scholarly journals Effect of heat exposure on dehydration and kidney function among sea salt workers in Thailand

2021 ◽  
pp. 435-442

Background. Excessive heat exposure and dehydration among agricultural workers have been reported to reduce kidney function and lead to chronic kidney disease of unknown etiology (CKDu). Objective. This cross-sectional study aimed to assess heat exposure, factors related to dehydration and the relationship between dehydration and biomarkers of kidney function among sea salt workers in Thailand. Material and methods. Wet bulb globe temperature (WBGT) was used at the time workers started work outdoors on salt farms. Urine-specific gravity, urine osmolarity, and serum creatinine were collected from 50 workers after work. Results. The results showed that more than 50% of the participants were dehydrated after work. The maximum hours spent working per day was 10. The average water intake was 1.51 L. Urine specific gravity was highly significant correlated with urine osmolality (rs = 0.400, p<0.01), and urine osmolality was significantly correlated with the estimated glomerular filtration rate (eGFR) (rs = 0.349, p<0.05). In bivariate analysis adjusted for age, sex, and current alcohol consumption, we found that a WBGTTWA ≥ 30°C (OR = 0.08, 95% CI = 0.01-0.44, p = 0.003) and hours spent working (OR=2.22, 95% CI = 1.42-3.47, p <0.001) were independently associated with dehydration. This suggests that workers should increase their time spent on breaks and increase water consumption. Conclusions. Educational program on heat exposure and heat-related illness prevention strategies should be provided

2010 ◽  
Vol 50 (5) ◽  
pp. 269 ◽  
Author(s):  
Kalis Joko Purwanto ◽  
Mohammad Juffrie ◽  
Djauhar Ismail

Background Using clinical judgment to diagnose dehydration can be highly subjective. To diagnose dehydration, it would be ideal to have an accurate, inexpensive, objective and easy-to-perform diagnostic tool. In cases of dehydration, plasma osmolality rises, causing an increase in antidiuretic hormone (ADH) secretion. The increased ADH reduces urine production and increases urine osmolality. Previous studies have show that urine osmolality correlates well to urine specific gravity. We investigated if urine specific gravity can be a reliable and objective detennination of dehydration status.Objective To assess the accuracy of using urine specific gravity as a diagnostic tool to determine dehydration status of children with diarrhea.Methods We conducted the study in the pediatric ward of Sardjito Hospital from September 2009 to December 2009. Using a refractometer we measured urine specific gravity from patients with diarrhea. This measurement was then compared to a standard of acute body weight loss, with dehydration defined as weight loss of 5% or more. The cut-off value for defining dehydration using specific gravity measurements was detennined by a receiver-operator curve (ROC).Results Out of 61 pediatric patients who were recruited in this study, 18 (30%) had dehydration as defined by a body weight loss of 5% or more. Based on the ROC, we determined the cut off  value for urine specific gravity to be 1.022. Using this value, urine specific gravity was 72% sensitive (95% CI 52 to 93), and 84% specific (95% CI 73 to 95) in determining dehydration status.Conclusion Urine specific gravity is less accurate than clinical judgment in determining dehydration status in children with diarrhea.


2020 ◽  
Vol 319 (5) ◽  
pp. R560-R565
Author(s):  
Gabrielle E. W. Giersch ◽  
Abigail T. Colburn ◽  
Margaret C. Morrissey ◽  
Cody R. Butler ◽  
Michaela L. Pruchnicki ◽  
...  

Reproductive hormones have significant nonreproductive physiological effects, including altering fluid regulation. Our purpose was to explore the impact of sex and menstrual cycle (MC) phase on volume-regulatory responses to 24-h fluid restriction (24-h FR). Participants (men: n = 12, 20 ± 2 yr; women: n = 10, 20 ± 1 yr) were assigned two randomized and counterbalanced fluid prescriptions [Euhy: euhydrated, urine specific gravity (USG) < 1.020; Dehy: 24-h FR, USG > 1.020]. Men completed both (MEuhy, MDehy), while women completed both in the late-follicular ( days 10–13; FDehy, FEuhy) and midluteal ( days 18–22; LDehy, LEuhy) phases. We measured body mass, plasma and urine osmolality (Posm, Uosm), urine specific gravity (USG), urine color (Ucol), and serum copeptin; 24-h FR yielded mild dehydration without influence of sex or MC ( P > 0.05). Copeptin increased in men following Dehy (pre: 8.2 ± 5.2, post: 15.8 ± 12.6, P = 0.04) but not in women (FDehy pre: 4.3 ± 1.6, post: 10.5 ± 6.9, P = 0.06; LDehy pre: 5.6 ± 3.5, post: 10.4 ± 6.2, P = 0.16). In FDehy, Posm increased following FR (pre: 288 ± 2, post: 292 ± 1, P = 0.03) but not in men (pre: 292 ± 3, post: 293 ± 2, P = 0.46). No MC differences were observed between body mass loss, Posm, Uosm, USG, and copeptin ( P > 0.05). These results suggest that volume-regulatory responses to 24-h FR were present in men but not in women, without apparent effects of the menstrual cycle.


2013 ◽  
Vol 38 (6) ◽  
pp. 621-625 ◽  
Author(s):  
Vahur Ööpik ◽  
Saima Timpmann ◽  
Andres Burk ◽  
Innar Hannus

We assessed the urinary indexes of hydration status of Greco-Roman wrestlers in an authentic precompetition situation at the time of official weigh-in (OWI). A total of 51 of 89 wrestlers competing in the Estonian Championship in 2009 donated a urine sample. Questionnaire responses revealed that 27 wrestlers (body mass losers (BMLs)) reduced body mass before the competition, whereas 24 wrestlers (those who do not lose body mass (n-BMLs)) did not. In 42 wrestlers, values of urine specific gravity ≥1.020 and urine osmolality ≥700 mOsmol·kg−1 revealed a hypohydrated status. The prevalence of hypohydration in the BMLs (96%) was higher than in the n-BMLs (67%) (χ2 = 7.68; p < 0.05). The prevalence of serious hypohydration (urine specific gravity >1.030) was 5.3 times greater (χ2 = 8.32; p < 0.05) in the BMLs than in the n-BMLs. In the BMLs, the extent of body mass gain during the 16-h recovery (2.5 ± 1.2 kg) was associated (r = 0.764; p < 0.05) with self-reported precompetition body mass loss (4.3 ± 2.0 kg) and exceeded the body mass gain observed in the n-BMLs (0.7 ± 1.2 kg; p < 0.05). We conclude that hypohydration is prevalent among Greco-Roman wrestlers at the time of OWI. The prevalence of hypohydration and serious hypohydration is especially high among wrestlers who are accustomed to reducing body mass before competition. These results suggest that an effective rehydration strategy is needed for Olympic-style wrestlers, and that changes in wrestling rules should be considered to reduce the prevalence of harmful body mass management behaviours.


2019 ◽  
Vol 34 (02) ◽  
pp. 161-174 ◽  
Author(s):  
Zayid K. Al Mayahi ◽  
Ibrahim Ali Kabbash

Background:The problems associated with exposure to excessive heat are a key health concern throughout the world, and are likely to become increasingly important as Earth’s climate warms. Heat exposure is particularly problematic when large groups of people gather, but there is relatively little literature on the subject. Islam requires all adherents who are able to undertake a pilgrimage to Mecca (Saudi Arabia), known as the Hajj. This can result in huge numbers of pilgrims travelling to Mecca in the summer months, during which the temperatures can be very high, and to undertake physically demanding activities.Objective:The aim of this study was to identify the perception level of heat-related health issues and the coping behaviors adopted by pilgrims in the face of excessive heat exposure.Methods:A cross-sectional study was conducted in Mecca, Saudi Arabia among male Arab pilgrims performing Hajj of the Islamic calendar year 1436 (Summer 2015). Sample was divided into two strata: domestic pilgrims and international Arabs. A total of 14 camps were selected randomly, seven from each stratum. A total of 412 participants completed the questionnaire.Results:Mean age was 43.48 (SD = 13.42) years. Majority of pilgrims had never performed Hajj before (68.2%). Almost 89.5% among pilgrims more than 40 years of age had more water intake compared to only 76.5% for people under 40 years. Only 7.3% of educated people used to go out at noon time, and almost two-fold of pilgrims with lower educational level did so (15.4%). Approximately 51.8% among those who were aware of Mecca’s weather used cotton clothes, compared to 36.0% among pilgrims unaware of Mecca’s weather.Conclusion:This study reveals the extent of pilgrims’ understanding of, and abilities to cope with, excessive heat and also suggests coping strategies and options for improved understanding of heat-related health issues world-wide.Al Mayahi ZK, Ali Kabbash I. Perceptions of, and practices for coping with, heat exposure among male Arab pilgrims to the Hajj, 1436. Prehosp Disaster Med. 2019;34(2):161–174


2009 ◽  
Vol 44 (1) ◽  
pp. 53-57 ◽  
Author(s):  
Kristin L. Osterberg ◽  
Craig A. Horswill ◽  
Lindsay B. Baker

Abstract Context: Urine specific gravity (USG) has been used to estimate hydration status in athletes on the field, with increasing levels of hypohydration indicated by higher USG measurements (eg, greater than 1.020). Whether initial hydration status based on a urine measure is related to subsequent drinking response during exercise or athletic competition is unclear. Objective: To determine the relationship between pregame USG and the volume of fluid consumed by players in a professional basketball game. Design: Cross-sectional study. Setting: Basketball players were monitored during Summer League competition. Patients or Other Participants: Players (n  =  29) from 5 teams of the National Basketball Association agreed to participate. Main Outcome Measure(s): Pregame USG was measured for each player on 2 occasions. Athletes were given ad libitum access to fluid during each game and were unaware of the purpose of the study. Volume of fluid intake was measured for each player. To assess sweat loss, athletes were weighed in shorts before and after each game. Results: Sweat loss ranged from 1.0 to 4.6 L, with a mean sweat loss of 2.2 ± 0.8 L. Fluid intake ranged from 0.1 to 2.9 L, with a mean fluid intake of 1.0 ± 0.6 L. Pregame USG was greater than 1.020 in 52% of the urine samples collected and was not correlated with fluid volume consumed during either of the games (r  =  0.15, P  =  .48, and r  =  0.15, P  =  .52, respectively). Conclusions: Approximately half of the players began the games in a hypohydrated state, as indicated by USG. Fluid intake during the game did not compensate for poor hydration status before competition. Furthermore, sweat losses in these players during games were substantial (greater than 2 L in approximately 20 minutes of playing time). Therefore, both pregame and during-game hydration strategies, such as beverage availability and player education, should be emphasized.


Author(s):  
Tiphaine Vanhaecke ◽  
Alberto Dolci ◽  
Victor L. Fulgoni ◽  
Harris R. Lieberman

Abstract Purpose Growing evidence suggests hydration plays a role in metabolic dysfunction, however data in humans are scarce. This study examined the cross-sectional association between hydration and metabolic dysfunction in a representative sample of the US population. Methods Data from 3961 adult NHANES (National Health and Nutrition Examination Survey) participants (49.8% female; age 46.3 ± 0.5 years) were grouped by quartile of urine specific gravity (USG, 2007–2008 cohort) or urine osmolality (UOsm, 2009–2010 cohort) as measures of hydration. Metabolic dysfunction was assessed by glycemic and insulinemic endpoints and by components of the metabolic syndrome. Multivariate-adjusted linear and logistic regression models were used. Results Increasing quartiles of USG but not UOsm was associated with higher fasting plasma glucose (FPG), glycated hemoglobin (all P < 0.01), HOMA-IR and elevated insulin (all P < 0.05). Compared with the lowest quartile, those with the highest USG but not UOsm had greater risk of metabolic syndrome (Q4 vs. Q1, OR (99% CI): 1.6 (1.0, 2.7), P = 0.01) and diabetes (Q4 vs. Q1, OR: 1.8 (1.0, 3.4), P < 0.05). Additionally, those with USG > 1.013 or UOsm > 500 mOsm/kg, common cut-off values for optimal hydration based on retrospective analyses of existing data, had less favorable metabolic markers. In a subset of participants free from diabetes mellitus, impaired kidney function, hypertension and diuretic medication, USG remained positively associated with FPG (P < 0.01) and elevated FPG (P < 0.05). Conclusion These analyses provide population-based evidence that USG as a proxy for hydration is associated with glucose homeostasis in NHANES 2007–2008. The same association was not significant when UOsm was used as a proxy for hydration in the 2009–2010 wave. Clinical trial registry Not applicable, as this was a reanalysis of existing NHANES data.


2021 ◽  
Vol 5 (1) ◽  
pp. 88
Author(s):  
Dwi Lisa Nur'aini ◽  
Ardesy Melizah Kurniati ◽  
Moretta Damayanti ◽  
Syarif Husin ◽  
Joko Marwoto

Background: Adequate fluid consumption and hydration status of students become a special concern because being dehydrated by just 1%-2% can impair cognitive performance. The objectives of this study were to assess the daily fluid consumption, and analyze the correlation of fluid consumption and other associated factors with hydration status of medical students in Universitas Sriwijaya.Methods: A total of 93 medical students in Universitas Sriwijaya were recruited to complete a 7-day cross-sectional study. Subjects were asked to complete a self-administered 7-day-24-hours fluid record and provide first morning urine sample on the last day. Gender information was collected. Physical activity was evaluated by self-administered long version of IPAQ. Body mass index was calculated using body weight and body height measurement. Urine specific gravity was determined by urinometer. The 7-day-24-hours fluid record and 1-day-24-hours urine specific gravity were calculated and analyzed.Results: Majority of the subjects were well hydrated, while 10.8% were slightly dehydrated, 6.5% were moderately dehydrated and 9.7% were severely dehydrated. The average of daily fluid consumption was 1789.28 (989.3-2930) mL. Coefficient correlation of fluid consumption from beverages with urine specific gravity was -0.651 (p=0.00) by Pearson correlation test. The hydration status showed no association with gender, physical activity and body mass index.Conclusions: Most subjects in this study were well hydrated. A strong association was found between fluid consumption and hydration status. It was feasible to use daily fluid consumption from beverages to predict hydration status.


Author(s):  
Snezana Burmazovic ◽  
Christoph Henzen ◽  
Lukas Brander ◽  
Luca Cioccari

Summary The combination of hyperosmolar hyperglycaemic state and central diabetes insipidus is unusual and poses unique diagnostic and therapeutic challenges for clinicians. In a patient with diabetes mellitus presenting with polyuria and polydipsia, poor glycaemic control is usually the first aetiology that is considered, and achieving glycaemic control remains the first course of action. However, severe hypernatraemia, hyperglycaemia and discordance between urine-specific gravity and urine osmolality suggest concurrent symptomatic diabetes insipidus. We report a rare case of concurrent manifestation of hyperosmolar hyperglycaemic state and central diabetes insipidus in a patient with a history of craniopharyngioma. Learning points: In patients with diabetes mellitus presenting with polyuria and polydipsia, poor glycaemic control is usually the first aetiology to be considered. However, a history of craniopharyngioma, severe hypernatraemia, hyperglycaemia and discordance between urine-specific gravity and osmolality provide evidence of concurrent diabetes insipidus. Therefore, if a patient with diabetes mellitus presents with severe hypernatraemia, hyperglycaemia, a low or low normal urinary-specific gravity and worsening polyuria despite correction of hyperglycaemia, concurrent diabetes insipidus should be sought.


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