Association Between Occupational Heat Stress and Kidney Disease Among 37,816 Workers in the Thai Cohort Study (TCS)


– Provides background on the rising issue of heat stress due to climate change and its potential health impacts, including kidney disease.
– Highlights the lack of studies examining the association between occupational heat stress and kidney disease, particularly in tropical countries like Thailand.
– Outlines the objectives of the study to examine this relationship using a large national cohort in Thailand.


– Study design: Longitudinal analysis using data from the Thai Cohort Study (TCS), a prospective cohort of Open University students in Thailand.
– Study population: 37,816 full-time workers (17,402 men and 20,414 women) without kidney disease at baseline in 2005.
– Exposure assessment: Self-reported occupational heat stress in 2005 and from 2005-2009, categorized into levels of exposure.
– Outcome assessment: Self-reported doctor-diagnosed incident kidney disease from 2005-2009.
– Covariates: Age, sex, education, income, alcohol, smoking, BMI, job type, job location.
– Statistical analysis: Logistic regression models to estimate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for covariates. Sensitivity analysis using an alternative case definition.


– 18% of workers reported heat stress at baseline in 2005, more common in men (22%) than women (15%).
– Among men, heat stress in 2005 was associated with increased kidney disease incidence (adjusted OR 1.48, 95% CI 1.01-2.16).
– Dose-response relationship between heat stress levels and kidney disease in men (p-trend=0.046).
– Prolonged heat stress in 2005-2009 further increased kidney disease risk in men (adjusted OR 2.22, 95% CI 1.48-3.35).
– Highest risk among men aged ≥35 years in physical jobs with prolonged heat stress (adjusted OR 5.30, 95% CI 1.17-24.13).
– No significant associations found among women.
– Sensitivity analysis using alternative case definition showed similar results.


– Novel finding of an association between occupational heat stress and kidney disease among Thai male workers.
– Increased risk with older age, physical jobs, and prolonged heat exposure, suggesting dose-response.
– Potential mechanisms discussed but require further study with detailed exposure and outcome assessment.
– Limitations include self-reported data, lack of clinical verification, and limited exposure characterization.
– Significant public health implications given the increasing kidney disease burden and climate change projections.
– Recommendations for interventions targeting heat strain reduction and hydration for at-risk workers.

– The study found an association between occupational heat stress and increased kidney disease incidence among male workers in Thailand, particularly older men in physical jobs with prolonged heat exposure.
– The findings have implications for occupational health interventions in tropical countries likely to experience worsening heat exposure due to climate change.

Overall, the review report summarizes the key elements of the research study, including the background, methods, primary findings, discussion of results in context, limitations, and conclusions. The report follows the standard structure for effectively communicating the motivations, approach, and implications of this epidemiological study.

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