
(2020)
Insulation and Evaporative Resistance of Clothing for Sugarcane Harvesters and Chemical Sprayers, and Their Application in PHS Model-Based Exposure Predictions
in International Journal of Environmental Research and Public Health
Lucas RAI
(2023)
Targeting workload to ameliorate risk of heat stress in industrial sugarcane workers.
in Scandinavian journal of work, environment & health
Pacheco-Zenteno F
(2021)
The Prevention of Occupational Heat Stress in Sugarcane Workers in Nicaragua-An Interpretative Phenomenological Analysis.
in Frontiers in public health
Title | Adelante Initiative |
Description | A short video |
Type Of Art | Film/Video/Animation |
Year Produced | 2021 |
Impact | This video is available on a public platform (you tube) for general viewing. This video is also used by researchers when presenting to introduce the workplace intervention use in PREP and the Adelenta Initiative. |
URL | https://www.youtube.com/watch?v=6pftN0iBLXE |
Title | Impact of Heat stress |
Description | This short video describes the impact of occupational heat exposure on the health of workers around the world, particularly focusing on worker in unregulated and/or unprotected jobs. |
Type Of Art | Film/Video/Animation |
Year Produced | 2020 |
Impact | This video is incorporated into presentations presented to stakeholders (e.g., development banks (Deutsche Investitions (DEG) and Germany's ministry for economic cooperation and development (BMZ)), as well as certification bodies (Fairtrade international, Bonsucro, ISEAL) to provide context to data we present and recommendations we make. |
URL | https://vimeo.com/434121665 |
Title | Photography installation at COP26 |
Description | We were granted a photographic display space to install a high-quality photography installation at COP 26. Images used in this installation intimately conveyed the work environments and health consequences of workers in developing countries exposed to excessive occupational heat stress. These images were taken in communities and work settings where our research is focused and illustrate work-place interventions we have successfully implemented through our research efforts. Through this visual storytelling display at COP26, the lives and circumstances of marginalised and climate-vulnerable workforces was brought into world view, giving these workers a voice and raising awareness. Through these displayed images we aimed to tell the stories of workers and raise the public's awareness of the work environments, illnesses and diseases that are being directly affected by increasing global temperatures. |
Type Of Art | Artistic/Creative Exhibition |
Year Produced | 2021 |
Impact | Through this photographic display we were able to tell the stories of workers and raise awareness of the work environments, illnesses and diseases that are being directly affected by increasing global temperatures. These images were available to all who attended and were involved in COP 26, including politicians and policymakers. |
Description | Some manual jobs in industrial agriculture are very physically demanding and place workers at high-risk of suffering from excessive heat stress. Workers performing the most strenuous manual jobs in sugarcane are at greater risk of kidney injury over the harvest. Females maintained a higher workload than male co-workers. Within the sugar industry, workers' physical workload, level of heat strain and risk of kidney injury can be reduced with the implementation of regulated rest periods, where workers can easily access shade and cool water. Long-term implementation of work-place intervention requires significant investment from employers. However, companies can see a return on their investment through increased labor productivity, lower treatment costs for chronic and acute injuries as well as savings due to reduced turnover costs. When assessing how effective a work-place intervention is, how well an intervention is implemented must also be evaluated. The learning curve for the various stakeholders as well as the barriers to success demonstrate that effectiveness of an intervention cannot be adequately assessed without considerations of implementation. Designing, effectively implementing, and assessing both health impacts and implementation quality is a resource-intensive endeavor requiring a transdisciplinary approach. |
Exploitation Route | Sustainable development requires appropriate occupational health and safety policies and programmes that protect workers at all levels. Further work is required to identifying where and how regulatory bodies, and development banks can support and enhance occupational health and safety policies and programmes, particularly in developing economies. Can evidence-based recommendations, actionable toolkits and educational materials developed for industrial sugarcane industry be adapted and used in other industries where heat stress affects workers health and productivity? Can evidence-based recommendations, actionable toolkits and educational materials developed for the Central American industrial sugarcane industry be adapted and used in other geographical settings? How does incentive piecework influence workers to ignore or temper necessary worker protections? |
Sectors | Agriculture, Food and Drink,Government, Democracy and Justice |
URL | https://laislanetwork.org/prep/ |
Description | We have advocate for additional worker protection regulations to be included in Bonsucro Production Standard that was being revised. This advocacy was achieved via presentations to The Bonsucro team and also via suggested edits to their Production Standard. The "Bonsucro Production Standard" contains principles and criteria for achieving sustainable production of sugarcane and all sugarcane derived products in respect of economic, social and environmental dimensions. Its primary purpose is to define a set of principles, criteria and indicators, along with explanatory notes, for the assessment of the performance of operators against the three pillars of sustainability. The Standard is used by Bonsucro members who wish to achieve certification. It is also used by Licensed Certification Bodies and auditors when carrying out certification audits. We have presented this project as a case study at the WHO Pan American Regional consultation. This was part of an online 2-day workshop on Climate Change and Health held in May over 3-days to approximately 60 researchers and policy makers. In addition to a 10 min presentation We also wrote a short case-study report for the WHO. Outcomes from our project contribute (images and text) to a new 'Changing Planet' exhibition at the Thinktank, Birmingham Science Museum. The target audience was 11 -19 year olds. We were granted a photographic display space to install a high-quality photography installation at COP 26. Images used in this installation intimately conveyed the work environments and health consequences of workers in developing countries exposed to excessive occupational heat stress. They have been taken in communities and work settings where our project and research is focused and illustrate work-place interventions we have successfully implemented through this project. Through this visual storytelling display at COP26, the lives and circumstances of marginalised and climate-vulnerable workforces was brought into world view, giving these workers a voice and raising awareness. Through these displayed images we aimed to tell the stories of workers and raise the public's awareness of the work environments, illnesses and diseases that are being directly affected by increasing global temperatures. |
First Year Of Impact | 2021 |
Sector | Agriculture, Food and Drink,Education,Government, Democracy and Justice,Culture, Heritage, Museums and Collections |
Impact Types | Cultural,Economic,Policy & public services |
Description | Bonsucro Production Standard Consultation Questionnaire |
Geographic Reach | Multiple continents/international |
Policy Influence Type | Membership of a guideline committee |
Description | European Development Finance Institutions monthly meetings |
Geographic Reach | Europe |
Policy Influence Type | Contribution to new or Improved professional practice |
Description | Influencing DEG's loan policies: Incorporating worker protection policies |
Geographic Reach | Multiple continents/international |
Policy Influence Type | Contribution to new or Improved professional practice |
Impact | We have generated evidence-based recommendations for improving worker protections in industrial sugarcane production. These recommendations as well as our research findings have been reported, via written reports and presentations, to DEG. As a result of this work DEG has included policies on assessing and addressing occupational health and safety (with a particular focus on reducing heat illness and heat stress exposure) in their loans related to sugarcane in Mesoamerica. |
Description | Launch of new Bonsucro standard, including Rest, Shade, Water and Sanitation |
Geographic Reach | Multiple continents/international |
Policy Influence Type | Influenced training of practitioners or researchers |
Impact | Bonsucro partnered with Vinmonopolet to offer training on implementing a water, rest and shade protocol and sanitation to protect workers from chronic kidney disease. The training was led by Ilana Weiss, a research partner from La Isla Network working on this on this project and the Adelante Initiative. The training took place online in Spanish on 4 May 2021. |
URL | https://bonsucro.com/water-rest-shade-and-sanitation-training-to-maintain-a-healthy-and-productive-w... |
Description | Presentation to Bonsucro to advocate for worker protection regulations to be included in Bonsucro Production Standard |
Geographic Reach | Multiple continents/international |
Policy Influence Type | Participation in a guidance/advisory committee |
Impact | We (headed up by our research partners La Isla Network) presented findings from our long term study at Ingenio San Antonio de Nicaragua (called the Adelante Initiative) showing the effectiveness of workplace interventions implemented for agricultural workers. This presentation largely focused on how consistent implementation/access to water, rest and shade reduces the physical work strain experienced by workers during the workday as well as reduces rates on kidney injury across the harvest. This presentation was created to advocate for additional worker protection regulations to be included in Bonsucro Production Standard that was being revised. The "Bonsucro Production Standard" contains principles and criteria for achieving sustainable production of sugarcane and all sugarcane derived products in respect of economic, social and environmental dimensions. Its primary purpose is to define a set of principles, criteria and indicators, along with explanatory notes, for the assessment of the performance of operators against the three pillars of sustainability. The Standard is used by Bonsucro members who wish to achieve certification. It is also used by Licensed Certification Bodies and auditors when carrying out certification audits. |
Description | Preventing the spread of COVID-19 in the Mexican sugarcane sector |
Geographic Reach | Multiple continents/international |
Policy Influence Type | Membership of a guideline committee |
URL | https://www.bonsucro.com/preventing-the-spread-of-covid-19-in-the-mexican-sugarcane-sector/ |
Description | Effects of acute heat stress and heat acclimatization on exogenous carbohydrate oxidation during steady-state aerobic exercise |
Amount | £812,573 (GBP) |
Funding ID | W81XWH21C0072 |
Organisation | US Army |
Sector | Public |
Country | United States |
Start | 04/2021 |
End | 04/2024 |
Description | Migrant work in heat and health - a study in Nepal with focus on kidney disese |
Amount | 4,497,000Â kr (SEK) |
Funding ID | 2022-03318 |
Organisation | Swedish Research Council |
Sector | Public |
Country | Sweden |
Start | 01/2023 |
End | 12/2025 |
Description | University of Birmingham Internal Research Funding - Global Challenges Research Fund |
Amount | £60,000 (GBP) |
Organisation | University of Birmingham |
Sector | Academic/University |
Country | United Kingdom |
Start | 04/2021 |
End | 07/2021 |
Description | Work in heat and health - a toolbox for occupational studies in manual workers in LMIC countries |
Amount | 799,000Â kr (SEK) |
Funding ID | 2021-04421 |
Organisation | Swedish Research Council |
Sector | Public |
Country | Sweden |
Start | 01/2022 |
End | 12/2023 |
Title | A Measure of the Return on Ingenio San Antonio's Investment in the Adelante Initiative |
Description | Using data provided by Ingenio San Antonio (ISA), as well as data collected from secondary sources, we have attempted to estimate an return on investment for the Adelante Initiative. Based on what we believe to be conservative estimates, we calculate that for every dollar spent on Adelante's rest, Shade water intervention, ISA receives a return of approximately 22%. It is important to note that this estimate is based primarily on ISA-provided data. While there is no reason to doubt the accuracy of the data, the fact that most of it comes from a single source should be noted. |
Type Of Material | Database/Collection of data |
Year Produced | 2020 |
Provided To Others? | Yes |
Impact | The return on investment information in this report helped maintain ISA's commitment to implementing a rest, shade and water intervention for all outdoor manual workers. This report has help demonstrate the importance of looking at return on investment for occupational interventions to support long-term implementation. This report has also encouraged other companies in the region to implement a rest, shade and water intervention for their vulnerable workers. |
URL | https://adelanteinitiative.org/reports-for-download/ |
Title | Adelante Initiative Workload Report for Deutsche Investitions |
Description | The aim of this report was to assess and compare physical workload in a range of outdoor jobs performed at the industrial sugarcane mill Ingenio San Antonio (ISA) in Chinandega, Nicaragua. Ten manual jobs performed by workers at ISA (selected based on apparent differences in work effort) were identified for comparison. Key findings from these data are: i) the longer and more frequent rest breaks taken by Burned Cane Cutters (with better heat mitigation strategies i.e., rest, shade, access to water, and work ending by 12pm) was associated with reduced overall strain for these workers that appeared to largely prevent their internal body temperature exceeding 38 °C and subsequently suffering from occupational heat stress; ii) Climate data indicated that any outdoors workers at ISA are at risk of suffering occupational heat strain from 11am onwards during the harvest; and iii) From 8am onwards, workers performing moderate and heavy manual work (such as the job assessed for the current report: Burned Cane Cutting, Seed Cutting, Manual Seeding, Semi-Mechanised Reseeding, Manual Reseeding, Semi-Mechanised Seeding in moist soil, Gravity Irrigation, Drip Irrigation Repair, Weeding, and Semi-Mechanised Reseeding) must have sufficient heat mitigation strategies. |
Type Of Material | Database/Collection of data |
Year Produced | 2020 |
Provided To Others? | Yes |
Impact | A report was written and presented to Deutsche Investitions (DEG, Development bank) describing the workload and heat exposure experienced by agricultural workers performing manual work at the sugarcane mill Ingenio San Antonio (ISA) in Chinandega, Nicaragua. This report will inform recommendations and toolkits that we will produce for DEG. |
URL | https://laislanetwork.org/adelante-initiative-workload-data-report-2020/ |
Title | Burden of disease for communities facing CKDnt and COVID-19 |
Description | We conducted a follow up study of ~2,000 individuals (all previously recruited as part of the Adelante Initiative from 2017 - 2019) to determine their kidney and overall health pre/post COVID-19. In June 2021 we visited participant communities and conducted health assessments (including a general health questionnaire plus collection of urine and blood samples). Health, kidney metrics and antibodies from pre (2017-2019 baseline) and post (follow up) are currently being analyzed. |
Type Of Material | Database/Collection of data |
Year Produced | 2022 |
Provided To Others? | No |
Impact | These data will support health and economic impact assessments in communities facing CKDnt and/or COVID-19 (i.e., burden of disease, assessment of return of investment from sufficient interventions, resilience of communities facing CKDnt and COVID-19). |
Title | How well are workers able to recovery following a week of strenuous, hot, manual labor? |
Description | The aims of this study were to examine: i) Changes in cross-shift blood chemistry at the end of a working week, as compared to changes at the beginning of a working week following a day off. ii) Blood chemistry recovery following one and two nights' recovery, respectively. iii) Changes in internal heat stress and work intensity across a workday at the end of a working week, as compared to changes at the beginning of a working week after a day off. iv) Workers' physical activity levels and environmental heat stress exposure at their home. 20 Burned cane cutters were recruited to participate in this study. Blood and urine samples were collected pre and post a work shift at the end of the work week (Fri and Sat) and then the following Monday, after a one day weekend. Heart rate and internal body core temperature was recorded during work shifts (Fri, Sat and Sun). Workers wore a heart rate monitor and an accelerometer during their weekend. Workers also took a temperature monitor (ibutton logger) home to record temperatures in their homes. Data collection occurred Feb 2020. Initial data analysis of the data collected for this study has been completed. We are waiting for blood and urine samples from this study to be shipped to Sweden for subsequent analysis. |
Type Of Material | Database/Collection of data |
Year Produced | 2020 |
Provided To Others? | No |
Impact | As a result of the COVID-19 pandemic we have not been able to safely ship our blood and urine samples form this study to Sweden for subsequent analysis. This has halted progress on this data set. However, we anticipate that we will be able to ship these samples in the next month. A scientific peer-reviewed publication will be the first output from this dataset. |
Title | The Economic impact of CKDnt on Households |
Description | A pilot survey of households was conducted in 3 communities in Chichigalpa, Nicaragua, including La Isla, Manhattan, Candelaria, each of which provide labor for the Ingenio San Antonio sugar mill, and from Asochivida, an association of ex-mill workers and their widows. The sample of households was a purposive sample drawn specifically from households that have, or had, a member with Chronic Kidney Disease of non-traditional Etiology (CKDnt). As such, it is not meant to be a convenience sample or a random sample and, therefore, not meant to be representative of the whole populations in these communities. Instead, the intent was to examine the nature of the economic effects that CKDnt has on households and their communities as a pilot study to assess our questionnaire and the feasibility of conducting a representative survey of this nature in this area. |
Type Of Material | Database/Collection of data |
Year Produced | 2020 |
Provided To Others? | Yes |
Impact | This pilot study raised several interesting questions that merit additional study. First, and most important, a study that expands on this purposive survey to include non-CKDnt households is clearly needed for a picture of how CKDnt households differ from non-CKDnt households. This study was intended as a feasibility study to determine whether and to what extent we could collect reliable data from these communities. We are now confident that we can. Second, additional information on sources of other income, on the extent to which the need for dialysis exceeds the availability, and on the level of household debt and how it is retired is needed. Third, a follow-on survey of these communities needs to address the fact that the work done by most of the members of these communities is being mechanized, displacing significant numbers of workers. And we need to study how these workers cope with the loss of employment-do they relocate, are they hired by other sugar mills, do they take up another line of work, etc.? What is clear, however, is that CKDnt affects not only the worker himself and his household, but also future generations as opportunities for their children diminish, or are closed off entirely, as a result of the disease. Further research into this aspect of the disease is also needed. |
URL | https://adelanteinitiative.org/reports-for-download/ |
Description | Bodytrak - Industry collaboration |
Organisation | Inova Design Solutions |
Country | United Kingdom |
Sector | Private |
PI Contribution | Working to create and test engineering solutions to better protect workers and reduce their workload and heat exposure. |
Collaborator Contribution | La Isla Network have taken the lead with establishing a relationship with Bodytrack and are the principal investigators for a USAID grant we are writing to support this work. I am a co-applicant on this grant. |
Impact | Co-applicants for a USAID grant application (https://www.usaid.gov/di). |
Start Year | 2020 |
Description | Kenzen - Industry collaboration |
Organisation | Kenzen |
Country | United States |
Sector | Private |
PI Contribution | Kenzen has developed a safety monitoring device and an integrated platform that analyses biometric data in real time and allows individual workers or managers to monitor key physiological indicators, resulting in increased awareness and adoption of safer work practices. We will performing some independent testing of this device to assess the validity of measure. This validation testing will commence once we are able to recommence testing on campus (human-based testing has been temporarily halted at the University of Birmingham due to Covid-19). |
Collaborator Contribution | Partners at Gothenburg University and La Isla Network has supported this collaboration with Kenzen through data analysis and pictures/videos/infographics illustrating workplace interventions as well as findings from our studies. |
Impact | I have also been asked to support a Kenzen-hosted webinar on the 10th February 2021 (with 500-1000 EHS/healthy + safety managers attending)) about keeping workers safe in the heat, with hydration, work/rest schedules. In this webinare I will share data about the efficacy of the workplace interventions we have implemented in industrial agricultural settings. This collaboration is multi-disciplinary, including physiology, epidemiology, policy and industry. |
Start Year | 2019 |
Description | BBC story: Climate change: Summers could become too hot for humans |
Form Of Engagement Activity | A broadcast e.g. TV/radio/film/podcast (other than news/press) |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Media (as a channel to the public) |
Results and Impact | David Shukman, the Science editor from the BBC News wrote a story about the challenges of outdoor working in the temperature and humidity conditions projected for climate change. R Lucas was interviewed by David and quoted in this story featured on BBC news (Television and online media). David is running a series of reports in the run-up to COP26 in Glasgow and is planning to run additional stories about the work our group is doing in Nicaragua and India. So there is a strong possibility that we will be contacted again for a follow-up. |
Year(s) Of Engagement Activity | 2020 |
URL | https://www.bbc.co.uk/news/science-environment-53415298#:~:text=Millions%20of%20people%20around%20th... |
Description | Bonsucro webinars |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Third sector organisations |
Results and Impact | Research partner, I Weiss, lead a series of webinars outlining findings from the PREP project to Bonsucro members, a leading international sustainability platform and standard for sugarcane. |
Year(s) Of Engagement Activity | 2022 |
Description | Climate change and Health - Research Spotlight |
Form Of Engagement Activity | A magazine, newsletter or online publication |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Media (as a channel to the public) |
Results and Impact | The University of Birmingham uses "Research Spotlights" to showcase pioneering breakthroughs, multidisciplinary collaborations and research with a significant global impact. |
Year(s) Of Engagement Activity | 2021 |
URL | https://www.birmingham.ac.uk/research/spotlights/climate-change-health.aspx |
Description | Guardian News Article |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Media (as a channel to the public) |
Results and Impact | A news article on how rising global temperatures affect workers around the world, from Nicaragua to Nepal. Quotes from research team members including William Martinez who used to be a child laborer and is now a community leader, and researcher working with us in Nicaragua. |
Year(s) Of Engagement Activity | 2021 |
URL | https://www.theguardian.com/global-development/2021/jul/14/deadly-heat-how-rising-temperatures-threa... |
Description | Guardian Photo essay |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Media (as a channel to the public) |
Results and Impact | A news article looking at the impact of interventions with interviews from research partners on this project. |
Year(s) Of Engagement Activity | 2021 |
URL | https://www.theguardian.com/global-development/2020/nov/27/the-mystery-epidemic-striking-nicaraguas-... |
Description | Guardian Podcast |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Media (as a channel to the public) |
Results and Impact | A podcast with voices from Nicaragua and research partners discussing the impact of rising temperatures and of heavy work in sugarcane fields and the need to act there and in other affected industries at COP 26 and beyond. |
Year(s) Of Engagement Activity | 2021 |
URL | https://www.theguardian.com/news/audio/2021/oct/20/cop-26-a-question-of-degrees-what-a-hotter-planet... |
Description | Heat stress and Workload exposure assessments |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | 20 Southern African-based individual attended this workshop. Attendees were professionals from government, industry, medical, and academic sectors. R Lucas, K Jakobsson and B Skinner from the University of Birmingham and Gothenburg University lead this workshop. The aims for this workshop were for attendees to: - Network - Gain an understanding of human physiological responses to the heat - Gain a working understanding of heat exposure measures - Know where to access International and African-based heat exposure regulations - Gain a working understanding of qualitative and quantitative workload measures |
Year(s) Of Engagement Activity | 2022 |
Description | Invited to attended The London School of Hygiene & Tropical Medicine to meet and discuss interventions and share recent findings from the Adelante Initiative in Nicaragua |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Other audiences |
Results and Impact | Invited by Assoc Prof. Sari Kovats (Consortium lead for the Belmont funded project CHAMNHA - Climate, Heat and Maternal and Neonatal Health in Africa). Invited to attend their Belmont kick off meeting to discuss the implementation of interventions, methods to measure local climate and share recent findings from the Adelante Initiative in Nicaragua. R Lucas gave a presentation titled "Intervention to reduce heat strain and kidney damage in industrial agricultural workers in Central America". |
Year(s) Of Engagement Activity | 2020 |
Description | Min. of Health Offices in in Veracruz, Mexico. |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Policymakers/politicians |
Results and Impact | Research partners, I Wesseling and E Arias, gave a presentation outlining findings from the PREP project to staff at the Ministry of Health Offices in in Veracruz, Mexico. |
Year(s) Of Engagement Activity | 2022 |
Description | Photography installation at COP26 |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Policymakers/politicians |
Results and Impact | We were granted a photographic display space to install a high-quality photography installation at COP 26. Images used in this installation intimately conveyed the work environments and health consequences of workers in developing countries exposed to excessive occupational heat stress. They have been taken in communities and work settings where our research is focused and illustrate work-place interventions we have successfully implemented through our research efforts. Through this visual storytelling display at COP26, the lives and circumstances of marginalised and climate-vulnerable workforces was brought into world view, giving these workers a voice and raising awareness. Through these displayed images we aimed to tell the stories of workers and raise the public's awareness of the work environments, illnesses and diseases that are being directly affected by increasing global temperatures. |
Year(s) Of Engagement Activity | 2021 |
Description | Preventing the spread of COVID-19 in the Mexican sugarcane sector |
Form Of Engagement Activity | Engagement focused website, blog or social media channel |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Industry/Business |
Results and Impact | We (headed up by our research partners La Isla Network) created key recommendations to prevent COVID-19 transmission amongst workers at sugarcane mills. These were shared with Bonsucro who advertised this on their website to promote the use of this resources in the sector. |
Year(s) Of Engagement Activity | 2020 |
URL | https://www.bonsucro.com/preventing-the-spread-of-covid-19-in-the-mexican-sugarcane-sector/ |
Description | Queen's Baton Relay Scientific Webinar |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Other audiences |
Results and Impact | R Lucas gave a presentation titled "Optimising performance in hot conditions: Insights from applied physiology research" as part of a 2-day webinar for the Singapore leg of the Queen's Baton Relay event. |
Year(s) Of Engagement Activity | 2022 |
Description | The Guardian: The mystery epidemic striking Nicaragua's sugar cane workers |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Media (as a channel to the public) |
Results and Impact | Kate Hodal a reporter at The Guardian interviewed myself and other members of our research team for a story titled 'The mystery epidemic striking Nicaragua's sugar cane workers'. In additional to commenting on the health risks associated with regular work while exposed to excessive heat stress, Kate also asked questions about the workplace interventions we have been supporting at Ingenio San Antonio (ISA) in Nicaragua. |
Year(s) Of Engagement Activity | 2020 |
URL | https://www.theguardian.com/global-development/2020/nov/27/the-mystery-epidemic-striking-nicaraguas-... |
Description | Thinktank, Birmingham Science Museum 'Changing Planet' exhibition |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Public/other audiences |
Results and Impact | We were asked to contribute (images and text) to a new 'Changing Planet' exhibition at the Thinktank, Birmingham Science Museum. The target audience was 11 -19 year olds. |
Year(s) Of Engagement Activity | 2021 |
URL | https://www.birminghammuseums.org.uk/thinktank/highlights/our-changing-planet |
Description | Work in Heat and Health Toolbox Training Session |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | R Lucas and Beth Skinner presented at a hybrid conference discuss the key physiological concepts underlying heath exposed surveillance in occupational settings. R Lucas gave an presentation and lead a discussion on the "Key physiological concepts underlying heat exposed surveillance in occupational settings". B Skinner gave a presentation titled "Tools for heat exposed surveillance". R Lucas also gave a presentation titled "Heat surveillance in action". Conference attendees were chiefly from the University of Eswatini, the University of Zimbwabwe. |
Year(s) Of Engagement Activity | 2022 |
Description | World Health Organisation |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Other audiences |
Results and Impact | R Lucas presented this project as a case study at the WHO Pan American Regional consultation. This was part of an online 2-day workshop on Climate Change and Health held in May over 3-days to approximately 60 researchers and policy makers. In addition to my presentation We also wrote a short case-study report for the WHO. |
Year(s) Of Engagement Activity | 2021 |