Project Profile: PREP

Protection Resilience Efficiency and Prevention for workers in industrial agriculture in a changing climate


Principal Investigators: Kristina Jakobsson, University of Gothenburg, Sweden
Partners: Ilana Weiss, La Isla Network, United States
Catharina Wesseling, Karolinska Institute, Sweden
Johanna Alkan Olsson, Lund University, Sweden
Christian Lindh, Lund University, Sweden
Vidhya Venugopal, Sri Ramachandra University, India
Heath Prince, The University of Texas at Austin, United States
Lucas Rebekah, The University of Birmingham, United Kingdom
Scott Montegna, LaIsla Network, United States
Sponsors: Forte, Sweden
UKRI, United Kingdom


Full Project Title: Protection Resilience Efficiency and Prevention for workers in industrial agriculture in a changing climate
Full Call Title: CEH2019


Project Objective: Chronic kidney disease of undetermined cause (CKDu), affects millions of workers in Latin America and Asia. Treatment is expensive, resulting in early death for those affected. Strenuous work in extreme heat without sufficient rest and hydration is considered a main driver. Industrial agriculture is the most affected, especially the sugarcane sector. Without prevention, this epidemic is likely to accelerate due to climate change. Increasing temperatures, coupled with decreasing precipitation in drier agricultural regions, is also causing pesticides and other toxins to concentrate at higher levels.

As a response to this heat stress related disease, we have collectively implemented the Adelante Initiative, a workplace intervention with focus on adequate water, and rest in shade together with improved ergonomics, designed to prevent CKDu among workers at a sugarcane mill in Nicaragua. Due to the high prevalence of CKDu among sugarcane workers, we are concentrating our efforts in this sector; from there we will adapt the program to other geographies and industries.

Our proposed project builds on current efforts and investigates the following: 1) the immediate and long-term impact the intervention has on workforce health (kidney health and heat related injuries) and productivity; 2) the economic and social impacts on those affected by the disease and whether our intervention aids in resilience, including mitigating migration pressures; 3) the economic burden on health systems treating CKDu; and 4) an analysis of public health policies to understand what policies, or absence of policy, have contributed to the disease while investigating what policies are required to effectively address it.

The knowledge gained will create the groundwork to expand to other sugarcane mills and eventually other industries at-risk for heat stress and CKDu. As climate change means more extreme temperatures in already impacted regions, and the likelihood that regions further north and south of the equator will also be impacted by CKDu, it is essential a model to protect worker health and productivity is developed.
Call Objective: To improve understanding of the pathways between climate, environment, and health to protect and promote human health and well-being in the face of climate challenges. Multilateral, inter- and transdisciplinary research projects will investigate where significant uncertainties exist that are barriers to action; address complex climate, ecosystem and health pathways to determine processes underlying causal links; and foster the use of scientific information and climate-related decision support tools to better inform planning and enhance resilience.


Regions: Asia, Europe, North America
Countries: India, Sweden, United Kingdom, United States of America (USA)


Duration: 37
Call Date: 14 March 2019
Project Award Date: 10 June 2020