ArticleOccupational and environmental medicine2016
Intervention to reduce heat stress and improve efficiency among sugarcane workers in El Salvador: Phase 1.
Article in Occupational and environmental medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 74 papers, 6 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
74 citing papers in PubMed, 6 syntheses or guidelines pooled it, 134 citations in OpenAlex.
- Systematic review and narrative synthesis of behavioral interventions to improve heat-related illness prevention in community and occupational populations.BMC public health · 2025Pooled it
- International migrant workers, heat exposure, and climate change: a systematic review of health risks and protective interventions.BMC global and public health · 2025Pooled it
- Heat Stress Prevention and Management in the Construction Industry: A Gap Analysis.Annals of global health · 2025Pooled it
- Cooling intervention studies among outdoor occupational groups: A review of the literature.American journal of industrial medicine · 2020Pooled it
- Sustainable solutions to mitigate occupational heat strain - an umbrella review of physiological effects and global health perspectives.Environmental health : a global access science source · 2020Pooled it
- Impact of climate change on occupational health and productivity: a systematic literature review focusing on workplace heat.La Medicina del lavoro · 2018Pooled it
- Trends in Occupational Heat-Health Research in Low-and Middle-Income Countries: A Mapping Review.Current environmental health reports · 2026Review
- Assessing the Feasibility of Wearable Devices for Physiological Monitoring and Heat Risk Prediction in Outdoor Agricultural Workers.American journal of industrial medicine · 2026Article
- Validation of the ECTemp™ algorithm in construction workers: a comparison of photoplethysmography smartwatch and chest strap heart rate monitors.Environmental research communications · 2026Article
- Scoping Review of Interventions to Prevent CKD of Unknown Origin in Working Populations.Kidney international reports · 2026Article
- Heat-related symptom profiles among construction workers: a latent class analysis of behavioral and workplace factors.Journal of occupational health · 2026Article
- Heat-health warning systems for outdoor workers: recent advances, implementation gaps, and future priorities.Frontiers in public health · 2026Review
- Article
- Heat Exposure and Short-Term Changes in Kidney Biomarkers: Answers to the CKD of Unknown Etiology Conundrum?Kidney international reports · 2025Article
- Work and work exposures in sugarcane farming in Eswatini, Southern Africa.International archives of occupational and environmental health · 2025Article
- Development, validation, and reliability of a questionnaire to assess risk-factors of chronic kidney disease of unknown etiology.Journal of nephrology · 2025Article
- Health Interventions for the Prevention of Dehydration in Agricultural Workers Exposed to Heat Stress: A Systematic Review.Healthcare (Basel, Switzerland) · 2025Review
- Airborne particulate matter exposure in male sugarcane workers at risk for chronic kidney disease in Guatemala.Annals of work exposures and health · 2025Article
- Integrating gender in health interventions for adapting to extreme heat in low- and middle-income countries: a scoping review.BMJ public health · 2025Article
- Evaluation of community-based heat adaptation interventions: a systematic review.BMJ public health · 2025Article
14 more citing papers are in PubMed but not listed here.
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Authors and funding
11 authors at 6 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundChronic heat stress and dehydration from strenuous work in hot environments is considered an essential component of the epidemic of chronic kidney disease in Central America.
objective(1) To assess feasibility of providing an intervention modelled on OSHA's Water.Rest.Shade programme (WRS) during sugarcane cutting and (2) to prevent heat stress and dehydration without decreasing productivity.
methodsMidway through the 6-month harvest, the intervention introduced WRS practices. A 60-person cutting group was provided water supplied in individual backpacks, mobile shaded rest areas and scheduled rest periods. Ergonomically improved machetes and efficiency strategies were also implemented. Health data (anthropometric, blood, urine, questionnaires) were collected preharvest, preintervention, mid-intervention and at the end of harvest. A subsample participated in focus group discussions. Daily wet bulb globe temperatures (WBGT) were recorded. The employer provided individual production records.
resultsOver the harvest WBGT was >26°C from 9:00 onwards reaching average maximum of 29.3±1.7°C, around 13:00. Postintervention self-reported water consumption increased 25%. Symptoms associated with heat stress and with dehydration decreased. Individual daily production increased from 5.1 to a high of 7.3 tons/person/day postintervention. This increase was greater than in other cutting groups at the company. Focus groups reported a positive perception of components of the WRS, and the new machete and cutting programmes.
conclusionsA WRS intervention is feasible in sugarcane fields, and appears to markedly reduce the impact of the heat stress conditions for the workforce. With proper attention to work practices, production can be maintained with less impact on worker health.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.