I like working (and playing) in the heat. But my kidneys might not—researchers are finding evidence of chronic kidney disease caused by more people working in hotter weather:
Workers routinely exposed to heat — in construction, landscaping, and agriculture, for example — are at greatest risk. The International Labor Organization estimates that 26.2 million people worldwide are living with CKD attributable to work-related heat stress.
When Bethany Boggess Alcauter conducted a pilot study of heat-related kidney disease among construction workers in Texas, she was struck by the findings. The study, funded by the Southwest Center for Occupational and Environmental Health at UT Health Houston, followed 16 workers for a couple of days in 2022. One was taken to the emergency room after suffering heat stroke.
“Because the study was so small,” Boggess Alcauter said, “I hadn’t anticipated what should be a very rare event.”
Boggess Alcauter, director of research and public health programs at the nonprofit National Center for Farmworker Health, based in Buda, had previously worked with La Isla Network, a nonprofit research group studying kidney disease among young, heat-exposed agricultural workers in Central America and Asia. She wondered if heat was affecting workers in the United States. About half the workers she studied in Texas had blood in their urine, and some had brown urine — signs of severe dehydration. Boggess Alcauter found evidence of early kidney damage in 12 percent of the workers.
…A study published in 2018 looked at almost 200 agricultural workers in Florida and found that one in three had acute kidney injury at least once a week. A paper published in 2020 found agricultural work nearly doubled the chances of workers suffering the condition. A third, published in 2024, found that 38 percent of construction workers participating in a study in Florida had experienced acute kidney injury while on the job [Gina Jiménez, “In the U.S., Heat-Exposed Workers Risk Chronic Kidney Disease,” Undark, 2025.11.05].
Preventing this kidney danger isn’t hard: a jug of water and a 15-minute break under an cottonwood tree cost far less than lifelong dialysis, not to mention the more mundane green-eyeshade costs of lost productivity and replacing sick workers. A sugar plantation in Nicaragua worked with non-profit La Isla Network to implement a pretty simple strategy to mitigate heat harms for its workers: mandatory breaks, mobile tents for shade, water both pure and electrolyted, and more porta-potties (because, even in the heat, if you drink more, you pee more, which is o.k., because it means your kidneys are working!). The results:
In the first three years, the methodology reduced harm with a sharp decline (94 per cent) in cases of acute kidney injury arising from excessive heat, eliminated fatal incidences of heatstroke, increased productivity by 10-20 per cent and provided a 22 per cent positive return on investment as accidents, staff turnover and absenteeism were reduced [International Labour Organization, “Heat at Work: Implications for Safety and Health,” 2024, p. 70].
The richest country in the world could easily implement these strategies to keep its workers’ kidneys great, but…
For three years, Jason Glaser, the CEO of La Isla Network, has tried to promote greater use of those practices in the U.S. This year, the organization was preparing to expand partnerships with U.S. employers when word came that it would lose two-thirds of its federal funding. The cuts were driven by President Donald Trump’s Department of Government Efficiency, or DOGE, Glaser wrote in a letter published online. Now, the organization’s efforts in the U.S. are stalled.
“Why do workers in a field in Nicaragua have better protections than a worker in Texas?” Glaser asked in an interview with Public Health Watch [Jiménez, 2025.11.05].
King Don may ignore climate change, but you can be like the rest of the world and take action, for the sake of your kidneys! Take an extra bottle of water to work, and make sure your workers have water and time to step out of the heat to drink it and let it soak in.