The Occupational and Health Histories of Undocumented Immigrants Receiving Frequent, Emergent-Only Hemodialysis Restricted; Files Only

Abstract

Chronic kidney disease of unknown etiology represents one of the first new chronic conditions to appears as a result of global climate change and has been mainly describe in agriculture workers in Central America. The leading etiological hypothesis is that in the absence of traditional risk factors for developing kidney disease (i.e., hypertension, diabetes, and advanced age), workers experience acute kidney injury secondary to daily dehydration and heat exposure at work. Utilizing a scoping review methodology, chapter 2 presents the analysis of the totality of evidence linking occupational heat exposure to kidney health in immigrant, Latinx agriculture workers located in the United States. This scoping review identified three quantitative studies and one ethnography describing the impacts of occupational heat exposure on kidney health. Chapters 3 and 4 describe other health and occupational risk factors for developing kidney disease in immigrant workers recruited from the emergency dialysis unit of Grady Hospital that primarily serves undocumented Latinx persons from the great-Atlanta Metro Area. Fifty persons were interviewed using both the Grady Dialysis Questionnaire and the Occupational/Environmental Health History form to assess sociodemographic, housing, health, and work histories. Seven persons were found to lack the traditional risk factors for developing end stage renal disease. The occupational histories showed that further work is needed to investigate the impacts of working in high heat conditions for other outdoor workers (i.e., construction workers and landscapers) and differentiate their risks for developing kidney disease from indoor workers. 

Table of Contents

Table of Contents

CHAPTER 1: INTRODUCTION

1.1   Objectives

1.2 Scoping Review

1.3 Sociodemographics and Health Histories

1.4 Occupational Histories

CHAPTER 2: HEAT STRESS AND KIDNEY FUNCTION IN FARMWORKERS: A SCOPING REVIEW.

2.1 Abstract

2.2 Introduction

2.2.1 Objectives

2.3 Methods

2.3.1 Design

2.3.2 Literature search

2.3.3 Eligibility criteria

2.3.4 Data extraction

2.4 Results

2.5 Discussion

2.6 Conclusion

2.7 Tables

Table 2.7.1. Definitions of key terms

Table 2.7.2. Extracted data from studies included in the scoping review presented in this dissertation

2.8 Figures

Figure 2.8.1. PRISMA-ScR Flow Diagram of studies screen for inclusion and exclusion as part of the scoping review process.

CHAPTER 3: SELF-REPORTED HEALTH HISTORIES AND SOCIODEMOGRAPHIC CHARACTERISTICS OF UNDOCUMENTED IMMIGRANTS RECEIVING FREQUENT, EMERGENT-ONLY HEMODIALYSIS: A CROSS-SECTIONAL STUDY

3.1 Abstract

3.2 Introduction

3.3 Methods

3.3.1 Survey

3.3.2 Data Analysis

3.4 Results

3.5 Discussion

3.6 Conclusion

3.7 Tables

Table 3.7.1. Sociodemographic, Housing, and Basic Work Characteristics of Undocumented Immigrants Receiving Emergent Hemodialysis at a U.S. Safety-New Hospital, 2019

Table 3.7.2. Self-Reported Health Histories and Behaviors of Undocumented Immigrants Receiving Emergent Hemodialysis at U.S. Safety-Net Hospital, 2019

Table 3.7.3. Self-Reported Familial Health Histories of Undocumented Immigrants Receiving Emergent Hemodialysis at U.S. Safety-Net Hospital, 2019

CHAPTER 4: OCCUPATIONAL HISTORIES OF UNDOCUMENTED IMMIGRANTS RECEIVING FREQUENT, EMERGENT-ONLY HEMODIALYSIS: A CROSS-SECTIONAL STUDY

4.1 Abstract

4.2 Introduction

4.3 Methods

Survey

4.3.1 Data Analysis

4.3.2 Text Data Cleaning

4.3.3 Topic Modeling

4.4 Results

4.4.1 Topic Modeling

4.5 Discussion

4.6 Conclusion

4.7 Tables

Table 4.7.1. Sociodemographic and Basic Work Characteristics of Undocumented Immigrants Receiving Emergent Hemodialysis at a U.S. Safety-New Hospital, 2019

Table 4.7.2. Work Characteristics of Those Currently Working, n=14

Table 4.7.3. Work Characteristics of Those Having Ever Worked in Occupations of Interest and Reported PPE Use

4.8 Figures

Figure 4.8.1. Topic modeling results showing two distinct topics in the occupational histories of participants. Topic 1 “outdoor workers” and topic 2 “indoor workers”.

CHAPTER 5: INTEGRATIVE SUMMARY

REFERENCES

APPENDIX A. THE GRADY DIALYSIS QUESTIONNAIRE

APPENDIX B. THE OCCUPATIONAL/ENVIRONMENTAL HEALTH HISTORY FORM

About this Dissertation

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School	Laney Graduate School
Department	Nursing
Degree	Ph.D.
Submission	Dissertation
Language	English
Research Field	Environmental Health Health Sciences, Occupational Health and Safety Health Sciences, Nursing
Keyword	Nursing CKDu Occupational Health
Committee Chair / Thesis Advisor	Vicki Hertzberg, Emory University
Committee Members	Valerie Mac, Emory University Laura Plantinga, Emory University Lisa Thompson, Emory University

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