High temperatures and air pollution exposure are individually known risks to human health, with amplifying adverse health effects during periods of co-exposure. This study compared co-occurring individual-level exposures to particulate matter (PM₅, aerodynamic diameter of ≤5 μm) and heat among women in residential and agricultural settings in Guatemala. We measured personal and ambient exposure to PM₅, temperature, and humidity among 21 female sugarcane workers in the fields and on their off days. We measured similar exposures among a group of 30 community members not involved in sugarcane work. We collected 171 personal PM₅ measurements across 18 sampling days. The median workday personal PM₅ concentration was 271 µg/m³, which was 3.6-fold higher than ambient area levels in the fields. The median personal PM₅ concentration was 95.8 µg/m³ for off-work days and 83.5 µg/m³ for community days. The average workday individual-level temperature and humidity were 39.4 °C and 82.4%, respectively, with significantly lower temperatures on off-work and community days. The women workers and community members were exposed to high levels of PM₅ and heat in both occupational and residential settings. Research needs to consider individual-level exposures at both work and home to help tailor more effective comprehensive prevention efforts to reduce risks.

Chronic kidney disease of unknown origin (CKDu) is a public health concern, particularly in agricultural communities, with multiple environmental exposures hypothesized as potential contributors. This study employed a targeted exposure assessment using personal silicone wristbands to characterize chemical exposures among women living and working in CKDu-affected regions of Guatemala. Participants wore wristbands for seven days, passively sampling air and dermal exposures. Overall, 45 wristbands were collected from 37 female participants (19 sugarcane workers and 18 community members). Of the 1530 chemicals measured using a single semi-quantitative method, 103 were detected, with an average of 27 chemicals per wristband (range: 16–40). Polycyclic aromatic hydrocarbon (PAH) levels were higher in community members’ wristbands, whereas workers exhibited higher exposure to pesticides (i.e., pendimethalin and fipronil). Workers had worse kidney function compared to community members, with almost half of the workers having an estimated glomerular filtration rate, eGFR, <90 mL/min/1.73 m². Correlations were observed between kidney function markers and specific chemicals, with the strongest correlation between albumin-to-creatinine ratio and pyrene levels (ρ = 0.57, p < 0.01) among workers. Women in agricultural regions of Guatemala experience widespread exposure to diverse environmental chemicals, some of which may contribute to kidney function decline.

Rising global temperatures raise concerns about climate change's health impacts. Agricultural workers are particularly vulnerable due to prolonged exposure to heat and environmental pollutants, including airborne particulate matter (PM), which may increase their risk for kidney injury. This study explores the relationships between core body temperature (CBT), markers of hydration, PM exposure, and kidney injury, offering insights into public health risks related to climate change. We conducted a longitudinal study of 148 sugarcane workers in Guatemala, monitoring them over 378 person-workdays. CBT and personal PM exposure were recorded throughout the workday, while markers of hydration and kidney function were assessed pre- and post-shift. Linear mixed-effects models were used to assess the relationships between these exposure factors, dehydration markers, and serum creatinine changes, an indicator of kidney injury. CBT exceeded 38.0 °C on 53 % of workdays, with 15 % surpassing 38.5 °C. Higher urinary specific gravity (β: 3.82, 95 % CI: 0.84, 6.80), serum uric acid (β: 2.46, 95 % CI: 0.70, 2.14), average heat index (β: 1.33, 95 % CI: 0.53, 2.14), and CBT exceeding 38.5 °C (β: 8.95, 95 % CI: 2.89, 15.02) were significantly associated with cross-shift increases in serum creatinine. Despite substantial PM₅ exposure, no significant association with creatinine changes was found. Heat strain and dehydration are significant contributors to kidney injury in agricultural workers, highlighting critical public health risks. These findings emphasize the urgent need for interventions to mitigate heat-related health hazards, including workplace protections, hydration strategies, and climate adaptation policies to safeguard vulnerable populations worldwide.