Health Symposium Recap: Heat Stress and kidney Function among construction workers in Texas with SWCOEH alum Bethany Alcauter, PhD
The 2nd Annual Southwest Centers Occupational Health Research Symposium was held on June 10, 2022. The virtual event, a collaboration between the Southwest Center for Occupational and Environmental Health (SWCOEH) and the Southwest Center for Agricultural Health, Injury Prevention and Education (SW Ag Center). This series will highlight presentations made by Pilot Projects Research Training Awardees who were selected and awarded by the SWCOEH.
In Part III of our series, we discuss “Heat Stress and kidney Function among construction workers in Texas”. The study was led by Bethany Alcauter, PhD, an alumnus of the SWCOEH and the Director of Evaluation & National Agricultural Worker Health Program at the National Center for Farmworker Health.
“The number of illnesses and deaths among workers due to heat exposure at workplace have risen over the past decade, based on numbers reported by the Bureau of Labor Statistics,” said Jenil Patel, PhD, the Director of the Pilot Projects Research Training Program at the SWCOEH. “There is a continuous need of research on health effects due to heat stress among workers in states like Texas, where record-breaking summer temperatures are noted, and how heat stress affects workers in the form of several health hazards such as cramps, rash, exhaustion and stroke. While the employers are always encouraged to implement safer practices and trainings at work, research implications such as Dr. Alcauter’s project on heat stress and kidney function emphasize the need of safer practices and strict enforcement focusing on adequate work-breaks with appropriate safety and protective equipment, to protect the overall health of vulnerable outdoor working populations such as construction workers.”
SWCOEH.org: What findings did you find most interesting with this study?
Bethany Alcauter: This study was quite small, involving only 16 participants. Participants were recruited partly through the help of a non-profit that helps construction workers with labor issues, and partly through word-of-mouth from construction workers to their coworkers. What was most startling to me was that so many of the workers were experiencing several very concerning issues on a daily basis. Seventy-five percent reported at least one or more symptoms of a heat-related illnesses during one of the two days of data collection, 100% had at least one urine measurement that indicated severe dehydration, 44% tested positive for blood in their urine, and 12% (n = 2) may have experienced rhabdomyolysis during data collection.
SWCOEH.org: You mention a worker with kidney stones once per month. Is that a result of poor kidney health, dehydration, or both?
Bethany Alcauter: This worker did not have diabetes or hypertension. It's possible that he had some other underlying condition, but he had already sought medical care and been evaluated for other possible causes. A second participant later in the study also reported experiencing kidney stones about once a month. I can't say for certain, but it seems very possible that during warmer months, many workers simply cannot stay hydrated or maintain a good electrolyte balance, and this can have negative effects in different ways.
SWCOEH.org: Every site is different, but approximately how many times per day are workers allowed a break?
Bethany Alcauter: Many workers can self-pace, taking micro-breaks to drink water or rest for a bit throughout the day. However, these micro-breaks don't really allow the body to fully recover and cool off when working outside. Workers really need to have set times with frequent longer breaks (10-20 minutes) so that they can go to a shaded area, rest, drink and eat in order to recover, especially during these very hot days.
SWCOEH.org: In your estimation, is the largest danger a lack of water or a lack of shade or a combination of both?
Bethany Alcauter: Both, and a lack of salt! Not having access to electrolyte replacement through solutions or food is what has really stood out to me. This is difficult for workers as electrolyte solutions are often expensive. One young worker told me that he used to experience frequent dizziness and vomiting at work, and then he started buying little bottles of salt and lime flavoring that are sold at gas stations. He said once he started to eat those bottles of salt during the workday along with drinking lots of water, the vomiting stopped.
SWCOEH.org: If you could mandate one or two things for Southern construction sites to improve worker safety, what would it be?
Bethany Alcauter: We are facing a rapidly changing climate, and heat may intensify much more quickly than we are expecting. Workers feel this and intuitively know that it's getting hotter outside. We need to have logical, flexible regulations that won't become quickly outdated as temperatures increase. I would like to see mandated 15-minute paid rest breaks every hour once the temperature is 95 degrees or more, and I would really like to see far greater protections to prevent retaliating against workers who voice concerns or implement their own health and safety activities in the workplace, and strict enforcement of those protections. If workers feel safe bringing up their concerns, taking breaks when they need to, or even in refusing to work if it's simply too hot without fear of retaliation, we could make major advancements in improving multiple workplace health and safety outcomes.
The SWCOEH provides a variety of graduate-level training opportunities for occupational and environmental health professionals through our industrial hygiene, occupational and environmental medicine, occupational epidemiology, and Total Worker Health®.