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dc.contributor.authorHansson, Erik
dc.date.accessioned2022-05-19T08:15:06Z
dc.date.available2022-05-19T08:15:06Z
dc.date.issued2022-05-19
dc.identifier.isbn978-91-629- 8009-741-3 (PRINT)
dc.identifier.isbn978-91-629- 8009-742-0 (PDF)
dc.identifier.urihttps://hdl.handle.net/2077/70545
dc.description.abstractThis thesis examines the association between heat stress and kidney disease in Mesoamerica using different perspectives and methods. An ecologic study found that hot, sugarcane-cultivating regions had elevated chronic kidney disease (CKD) mortality. In a longitudinal workplace study, kidney injury incidence was higher among sugarcane harvest workers with high physical workload, and decreased with an intervention reducing heat stress. Low liquid intake and consumption of NSAIDs were additional risk factors for kidney injury. Kidney injury coincided with fever and elevated levels of inflammation biomarkers, suggesting that inflammation mediated kidney injury. These findings are consistent with excessive heat strain from high internal heat production and external heat load being a main cause of the Mesoamerican epidemic of CKD of non-traditional origin (CKDnT). Kidney injury assessed by repeat serum creatinine (SCr) measurements corresponded well to increasing levels of urine kidney injury markers and decreasing serum erythropoietin, strengthening SCr increase as an intermediary outcome. The implications of the findings for future research, and public and occupational health practice in low-income settings facing global warming are discussed.en
dc.language.isoengen
dc.relation.haspartI. Hansson E, Mansourian A, Farnaghi M, Petzold M, Jakobsson K. An ecological study of chronic kidney disease in five Mesoamerican countries: associations with crop and heat. BMC Public Health. 2021 May 1;21(1):840. https://doi.org/10.1186/s12889-021-10822-9en
dc.relation.haspartII. Hansson E, Glaser J, Weiss I, Ekström U, Apelqvist J, Hogstedt C, Peraza S, Lucas R, Jakobsson K, Wesseling C, Wegman DH. Workload and cross-harvest kidney injury in a Nicaraguan sugarcane worker cohort. Occup Environ Med. 2019 Nov;76(11):818-826. http://dx.doi.org/10.1136/oemed-2019-105986en
dc.relation.haspartIII. Glaser J, Hansson E, Weiss I, Wesseling C, Jakobsson K, Ekström U, Apelqvist J, Lucas R, Arias Monge E, Peraza S, Hogstedt C, Wegman DH. Preventing kidney injury among sugarcane workers: promising evidence from enhanced workplace interventions. Occup Environ Med. 2020 Aug;77(8):527-534. http://dx.doi.org/10.1136/oemed-2020-106406en
dc.relation.haspartIV. Hansson E, Glaser J, Jakobsson K, Weiss I, Wesseling C, Lucas RAI, Wei JLK, Ekström U, Wijkström J, Bodin T, Johnson RJ, Wegman DH. Pathophysiological Mechanisms by which Heat Stress Potentially Induces Kidney Inflammation and Chronic Kidney Disease in Sugarcane Workers. Nutrients. 2020 Jun 2;12(6):1639. ::doi::10.3390/nu12061639en
dc.relation.haspartV. Hansson E, Wegman DH, Wesseling C, Glaser J, Schlader ZJ, Wijkström J, Jakobsson K. Markers of kidney tubular and interstitial injury and function among sugarcane workers with cross-harvest serum creatinine elevation. Occup Environ Med. 2021 Dec. http://dx.doi.org/10.1136/oemed-2021-107989en
dc.subjectHeat stressen
dc.subjectheat strainen
dc.subjectchronic kidney diseaseen
dc.subjectacute kidney injuryen
dc.subjectoccupational medicineen
dc.titleOccupational heat exposure and kidney disease - Studies on the role of heat stress in the Mesoamerican epidemic of Chronic Kidney Disease of non-traditional originen
dc.typetexteng
dc.type.svepDoctoral thesiseng
dc.gup.mailerik.hansson@amm.gu.seen
dc.type.degreeDoctor of Philosophy (Medicine)en
dc.gup.originUniversity of Gothenburg. Sahlgrenska Academyen
dc.gup.departmentInstitute of Medicine. Department of Public Health and Community Medicineen
dc.gup.defenceplaceOnsdagen den 15 juni 2022, kl. 16.00, sal 2119, Arvid Wallgrens backe, hus 2, Göteborgen
dc.gup.defencedate2022-06-15
dc.gup.dissdb-fakultetSA


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