Examining the efficacy and feasibility of implementing an electrolyte hydration intervention among agricultural workers Open Access
Berra, Liris Stephanie (Spring 2022)
Abstract
Background: Farmworkers are amongst one of the most vulnerable populations in the United States; a myriad of structural, social, and occupational conditions expose significant health disparities. Of these, occupational heat exposure is particularly concerning due to rising global environmental temperatures. These hot environmental temperatures place farmworkers at a significant risk for experiencing dehydration and consequently heat-related illness (HRI).
Objective: To estimate the prevalence of dehydration/HRI and current hydration practices among agricultural workers in central Florida. To determine the efficacy and feasibility of an electrolyte intervention to prevent dehydration and HRI.
Methods: Prevalence estimates were calculated from parent study sample (n=88). Pilot participants were randomized to a water group (n=16) or an electrolyte group (n=14) who received 169oz (5L) of the respective beverage. A logistical regression model was utilized to calculate odds ratios and a thematic analysis was conducted from post shift interviews to identify barriers/facilitators to beverage consumption.
Results: At post shift, 46% of the study sample was dehydrated or severely dehydrated and 42% experienced at least one HRI symptom (n=88). Among electrolyte group participants, the odds of dehydration were 13.4 (95% CI =(1.17,152.95) times higher and the odds of experiencing heat related illness was 0.72 (95% CI =(0.07, 7.27) lower. Taste, feelings of wellness/energy, and the beverage container were identified as facilitators to beverage consumption. Factors identified as barriers were taste, increased urination, and beverage temperature.
Discussion: Regional variations exist; however, prevalence estimates confirm that findings confirm that the prevalence of HRI and dehydration is high. Hydration practices were consistent with other study findings, consumption of sugar sweetened beverages during work is a significant concern. Findings surrounding hydration status and consumption of electrolyte beverages is inconsistent with other studies that have found electrolytes to maintain adequate hydration status in outdoor workers. Failure of randomization to control and water group, differences in explanatory variables, and the electrolyte solution formula could be contributing factors to the discrepancy. Findings suggest that electrolytes may be protective against experiencing HRI. Further research with a larger sample size should be conducted to identify the optimal rehydration formula for agricultural workers laboring in hot conditions.
Table of Contents
Chapter 1: Introduction 1
Rationale 1
Purpose Statement 1
Research Questions & Aims 1
Significance Statement 2
Definition of Terms 2
Chapter 2: Review of the Literature 4
Introduction 4
Agricultural & Farmworker Situational Analysis 5
Overview 5
Demographic Profile 5
Structural, Social, and Occupational Conditions 6
Heat Stress & Kidney Disease 8
Overview 8
Biological Mechanisms 8
Epidemiology of HRI, CKDu, and AKI Among Farmworkers 11
Existing Efforts 12
Overview 12
Recommendations & Regulations 12
Existing Hydration Studies 13
Local Context 14
Introduction 14
Florida Heat 14
Farmworkers in Florida 15
Discussion 15
Chapter 3: Manuscript 17
Abstract 17
Introduction 18
Methods 19
Results 21
Discussion 23
References 28
Appendix 34
Chapter 4: Conclusion and Recommendations 40
Introduction 40
Mandates Not Guidance 40
Employer Accountability 41
Tailored Messaging 42
Readily Available Data 44
Conclusion 44
References 45
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