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A pilot field evaluation on heat stress in sugarcane workers in Costa Rica: what to do next?
Central American Institute for Studies in Toxic Substances (IRET) and the Program on Work and Health in Central America (SALTRA) at the Universidad Nacional in Costa Rica.
Central American Institute for Studies in Toxic Substances (IRET) and the Program on Work and Health in Central America (SALTRA) at the Universidad Nacional in Costa Rica.
Central American Institute for Studies in Toxic Substances (IRET) and the Program on Work and Health in Central America (SALTRA) at the Universidad Nacional in Costa Rica.
2009 (English)In: Global health action, ISSN 1654-9880, E-ISSN 1654-9880, Vol. 2, 71-80 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Climate change is producing major impacts including increasing temperatures in tropical countries, like Costa Rica, where the sugarcane industry employs thousands of workers who are exposed to extreme heat.

OBJECTIVES: This article outlines a pilot qualitative evaluation of working conditions and heat in the sugarcane industry.

DESIGN: A literature review, direct observations and exploratory interviews with workers were conducted to reach a preliminary understanding of the dimensions of heat-related health issues in the sugarcane industry, as a basis for the design of future studies.

RESULTS: The industry employs temporary workers from Nicaragua and Costa Rica as well as year-round employees. Temporary employees work 12-hour shifts during the harvest and processing ('zafra') season. In many cases, sugarcane field workers are required to carry their own water and often have no access to shade. Sugar mill workers are exposed to different levels of heat stress depending upon their job tasks, with the most intense heat and workload experienced by the oven ('caldera') cleaners.

CONCLUSIONS: Research is needed to achieve better understanding of the multiple factors driving and interacting with heat exposures in the sugarcane industry in order to improve the health and safety of workers while maintaining worker productivity.

Place, publisher, year, edition, pages
Co-action publishing , 2009. Vol. 2, 71-80 p.
Keyword [en]
sugarcane, Central America, Costa Rica, heat exposure, heat stress, agriculture, climate change
National Category
Public Health, Global Health, Social Medicine and Epidemiology
URN: urn:nbn:se:umu:diva-93013DOI: 10.3402/gha.v2i0.2062ISI: 000208160000034PubMedID: 20052430OAI: diva2:745242
Available from: 2014-09-10 Created: 2014-09-10 Last updated: 2015-07-07Bibliographically approved
In thesis
1. Heat exposure and health outcomes in Costa Rican sugarcane harvesters
Open this publication in new window or tab >>Heat exposure and health outcomes in Costa Rican sugarcane harvesters
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background The remarkably efficient mechanisms of the human body to maintain its core temperature of 37°C can be inadequate when harsh climatic conditions and excessive muscle movement lead to heat stress, dehydration and potential heat illness, ranging from minor symptoms such as fatigue to a potentially fatal heat stroke. Agricultural workers in the tropics are at high risk, which is expected to increase with climate change. Sugarcane harvesting in Costa Rica is largely done by cutting the cane with a machete, by temporary, sub-contracted workers who are often migrants and living in poverty. Sugarcane harvesters are known to be affected by an epidemic of chronic kidney disease of non-traditional origin, currently hypothesized to be related to working conditions.

Objectives This work aimed to better understand and document sugarcane harvester exposure to heat and the health consequences of working under such conditions. Specific objectives were to 1) Document working conditions and heat in the Costa Rican sugarcane industry (Paper I); 2) Quantify heat stress exposures faced by sugarcane harvesters in Costa Rica (Paper II); and 3) Quantify the occurrence of heat stress symptoms and abnormal urinary parameters in sugarcane workers in Costa Rica (Papers III and IV).

Methods This study took place over three harvests following a pilot assessment prior to the first harvest. Methods included direct observation, semi-structured interviews with 24 individuals and a participatory workshop with 8 harvesters about heat-related perceptions, exposures and coping strategies during the harvest and non-harvest season (Pilot). Researchers accompanied workers in the field during all three harvests, measured wet bulb globe temperature (WBGT) and conducted direct observation. Heat exposure assessment was conducted by calculating metabolic load, WBGT and corresponding limit values based on international guidelines (NTP and OSHA) (Harvest 1). Self-reported symptom data were collected using orally-administered questionnaires from 106 sugarcane harvesters and 63 non-harvesters from the same company (Harvest 2). Chi-square test and gamma statistic were used to evaluate differences in self-reported symptoms and trends over heat exposure categories. Finally, liquid consumption during the work shift was documented and urinalysis was conducted pre-and post-shift in 48 sugarcane harvesters on three days; differences were assessed with McNemar´s test on paired proportions (Harvest 3).

Results Sugarcane workers in both the harvest and non-harvest seasons are exposed to heat, but particularly during the harvest season. Field workers have to carry their own water to the field and often have no access to shade. Some plantworkers are also exposed to intense heat. The metabolic load of sugarcane harvesting was determined to be 261 W/m2. The corresponding threshold value is 26 ◦C WBGT, above which workers should decrease work load or take breaks to avoid the risk of heat stress. Harvesters in this study were at risk of heat stress as early as 7:15 am on some mornings and by 9:00 am on all mornings. After 9:15 am, OSHA recommendations would require that harvesters only work at full effort 25% of each hour to avoid heat stress. Heat and dehydration symptoms at least once per week were experienced significantly more frequently among harvesters than non-harvesters (p<0.05): headache, tachycardia, fever, nausea, difficulty breathing, dizziness, and dysuria. Percentages of workers reporting heat and dehydration-related symptoms increased over increasing heat exposure categories. Total liquid consumed ranged from 1 to 9 L and differed over days (median 5.0, 4.0 and 3.25 on days 1, 2 and 3 respectively). On these same days, the two principle indicators of dehydration: high USG (≥1.025) and low pH (≤5), changed significantly from pre to post-shift (p=0.000 and p=0.012).Proportions of workers with proteinuria >30 mg/dL, and blood, leucocytes and casts in urine were also significantly different between pre and post-shift samples at the group level, but unlike USG and pH, these alterations were more frequent in the pre-shift sample. 85% of workers presented with proteinuria at least once and 52% had at least one post-shift USG indicative of dehydration.

Conclusion Heat exposure is an important occupational health risk for sugarcane workers according to international standards. A large percentage of harvesters experience symptoms consistent with heat exhaustion throughout the harvest season. Pre and post-shift urine samples demonstrate dehydration and other abnormal findings. The results of this study demonstrate an urgent need to improve working conditions for sugarcane harvesters both under current conditions and in adaptation plans for future climate change.

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2014. 64 p.
Umeå University medical dissertations, ISSN 0346-6612 ; 1676
Agricultural worker, Central America, Chronic kidney disease, Climate change, Dehydration, Heat, Heat illness, Heat stress, Sugarcane, Urinalysis, Worker health
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public health; Epidemiology
urn:nbn:se:umu:diva-93609 (URN)978-91-7601-140-9 (ISBN)
Public defence
2014-10-24, Sal 135, Allmänmedicin, Norrlands universitetssjukhus, Umeå, 09:00 (English)
Available from: 2014-10-03 Created: 2014-09-29 Last updated: 2015-04-29Bibliographically approved

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